Prevalence and Factors Associated with Depression among Postgraduate Students in Dar- es-Salaam, Tanzania: A Case Study of Muhimbili University of Health and Allied Sciences

Prevalence and Factors Associated with Depression among Postgraduate Students in Dar- es-Salaam, Tanzania: A Case Study of Muhimbili University of Health and Allied Sciences | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Factors Associated with Depression among Postgraduate Students in Dar- es-Salaam, Tanzania: A Case Study of Muhimbili University of Health and Allied Sciences Salma Karim Mohamed, Elias Bukundi, Elihuruma Eliufoo Stephano, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6578166/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Depression is a growing global health concern characterized by hopelessness, disinterest in previously enjoyable activities, and potentially suicidal thoughts. Postgraduate university students face a particularly high risk due to the challenges of balancing academics, family responsibilities, and financial pressures. This study investigated depression factors among postgraduate students at Muhimbili University of Health and Allied Sciences, addressing a critical need given this population's unique stressors. Methods This cross-sectional study included 377 participants selected through stratified random sampling. Data collection utilized a self-administered questionnaire featuring the Patient Health Questionnaire (PHQ-9) depression scale and the Multidimensional Scale of Perceived Social Support. Analysis was performed using Stata 18, with descriptive statistics and logistic regression employed to identify depression-related factors. Results Among the respondents, 90 (23.9%) had probable depression, and multivariable logistic regression revealed several factors that independently had an association with depression. Those who consumed alcohol were twice as likely to experience depression compared to non-drinkers [Adjusted odds ratio (aOR) = 2.13, 95%CI (0.91–3.46)], while students who never engaged in physical exercise faced three times higher risk than those exercising regularly [aOR = 3.09, 95%CI (1.48–6.49)]. Financial challenges nearly tripled depression likelihood [aOR = 2.86, 95%CI (1.57–5.22)], and notably, students with low social support were seven times more likely to be depressed than those with high support [aOR = 7.55, 95%CI (3.64–15.69)]. Conclusion Nearly one in four postgraduate students exhibited probable depression. Physical inactivity, alcohol consumption, and financial difficulties significantly increased depression risk, while strong social support served as protection. This study recommends promoting regular physical activity, limiting alcohol use among postgraduate students in Tanzania and other similar contexts. Clinical trial number: Not applicable Depression Postgraduate students Mental health Tanzania Introduction Mental health is projected to become one of the greatest global disease burdens by 2030, increasing suffering, morbidity, and premature mortality worldwide [ 1 , 2 ]. Currently, over 1 billion people experience mental health problems, with the majority residing in low- and middle-income countries (LMICs) [ 1 ]. Depression stands out as a particularly severe public health challenge, affecting 5% of adults within this population [ 2 ]. This prevalence has established depression as a major contributor to the global disease burden and the leading cause of disability worldwide [ 3 ]. This disorder manifests through feelings of despair, suicidal ideation, sleep disturbances, concentration difficulties, low self-esteem, appetite changes, and fatigue, which potentially lead to suicide in severe cases [ 4 ] and affect the individual’s daily functions [ 4 , 5 ]. Depression prevalence has increased significantly, affecting 29.9 million people across Africa, with Tanzania reporting a 4.1% rate [ 5 ]. University students face a particularly high risk, showing a 24.4% prevalence compared to the general population [ 6 ]. The impacts are substantial, with depression ranking as a primary contributor to disability, causing an average loss of 7.5 years of healthy life [ 5 ]. Beyond mental health consequences, depression elevates risks for suicide, diabetes, cardiovascular disease, and cancer. It also severely impacts academic performance and social relationships through withdrawal behaviors, creating widespread repercussions in multiple life domains [ 4 ]. Postgraduate students represent a unique demographic facing distinctive academic and life stressors that significantly increase depression risk [ 7 ]. This heightened vulnerability negatively impacts their academic performance and overall well-being [ 8 ]. The rising prevalence of depression among postgraduate students has become an urgent concern requiring immediate attention from educational institutions and health authorities [ 9 ]. A systematic review of studies from American and Asian countries found that the prevalence of depression among postgraduate students ranges widely from 6.2–84.7%, with a pooled average prevalence of approximately 34% [ 10 ]. Notably, LMICs tend to exhibit even higher rates of depression among this population [ 11 ]. Similarly, research conducted in Europe and Saudi Arabia has reported that depression affects between 39.6% and 49.6% of postgraduate students. Furthermore, these studies highlight that depression in postgraduate students is frequently underestimated, often goes unrecognized, and is inadequately addressed in these regions [ 12 – 14 ]. Moreover, studies that were conducted in African countries, Kenya and Nigeria, reported the prevalence of depression among postgraduate students ranging between 17.3–29% [ 15 , 16 ]. Several