Comparative characteristics of the level of depressive symptoms in medical students

Introduction

Depression is one of the most common and socially significant mental disorders, exerting a substantial impact on quality of life, functional activity, and overall public health [1]. The prevalence of depression among the adult population is estimated to reach 5%, with the disorder showing a tendency toward increased incidence, particularly among young adults.

Current approaches to the treatment of depression include pharmacotherapy and psychotherapeutic interventions, the efficacy of which has been confirmed by clinical studies [2]. In particular, the use of antidepressants such as selective serotonin reuptake inhibitors and tricyclic agents can achieve a clinical response in more than half of patients. However, therapy is often accompanied by several limitations, including side effects, a delayed onset of therapeutic effect, risk of relapse, and variability in individual response to treatment. An additional factor limiting the effectiveness of care remains the insufficient availability of psychotherapeutic support [3-5].

Despite the significant volume of accumulated scientific data, the problem of depression remains a subject of active research. Current literature is characterized by fragmentation and heterogeneity of results, which is related to the diversity of diagnostic criteria and assessment tools. The etiology of depression is multifactorial and results from the interaction of genetic, biological, psychological, and social factors [6]. Genetic predisposition increases the risk of developing the disorder, but stressful life events, chronic somatic diseases, neurodegenerative processes, social isolation, and lack of support also play significant roles. Current understanding of the pathophysiology of depression includes disturbances in neurotransmitter systems, including serotonergic, noradrenergic, and dopaminergic transmission, as well as changes in neuroplasticity, receptor regulation, and intracellular signaling pathways. Additional importance is attributed to the role of limbic brain structures, frontostriatal neural networks, and circadian rhythms [7].

In recent years, particular attention has been paid to studying depressive manifestations among medical students, as this population is characterized by academic workload, the intense pace of the educational process, and the need to adapt to a professional environment [8, 9]. Early diagnosis and timely prevention of depressive states in the student population are considered important directions for preserving mental health and building sustainable professional resources for future healthcare specialists [10].

In light of the above, studying the prevalence, structure, and severity of depressive symptoms among students of medical educational institutions represents a relevant scientific and practical task that is important for the development of preventive programs and the improvement of psychological support systems for students [11, 12, 13].

Objective

The objective of this study is to assess the prevalence and severity of depressive manifestations among students of the General Medicine faculty and students of the International Medical Institute, as well as to conduct a comparative analysis of depression levels and symptom structure in the study groups.

Materials and Methods

The study had a cross-sectional comparative design and was conducted among medical university students. The study included medical university students aged 18 to 25 years, studying at either the General Medicine faculty or the International Medical Institute. The total sample consisted of 110 individuals. The first group included 50 General Medicine students, and the second group included 60 students from the International Medical Institute. The study participants took part voluntarily, anonymously, and with informed consent. To assess the level of depressive manifestations, the Beck Depression Inventory (BDI) was used, which includes 21 items and allows assessment of the severity of depression from minimal to severe. The obtained scores were interpreted according to the conventional classification: minimal depression (0–4 points), mild (5–9 points), moderate (10–14 points), marked (15–19 points), and severe (20–27 points).

For the purpose of quantitative comparison, depression categories were converted into averaged numerical values. Statistical data processing was performed using descriptive statistics methods. Student's t-test was used to compare mean values between independent groups. 95% confidence intervals were calculated. Before applying parametric statistical analysis methods, the normality of the distribution of quantitative data was tested using the Shapiro–Wilk test. Due to the absence of statistically significant deviations from a normal distribution (p>0.05), Student's t-test was used to compare mean values between independent groups.

Additionally, an analysis of individual depressive symptoms was conducted, including sleep disturbances, fatigue, loss of interest, difficulty concentrating, changes in appetite, feelings of guilt, and psychomotor disturbances.

