Prevalence of Depressive Symptomatology in Medical Internship Students from a Private University in Puebla, Mexico

Abstract

Depression is considered one of the main mental health issues in medical students. Previous studies have shown that medical students have a higher prevalence of depressive symptomatology than the general population and that said prevalence is higher during the medical internship stage compared to the rest of the training. In Mexico there are few reports on the prevalence rates of depressive symptomatology in medical students, particularly, during the medical internship. This work is a Descriptive-observational cross-sectional study and determines the prevalence of depressive symptomatology in medical students from a private university in Puebla city in Mexico undergoing the medical internship. The Center for Epidemiologic Studies Depression Scale Revised (CESD-R) was used as the main research instrument and validates 20 items in Mexican population. An online version of the CESD-R and a demographic questionnaire that includes a question about thoughts quitting career and/or internship, was applied to 204 students who were doing their undergraduate medical internship in February 2019. The sample was constituted by 71 men and 133 women with a mean age of 23.26 ± 1.28 years. For the total sample, 61.27 % were in their first month and 38.73 % in their sixth month of their internship stage; 70.59 % were carrying out their internship in a public hospital and 29.41 % in a private hospital. The results showed that the prevalence of subthreshold depression symptoms (> 16 points of the CESD-R) in the sample was 52.45% of which, 20.58 % were categorized under clinically significant depressive symptomatology with probable major depressive episode (MDE) and 31.86%, in the category of probable sub-threshold depression. Taking as reference the depressive symptoms established for the MDE criteria by DSM-V and its association with each item of the CESD-R, it is noted a prevalence of suicidal ideation from the total sample of 6.86 %. The most frequent depressive symptoms were sleep disturbances (66.17 %), depressive mood (dysphoria, 44.6 %) and fatigue (37.25 %). The proportion of the depressive mood was significantly higher in women than in men, 55.63 % and 23.94 %, respectively, as well as the persistence of fatigue or loss of energy, present in 43.6% of women and 25.35% of men. Whereas the prevalence of the sleep disturbances was greater in men 78.87 % than in women 59.39 %. The association of depressive symptomatology has been analyzed with thoughts about quitting career or internship and it was observed that 32.4% had thoughts about quitting career and/or internship in the last two weeks during the time of performing the questionnaire. The comparative analysis with the presence of depressive symptoms revealed significant differences as to the proportion between groups. Such thoughts were present in 32 of the 42 students with clinically significant depressive symptomatology and 24 of the 65 students with probable episode of sub-threshold depression. Through the analysis of odds ratio (OR), it was determined that the students with depressive symptomatology have 9.55 times greater predisposition to manifest thoughts about quitting career and/or internship. The prevalence of depressive symptoms in students undergoing the year of medical internship analyzed in this study was high and was associated with the idea of leaving the career and/or medical internship. These results support the need for research and implementation of new strategies to detect, prevent and treat depressive disorders in the next generations of medical internship students in the country.