studies have reported depression as a significant global mental health concern that disproportionately affects university students, with postgraduate students experiencing particularly high rates due to unique academic and social stressors [ 17 , 18 ]. Studies indicate that the prevalence of depressive symptoms among postgraduate students ranges widely [ 12 , 18 ]. Despite this, depression among this demographic remains frequently underestimated, unrecognized, and inadequately addressed, especially in LMIC settings such as Tanzania, where mental health resources are limited and access to care is often constrained [ 18 ]. Postgraduate students face intense academic pressures, social isolation, and socioeconomic challenges that may exacerbate mental health problems. Yet, research is scarce on the prevalence and determinants of depression within this group in Tanzania [ 19 ]. Given that untreated depression can impair academic performance, reduce quality of life, and result in severe consequences such as suicidality, addressing this gap is urgent and requires frequent exploration to inform available interventions. There is a critical need for context-specific data to inform effective mental health interventions and policy decisions, which can be applied in other similar contexts. Therefore, this research aims to fill this knowledge gap by examining the prevalence and factors associated with depression among postgraduate students using the Muhimbili University of Health and Allied Sciences (MUHAS) case study. This study will provide evidence essential for developing targeted prevention and support strategies to improve student well-being and academic outcomes in this studied population. Materials and Methods Study design and area This study was a cross-sectional study that started from April to June 2024. This study was conducted in MUHAS, a public university in Tanzania. MUHAS is located in West Panga, established in 1963 and initially opened as Dar es Salaam Medical School. MUHAS is dedicated to health science education, research, and service. MUHAS provides undergraduate and postgraduate programs in Medicine, Ophthalmology, Dentistry, Pharmacy, Nursing, Public Health, and Traditional Medicine [ 20 ]. Sampling technique A stratified sampling procedure was used to divide the study participants according to the schools available at MUHAS. There were six schools: medicine, nursing, dentistry, pharmacy, public health and social science, and the Institute of Traditional Medicine. Then, a proportionate-to-size method was used to obtain the number of participants from each school according to the overall count or number of students. Finally, within the stratum, the participants were selected randomly. Sample Size The study sample size was determined using the formula for cross-sectional study designs [ 21 ]. Based on a 95% confidence interval, 5% margin of error, and a prevalence of 29.6% from a similar study conducted in Kenya [ 15 ], the calculated minimum sample size was 320 participants. An additional 10% was added to this figure to account for potential non-response, bringing the final minimum sample size to 352 participants for this study. This study successfully recruited 377 participants, more than 100% respondent rate. Data collection process Data were collected over twelve weeks using a self-administered questionnaire, which assessed depression symptoms through the PHQ-9 score and gathered information on individual, postgraduate training-related, and socioeconomic factors. The participants were located in classes and clinical areas where they were given all the information about the research study. Those who consented were given the questionnaires to fill in. Study variables and measurements In this study, depression served as the dependent variable. It was assessed using the PHQ-9 score, a tool developed in 1999 by Dr. Robert Kroenke for screening, diagnosing, and measuring the severity of depression [ 22 ]. The PHQ-9 consists of nine questions reflecting depressive symptoms, each offering four response options scored from 0 to 3. These options indicate the frequency of symptoms experienced: 0 for “not at all,” 1 for “several days,” 2 for “more than half the days,” and 3 for “nearly every day”. A score of 10 and above was regarded as probable depression, as it has been documented to have 88% sensitivity and 88% specificity for depressive disorder [ 22 ]. This score range was adopted in this study to help categorize participants into probable depression and no depression. The social support was assessed using the 12-item Multidimensional Scale of Perceived Social Support. This scale evaluates an individual's perception of social support, with scores expressed as mean values categorized into three levels: a mean score between 1 and 2.9 indicates low support, scores from 3 to 5 represent moderate support, and scores ranging from 5.1 to 7 signify high support [ 23 ]. Data Analysis Data cleaning, coding, and all statistical analyses were performed using STATA version 18.5 (STATA Corp, College Station, TX) [ 24 ]. Descriptive statistics were used to summarize the data, including means and standard deviations (SD) for continuous variables and frequencies and proportions for categorical variables. The prevalence of depression was determined by calculating the proportion of postgraduate students with a PHQ-9 score of 10 or above, the categories used in a previous study [ 25 ]. To explore the association between depression and various factors, logistic regression was employed. Bivariate logistic regression was used to estimate the crude odds ratios (cOR), and variables with a p-value below 0.2 were included in a multivariable logistic regression to identify