Stress, Anxiety, and Depression in the First-year Students of Medical Education: A Prospective Cohort Study from a Women's Medical College in South India.

Background and aims: Medical students around the world have been found to have high rates of depression and anxiety as compared to the general population. This study aimed to assess these in medical students immediately after they joined medical school and six months later. This study also aimed to assess if there was any association with stress, anxiety, and depression scores at six months follow-up with coping styles, self-esteem, personality, family functioning, and academic performance.

Methods and materials: We enrolled 154 first-year undergraduate medical students in this study with a baseline assessment including sociodemographic factors and Depression, Anxiety, Stress Scale 21 (DASS 21). They were followed up at six months with assessments of DASS 21, family functioning using the Family Adaptability, Partnership, Growth, Affection, and Resolve Scale (APGAR), coping styles using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale, personality factors using the Big Five Inventory (BFI-10) and self-esteem using Rosenberg Self-Esteem Inventory (RSES). Change in scores in DASS 21 was measured. The DASS 21 scores at six months were correlated with other scale scores using appropriate statistical tools. Logistic regression analysis was done to study the effect of different variables on the outcomes.

Results: Mean DASS scores at baseline fell within the normal range. There was a significant increase in mean DASS scores six months after joining. Despite this, only three students reported receiving treatment for mental health problems. DASS scores showed positive correlations with neuroticism and emotion-focused coping styles. About 36.6% of students reported failing in at least one subject. Academic performance did not show any association with levels of psychological distress.

Conclusion: Students showed a striking rise in psychological distress six months after joining medical school. This suggests that the medical school environment could play a role. To meet students' needs, a change in medical school culture and the provision of accessible and flexible mental health services are required.