Results and Discussion

The obtained results indicate a high prevalence of depressive manifestations among medical university students, with no statistically significant differences between the study groups. In the group of General Medicine students (n=50), minimal manifestations of depressive symptoms (0–4 points on the BDI) were identified in 8% of respondents, mild (5–9 points) in 40%, moderate (10–14 points) in 24%, marked (15–19 points) in 12%, and severe (20–27 points) in 16%. Thus, minimal and mild forms of depressive manifestations predominated among the majority of students, while moderate and more severe symptoms were recorded in a portion of respondents, requiring increased attention from the perspective of prevention and psychohygiene. Among students of the International Medical Institute (n=60), a minimal level of depressive manifestations was noted in 15% of participants, mild in 40%, moderate in 23%, marked in 12%, and severe in 10% (Fig. 1). Overall, the distribution structure of depression levels in both groups was characterized by similar trends, with a predominance of mild and moderate forms.

Fig. 1. Comparison of depression levels

Comparative analysis showed that the differences between the groups were predominantly quantitative rather than qualitative. General Medicine students showed a slightly higher proportion of individuals with marked forms of depressive manifestations, while minimal manifestations were more frequently recorded among International Medical Institute students. At the same time, the prevalence of mild and moderate forms was almost identical in both groups. The mean depression score on the BDI among General Medicine students was 11.2±4.5 points, and among International Medical Institute students, 10.4±4.5 points. The difference between mean values was small, amounting to 0.8 points. Statistical analysis using Student's t-test for independent samples revealed that the differences between groups did not reach the level of statistical significance (t=0.96; p >0.05). This indicates comparable levels of depressive manifestations in students of both educational programs. Confidence interval analysis also confirmed the proximity of the values: the mean value for General Medicine students ranged from 9.9 to 12.5 points, and for International Medical Institute students from 9.3 to 11.5 points, which corresponds predominantly to mild and moderate manifestations of depressive symptoms.

Analysis of symptom structure revealed that the most common manifestations in both groups were fatigue, sleep disturbances, reduced concentration, and decreased interest in daily activities. These symptoms reflect features of adaptation to high academic workload and an intensive educational process. At the same time, General Medicine students slightly more frequently reported changes in appetite, difficulty concentrating, and psychomotor features, which may be related to the specifics of the academic schedule and greater involvement in clinical training. However, the overall symptom structure remained similar in both groups, without pronounced qualitative differences.

The results demonstrate that depressive manifestations in the majority of medical students fall within the minimal-to-mild range, indicating the preservation of overall functional and adaptive capacity in learners. At the same time, the identification of moderate and severe symptoms in a subset of students underscores the importance of early prevention and systematic monitoring of psycho-emotional state during professional training.

The similarity of indicators between groups points to the influence of common factors characteristic of medical education, such as high academic workload, the intensity of theoretical and practical training, and the need to master large volumes of information within limited timeframes. These features require significant adaptive resources from students, which may affect their emotional state.

Overall, the data obtained confirm the feasibility of developing a psychological support system for students, aimed not only at correcting severe conditions but also at preventing emotional overstrain, improving quality of life, and supporting the professional development of future medical professionals.

Conclusion

This study showed that depressive manifestations of varying severity are detected in a significant proportion of students in medical educational programs. Moderate and more severe forms of depression were recorded in 52% of General Medicine students and in 45% of International Medical Institute students, confirming the relevance of monitoring the psycho-emotional state of learners in the context of an intensive educational process.

Mean depression scores on the Beck Depression Inventory were 11.2±4.5 points and 10.4±4.5 points, respectively, with no statistically significant differences between the groups (p >0.05). These data indicate comparable levels of emotional distress among students from different educational tracks.

Analysis of symptom structure identified the most characteristic manifestations in the student environment, including fatigue, sleep disturbances, and reduced concentration, reflecting features of adaptation to a high academic workload. The noted differences in the severity of individual symptoms represent trends and are not accompanied by fundamental differences in the overall structure of depressive states.