independent associations to estimate adjusted odds ratios (aOR). Odds ratios and 95% confidence intervals (CIs) were reported, with statistical significance at p < 0.05. Results Social Demographic Characteristics of the study participants This study included 377 postgraduate students, and their median age was 32 years, ranging from 25 to 55 years. Slightly over half of the students were male (n = 210; 55.7%), and about half (n = 193; 51.2%) were in their first year of study. The largest proportion of the respondents (n = 220; 58.4%) reported being married, while nearly half of the students stated they had more than one child (n = 163; 43.2%). Regarding substance use, more than one-third of them reported using alcohol (n = 145; 38.5%). (Table 1 ). Table 1 Social Demographic Characteristics of Participants Variable Frequency (n) Percentage (%) Age ≥ 30 years 309 82 < 30 years 68 18 Sex Female 167 44.3 Male 210 55.7 Marital Status Single 133 35.3 Married/ Cohabiting 236 62.6 Divorced/Widowed 8 2.1 Number of children None 134 35.5 One child 80 21.2 More than one 163 43.2 Year of Study First 193 51.2 Second 137 36.3 Third 47 12.5 Schools Public Health 103 27.3 *Medicine 205 54.4 Pharmacy 11 2.9 Nursing 47 12.5 Dentist 9 2.4 **Traditional Med 2 0.53 Employment Status Employed 299 79.3 Not employed 78 20.7 Physical Activity Never 80 21.2 Rarely 176 46.7 Regular 121 32.1 Social Support Low 57 15.1 Medium 109 28.9 High 211 56.0 Key: *college, **institution Prevalence of depression among postgraduate students Overall, 90 (23.9%) of the 377 postgraduate students who participated in this study were depressed during the survey. Factors associated with depression among postgraduate students The bivariate logistic regression analysis identified associations between depression and several factors, including sex, alcohol, tobacco use, physical exercise, history of mental illness, and chronic diseases. However, the multivariable analysis revealed several significant factors associated with depression among postgraduate students. Those who consumed alcohol were twice as likely to experience depression compared to non-drinkers [aOR = 2.13, 95%CI (0.91–3.46)], while students who never engaged in physical exercise faced three times higher risk than those exercising regularly [aOR = 3.09, 95%CI (1.48–6.49)]. Financial challenges nearly tripled depression likelihood [aOR = 2.86, 95%CI (1.57–5.22)], and notably, students with low social support were seven times more likely to be depressed than those with high support [aOR = 7.55, 95%CI (3.64–15.69)]. All results are presented in Table 2 . Table 2 Bivariate and multivariable analysis of individual factors associated with depression Variables Crude Adjusted N cOR (95% CI) p-value aOR (95% CI) p-value Individual factors Age ≥ 30years 309 Reference <30 years 68 1.42(0.79–2.56) 0.238 Sex Female 167 1.43 (0.89–2.31) 0.137 1.27(0.74–2.18) 0.394 Male 210 Reference Reference Marital status Single 133 2.31 (0.69–1.88) 0.284 Married/Cohabiting 236 Reference Divorced/ Widowed 8 3.45(0.84–14.27) 0.087 No of children More than one 163 1.32 (0 .77–2.25) 0.304 One child 80 0 .8 (0.40–1.59) 0.528 None 134 Reference Alcohol consumption Yes 145 2.11 (1.30–3.41) 0.002 2.13 (0.91–3.46) 0.007* No 232 Reference Reference Tobacco use Yes 30 3.12 (1.46–6.68) 0.003 2.13 (0.91–4.97) 0.081 No 247 Reference Reference Physical activity Never 80 4.29 (2.18–8.47) < 0.001 3.09 (1.48–6.49) 0.003* Rarely 176 1.79 (0.97–3.35) 0.06 1.48 (0.77–2.85) 0.234 Regular 126 Reference Reference History of mental illness Yes 20 4.3 (1.72–10.75) 0.002 2.28 (0.85–6.22) 0.103 No 357 Reference Reference Presence chronic illness Yes 31 3.39 (1.60–7.17) 0.001 2.17 (0.95–4.95) 0.060 No 146 Reference Reference Socioeconomic factors Financial challenge Yes 197 4.77 (2.73–8.34) < 0.001 2.86 (1.57–5.22) 0.001 No 180 Reference Reference Employment status Employed 299 Reference Not employed 78 0.95(0.53–1.71) 0.850 Social support Low 57 10.61 (5.29–21.25) < 0.001 7.55 (3.64–15.69) < 0.001 Medium 109 5.54 (3.03–10.12) < 0.001 4.35 (2.32–8.15) < 0.001 High 211 Reference Reference Postgraduate training- related factors associated with depression The postgraduate training-related factors did not have any statistic significant association with depression. However, students in the school of nursing had twice the likelihood of developing depression, but it was not statistically significant. Discussion This study aimed to assess the prevalence and factors associated with depression among postgraduate students in Dar es Salaam, Tanzania, using a case study of MUHAS. The study found that nearly one in four postgraduate students had probable depression, which aligns with global findings. Still, in contrast, related studies conducted in countries like Nigeria, China, and the USA showed a lower prevalence than this current study [ 9 , 16 , 26 ]. Nevertheless, studies conducted in Kenya, South Africa, and Saudi Arabia showed a higher prevalence than the current study [ 12 , 15 , 27 ]. The difference in depression prevalence could potentially be due to differences in methodology, study setting, and tools used to measure the outcome, which is depression [ 12 , 15 ]. Moreover, the variation in depression prevalence observed in this study may stem from using the PHQ-9 scale, a self-reporting instrument. As a result, participants might have underreported or overreported their depressive symptoms, which could cause the prevalence to appear either higher or lower. Regarding the factors associated with depression, this study found that physically inactive postgraduate students are more likely to experience depression, which is consistent with studies from the USA and Kenya, which suggest that regular physical activity is a protective factor against depression [ 15 , 28 ]. Furthermore, physical activity programs are among the preventive programs encouraged in depression prevention as they reduce depression risk by enhancing mood, reducing anxiety, and improving sleep quality [ 4 ]. The findings in this study also showed that there is a significant association between alcohol use and depression, whereby students who use alcohol had an increased risk of depression in comparison to non-users. These findings align with previous studies, which also suggested an increase in the likelihood of depression among alcohol users [ 15 , 29 ]. Additionally, the World Health Organization (WHO) indicated that there is a causal relationship between alcohol use and mental health disorders, including depression [ 30 ]. This study found that low and medium social support significantly increased the likelihood of depression, with high social support acting as a protective factor, a pattern also observed in research from various countries like Kenya and South Africa [ 15 , 27 ], as did studies conducted in the USA [ 9 , 31 ], the UK [ 14 ]. Among others, WHO also indicated that having social support, including friends and family with whom you can interact with including sharing personal feelings and solving problems, can help to reduce the risk of developing depression or even help in the treatment of those who are already depressed [ 4 ]. Furthermore, the study found a significant link between financial problems and depression, with students facing economic challenges being more likely to develop depression. This finding aligns with the previous research, which also showed increased odds of depression among students with financial problems [ 31 ]. Studies in Australia and Kenya further supported this, attributing the link to the high cost of living, student loans, and limited funding for postgraduate students [ 15 , 32 ]. Regarding postgraduate training-related factors, this study found no significant association between the year of study or the specific school attended and depression, with students across all years and schools at similar risk. This aligns with findings from Saudi Arabia and the UK, suggesting that academic challenges are uniformly experienced regardless of year or department [ 14 , 33 ]. In contrast, a study from Serbia found higher depression rates in second-year students, and a Kenyan study indicated varying depression risks among different courses [ 15 , 34 ]. The current study’s results may be due to the shared academic challenges faced by students across different years and schools. Strengths and Limitations Its focus on a specific and vulnerable population within a Tanzanian setting is a key strength. It addresses a critical gap in mental health research by providing context-specific data on postgraduate students who are future health professionals. Moreover, using a validated screening instrument such as the PHQ-9 enhances the reliability of the depression assessment, while incorporating a range of socioeconomic and demographic variables allows for a comprehensive analysis of associated factors. However, the study is limited by the reliance on the PHQ-9 as a self-report tool, which may lead to underreporting or overreporting of depressive symptoms, potentially affecting prevalence estimates. Additionally, the cross-sectional design restricts causal inference between the associated factors and depression, and potential selection bias could influence the sample's representativeness. Lastly, the absence of clinical diagnostic confirmation and limited detail on the mental health service context may constrain the applicability of findings for intervention planning. Conclusion This study revealed that nearly one in four of the postgraduate students had probable depression, underscoring a significant mental health concern. Physical activity and the use of alcohol were identified as individual factors that have a significant association with depression. Likewise, having financial challenges appeared to have a substantial link with having depression. Additionally, social support emerged as a protective factor, whereby having a high level of social support correlated with a lower depression rate. Therefore, the recommendations include encouraging postgraduate students to engage in regular physical activities and limit alcohol consumption, implementing mental health policies targeting academic institutions, and introducing comprehensive mental health programs at MUHAS. We recommend conducting a qualitative study to explore factors linked to depression among postgraduate students. Abbreviations aOR Adjusted odds ratio cOR Crude odds ratio CI Confidence interval LMIC Low- and middle-income countries PHQ Patient Health Questionnaire MUHAS Muhimbili University of Health and Allied Sciences SD Standard deviation SSA Sub-Saharan Africa WHO World Health Organization Declarations Acknowledgement We want to express our heartfelt gratitude to everyone who contributed to this research's success. We are also thankful to my research participants for their time, cooperation, and willingness to share their experiences; this study would not have been possible without them. Authors’ Contribution SKM and ATK conceptualised the study, collected data, and performed the analysis. SKM, EB, EES, MJM, AAN, IHM, and ATK interpreted the results, drafted the manuscript, and reviewed all versions. All authors read and approved the final manuscript. Funding No funding Availability of data and materials Data and materials are available to the corresponding author upon reasonable request. Ethics approval and consent to participate Ethical approval for the study was obtained from the Institutional Review Board (IRB) of MUHAS (Ref. No. DA.282/298/01.C/2232), and the relevant authority granted permission to continue with the study within the university. This study was conducted in accordance with the principles of the Declaration of Helsinki. Participants were fully informed about the study's objectives, procedures, risks, and benefits, ensuring informed consent. Participation was voluntary, with the option to withdraw at any time without penalty. To protect confidentiality, numerical codes were used instead of names for all data collection and analysis procedures, and no personally identifiable information was retained in the study records. Consent for publication Not applicable. Conflict of interest We declare that there is no conflict of interest in this study. References Lancet T. Ensuring care for people with depression. The Lancet. 2022;399:885. Limenih G, MacDougall A, Wedlake M, Nouvet E. Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse. Int J Soc Determinants Health Health Serv. 2024;54:95–107. Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3:415–24. WHO. Depressive Disorder (Depression). Int. Immunopharmacol. 2019. WHO. Depression and Other Common Mental Disorders Global Health Estimates. 2017. Akhtar P, Ma L, Waqas A, Naveed S, Li Y, Rahman A, et al. Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis. J. Affect. Disord. Elsevier B.V.; 2020. p. 911–9. Malebari AM, Alamoudi SO, AL-Alawi TI, Alkhateeb AA, Albuqayli AS, Alothmany HN. Prevalence of depression and anxiety among university students in Jeddah, Saudi Arabia: exploring sociodemographic and associated factors. Front Public Health. 2024;12:1441695. Sanga SS, Tarimo EAM, Ambikile JS. Factors influencing career preference in mental health among nursing students and intern nurses in Dar es Salaam, Tanzania. PLOS Glob Public Health. 2023;3:e0002108. Barton BA, Bulmer SM. Correlates and Predictors of Depression and Anxiety Disorders in Graduate Students. Health Educ. 2017;49, 2. Satinsky EN, Kimura T, Kiang MV, Abebe R, Cunningham S, Lee H, et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci Rep. 2021;11:14370. Guo L, Fan H, Xu Z, Li J, Chen T, Zhang Z, et al. Prevalence and changes in depressive symptoms among postgraduate students: A systematic review and meta-analysis from 1980 to 2020. Stress Health. 2021;37:835–47. Alrasheedi J, Rabbani U. Prevalence of Anxiety and Depression among postgraduate trainees in Qassim, Saudi Arabia. World Fam Med J Middle East J Fam Med. 2022;20. Zaman S, Rahim M, Khan A, Habib S, Rahman M, Ahsan M, et al. Prevalence of Depression Among Post-Graduate Medical Trainees: A Multi-Centre Survey. BIRDEM Med J. 2014;4:18–21. Milicev J, McCann M, Simpson SA, Biello SM, Gardani M. Evaluating Mental Health and Wellbeing of Postgraduate Researchers: Prevalence and Contributing Factors. Curr Psychol. 2023;42:12267–80. Shah S, Hussein N, Laving A, Okech-helu VC, Kumar M. Depression and its associated factors : perceived stress , social support , substance use and related sociodemographic risk factors in medical school residents in Nairobi , Kenya. 2021;1–15. Gu A, Gm O, Mo B, Mn I. Prevalence of Depression among Resident Doctors in a. 2015;3:1–5. Mboya IB, John B, Kibopile ES, Mhando L, George J, Ngocho JS. Factors associated with mental distress among undergraduate students in northern Tanzania. 2020;1–7. Lugata S, Elinisa M, Doshi B, Kashuta RA, Mallosa WJ, Kelly C, et al. Symptoms and predictors of depression among university students in the Kilimanjaro region of Tanzania : a cross-sectional study. J Ment Health. 2020;0:1–8. Nkenguye W. Addressing the silent struggle: adolescent depression in Tanzania. IJS Glob Health. 2024;7:e0425. Muhimbili University. Background History. 2015. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35:121–6. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55:610–7. Stata. Statistical software for data science [Internet]. [cited 2025 Apr 4]. Available from: https://www.stata.com/ Shin C, Kim Y, Park S, Yoon S, Ko Y-H, Kim Y-K, et al. Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014. J Korean Med Sci. 2017;32:1861–9. Fang J, Wang TAO, Member S, Li C. Depression Prevalence in Postgraduate Students and Its Association With Gait Abnormality. IEEE Access. 2019;7:174425–37. Janse van Vuuren C, Bodenstein K, Oberholzer M. Exploring the psychological well-being of postgraduate accounting students at a South African university. South Afr J Account Res. 2021;35:219–38. Hoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49–59. Garcia-Williams AG, Moffitt L, Kaslow NJ. Mental health and suicidal behavior among graduate students. Acad Psychiatry. 2014;38:554–60. WHO. Alcohol: Fact Sheet 2015. 2015. Charles ST, Karnaze MM, Leslie FM. Positive factors related to graduate student mental health. J Am Coll Health. 2022;70:1858–66. Farrer LM, Gulliver A, Bennett K, Fassnacht DB, Griffiths KM. Demographic and psychosocial predictors of major depression and generalised anxiety disorder in Australian university students. BMC Psychiatry. 2016;16. Dabbagh R, Alwatban L, Alrubaiaan M, Alharbi S, Aldahkil S, AlMuteb M, et al. Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review. Med Teach. 2023;45:499–509. Simić-Vukomanović I, Mihajlović G, Kocić S, Djonović N, Banković D, Vukomanović V, et al. Prevalencija i uticaj socioekonomskih faktora na nastanak depresivnosti i anksioznosti na uzorku od 1 940 studenata u Srbiji. Vojnosanit Pregl. 2016;73:169–77. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6578166","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":496102103,"identity":"5a326e64-e8db-4291-be1d-e76f2f55520d","order_by":0,"name":"Salma Karim Mohamed","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYFAC5gYgkQCkGRgfAFk8fIS1MMK1MBuAtLARr4WBgU0CTBLSIN9+sO3Bjz9p8ubt3GmVX3PsZNgYmB8+uoFHi8GZxHbD3rYcwzmHebfdlt2WDHQYm7FxDj4tDIltErwNFYwzmIFaJLcxA7XwsEnj0yLf/7BN8s+fCnuQlmLJbfWEtTDcSGyT5mHLSQRpYfy47TBhLQY3HrZJy7alJQO1bJZm3Hach42ZgF/k+5OPSb75k2w7g//sxo8/t1Xb87M3P3yM12HIgJkHTBKrHAQYf5CiehSMglEwCkYMAAABVEOgIFHo+AAAAABJRU5ErkJggg==","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":true,"prefix":"","firstName":"Salma","middleName":"Karim","lastName":"Mohamed","suffix":""},{"id":496102104,"identity":"34f55d99-5ff0-444d-9cf8-b2305b1032d8","order_by":1,"name":"Elias Bukundi","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Elias","middleName":"","lastName":"Bukundi","suffix":""},{"id":496102105,"identity":"9b335148-4dba-457b-8cc3-ad6dd56331bc","order_by":2,"name":"Elihuruma Eliufoo Stephano","email":"","orcid":"","institution":"The University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Elihuruma","middleName":"Eliufoo","lastName":"Stephano","suffix":""},{"id":496102106,"identity":"ed0ee385-52a3-4f43-b700-40cb586dcb6b","order_by":3,"name":"Mtoro J Mtoro","email":"","orcid":"","institution":"TILAM International","correspondingAuthor":false,"prefix":"","firstName":"Mtoro","middleName":"J","lastName":"Mtoro","suffix":""},{"id":496102107,"identity":"f500b42e-fcde-4ce4-a227-315a4181231e","order_by":4,"name":"Azan Abubakar Nyundo","email":"","orcid":"","institution":"The University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Azan","middleName":"Abubakar","lastName":"Nyundo","suffix":""},{"id":496102108,"identity":"2d2574f2-8609-4dd7-b91f-135ec5fd0564","order_by":5,"name":"Idda Hubert Mosha","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Idda","middleName":"Hubert","lastName":"Mosha","suffix":""},{"id":496102109,"identity":"d30dbe82-a584-41d5-9f69-fbf3c8b62711","order_by":6,"name":"Anna Tengia-Kessy","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Anna","middleName":"","lastName":"Tengia-Kessy","suffix":""}],"badges":[],"createdAt":"2025-05-02 11:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6578166/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6578166/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90933281,"identity":"df49237b-7373-40c1-b763-7113869d02fe","added_by":"auto","created_at":"2025-09-09 16:38:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1149466,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6578166/v1/98255ee3-096f-4de6-ae2b-2b1cb7c90f8c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Factors Associated with Depression among Postgraduate Students in Dar- es-Salaam, Tanzania: A Case Study of Muhimbili University of Health and Allied Sciences","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMental health is projected to become one of the greatest global disease burdens by 2030, increasing suffering, morbidity, and premature mortality worldwide [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Currently, over 1\u0026nbsp;billion people experience mental health problems, with the majority residing in low- and middle-income countries (LMICs) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Depression stands out as a particularly severe public health challenge, affecting 5% of adults within this population [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This prevalence has established depression as a major contributor to the global disease burden and the leading cause of disability worldwide [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This disorder manifests through feelings of despair, suicidal ideation, sleep disturbances, concentration difficulties, low self-esteem, appetite changes, and fatigue, which potentially lead to suicide in severe cases [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] and affect the individual\u0026rsquo;s daily functions [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDepression prevalence has increased significantly, affecting 29.9\u0026nbsp;million people across Africa, with Tanzania reporting a 4.1% rate [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. University students face a particularly high risk, showing a 24.4% prevalence compared to the general population [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The impacts are substantial, with depression ranking as a primary contributor to disability, causing an average loss of 7.5 years of healthy life [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Beyond mental health consequences, depression elevates risks for suicide, diabetes, cardiovascular disease, and cancer. It also severely impacts academic performance and social relationships through withdrawal behaviors, creating widespread repercussions in multiple life domains [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePostgraduate students represent a unique demographic facing distinctive academic and life stressors that significantly increase depression risk [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. This heightened vulnerability negatively impacts their academic performance and overall well-being [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The rising prevalence of depression among postgraduate students has become an urgent concern requiring immediate attention from educational institutions and health authorities [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA systematic review of studies from American and Asian countries found that the prevalence of depression among postgraduate students ranges widely from 6.2\u0026ndash;84.7%, with a pooled average prevalence of approximately 34% [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Notably, LMICs tend to exhibit even higher rates of depression among this population [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Similarly, research conducted in Europe and Saudi Arabia has reported that depression affects between 39.6% and 49.6% of postgraduate students. Furthermore, these studies highlight that depression in postgraduate students is frequently underestimated, often goes unrecognized, and is inadequately addressed in these regions [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Moreover, studies that were conducted in African countries, Kenya and Nigeria, reported the prevalence of depression among postgraduate students ranging between 17.3\u0026ndash;29% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSeveral studies have reported depression as a significant global mental health concern that disproportionately affects university students, with postgraduate students experiencing particularly high rates due to unique academic and social stressors [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Studies indicate that the prevalence of depressive symptoms among postgraduate students ranges widely [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Despite this, depression among this demographic remains frequently underestimated, unrecognized, and inadequately addressed, especially in LMIC settings such as Tanzania, where mental health resources are limited and access to care is often constrained [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Postgraduate students face intense academic pressures, social isolation, and socioeconomic challenges that may exacerbate mental health problems. Yet, research is scarce on the prevalence and determinants of depression within this group in Tanzania [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Given that untreated depression can impair academic performance, reduce quality of life, and result in severe consequences such as suicidality, addressing this gap is urgent and requires frequent exploration to inform available interventions. There is a critical need for context-specific data to inform effective mental health interventions and policy decisions, which can be applied in other similar contexts. Therefore, this research aims to fill this knowledge gap by examining the prevalence and factors associated with depression among postgraduate students using the Muhimbili University of Health and Allied Sciences (MUHAS) case study. This study will provide evidence essential for developing targeted prevention and support strategies to improve student well-being and academic outcomes in this studied population.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy design and area\u003c/h2\u003e\u003cp\u003eThis study was a cross-sectional study that started from April to June 2024. This study was conducted in MUHAS, a public university in Tanzania. MUHAS is located in West Panga, established in 1963 and initially opened as Dar es Salaam Medical School. MUHAS is dedicated to health science education, research, and service. MUHAS provides undergraduate and postgraduate programs in Medicine, Ophthalmology, Dentistry, Pharmacy, Nursing, Public Health, and Traditional Medicine [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSampling technique\u003c/h3\u003e\n\u003cp\u003e A stratified sampling procedure was used to divide the study participants according to the schools available at MUHAS. There were six schools: medicine, nursing, dentistry, pharmacy, public health and social science, and the Institute of Traditional Medicine. Then, a proportionate-to-size method was used to obtain the number of participants from each school according to the overall count or number of students. Finally, within the stratum, the participants were selected randomly.\u003c/p\u003e\n\u003ch3\u003eSample Size\u003c/h3\u003e\n\u003cp\u003eThe study sample size was determined using the formula for cross-sectional study designs [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Based on a 95% confidence interval, 5% margin of error, and a prevalence of 29.6% from a similar study conducted in Kenya [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], the calculated minimum sample size was 320 participants. An additional 10% was added to this figure to account for potential non-response, bringing the final minimum sample size to 352 participants for this study. This study successfully recruited 377 participants, more than 100% respondent rate.\u003c/p\u003e\n\u003ch3\u003eData collection process\u003c/h3\u003e\n\u003cp\u003eData were collected over twelve weeks using a self-administered questionnaire, which assessed depression symptoms through the PHQ-9 score and gathered information on individual, postgraduate training-related, and socioeconomic factors. The participants were located in classes and clinical areas where they were given all the information about the research study. Those who consented were given the questionnaires to fill in.\u003c/p\u003e\n\u003ch3\u003eStudy variables and measurements\u003c/h3\u003e\n\u003cp\u003eIn this study, depression served as the dependent variable. It was assessed using the PHQ-9 score, a tool developed in 1999 by Dr. Robert Kroenke for screening, diagnosing, and measuring the severity of depression [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The PHQ-9 consists of nine questions reflecting depressive symptoms, each offering four response options scored from 0 to 3. These options indicate the frequency of symptoms experienced: 0 for \u0026ldquo;not at all,\u0026rdquo; 1 for \u0026ldquo;several days,\u0026rdquo; 2 for \u0026ldquo;more than half the days,\u0026rdquo; and 3 for \u0026ldquo;nearly every day\u0026rdquo;. A score of 10 and above was regarded as probable depression, as it has been documented to have 88% sensitivity and 88% specificity for depressive disorder [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This score range was adopted in this study to help categorize participants into probable depression and no depression.\u003c/p\u003e\u003cp\u003eThe social support was assessed using the 12-item Multidimensional Scale of Perceived Social Support. This scale evaluates an individual's perception of social support, with scores expressed as mean values categorized into three levels: a mean score between 1 and 2.9 indicates low support, scores from 3 to 5 represent moderate support, and scores ranging from 5.1 to 7 signify high support [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eData cleaning, coding, and all statistical analyses were performed using STATA version 18.5 (STATA Corp, College Station, TX) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Descriptive statistics were used to summarize the data, including means and standard deviations (SD) for continuous variables and frequencies and proportions for categorical variables. The prevalence of depression was determined by calculating the proportion of postgraduate students with a PHQ-9 score of 10 or above, the categories used in a previous study [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. To explore the association between depression and various factors, logistic regression was employed. Bivariate logistic regression was used to estimate the crude odds ratios (cOR), and variables with a p-value below 0.2 were included in a multivariable logistic regression to identify independent associations to estimate adjusted odds ratios (aOR). Odds ratios and 95% confidence intervals (CIs) were reported, with statistical significance at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eSocial Demographic Characteristics of the study participants\u003c/h2\u003e\u003cp\u003eThis study included 377 postgraduate students, and their median age was 32 years, ranging from 25 to 55 years. Slightly over half of the students were male (n\u0026thinsp;=\u0026thinsp;210; 55.7%), and about half (n\u0026thinsp;=\u0026thinsp;193; 51.2%) were in their first year of study. The largest proportion of the respondents (n\u0026thinsp;=\u0026thinsp;220; 58.4%) reported being married, while nearly half of the students stated they had more than one child (n\u0026thinsp;=\u0026thinsp;163; 43.2%). Regarding substance use, more than one-third of them reported using alcohol (n\u0026thinsp;=\u0026thinsp;145; 38.5%). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocial Demographic Characteristics of Participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge; 30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt; 30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried/ Cohabiting\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e62.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced/Widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of children\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOne child\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than one\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e163\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYear of Study\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFirst\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e193\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecond\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThird\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSchools\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePublic Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e103\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e*Medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e205\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e54.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNursing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDentist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e**Traditional Med\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.53\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmployment Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e79.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot employed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePhysical Activity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e176\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocial Support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e56.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eKey: *college, **institution\u003c/h2\u003e\u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\u003ch2\u003ePrevalence of depression among postgraduate students\u003c/h2\u003e\u003cp\u003eOverall, 90 (23.9%) of the 377 postgraduate students who participated in this study were depressed during the survey.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eFactors associated with depression among postgraduate students\u003c/h2\u003e\u003cp\u003eThe bivariate logistic regression analysis identified associations between depression and several factors, including sex, alcohol, tobacco use, physical exercise, history of mental illness, and chronic diseases. However, the multivariable analysis revealed several significant factors associated with depression among postgraduate students. Those who consumed alcohol were twice as likely to experience depression compared to non-drinkers [aOR\u0026thinsp;=\u0026thinsp;2.13, 95%CI (0.91\u0026ndash;3.46)], while students who never engaged in physical exercise faced three times higher risk than those exercising regularly [aOR\u0026thinsp;=\u0026thinsp;3.09, 95%CI (1.48\u0026ndash;6.49)]. Financial challenges nearly tripled depression likelihood [aOR\u0026thinsp;=\u0026thinsp;2.86, 95%CI (1.57\u0026ndash;5.22)], and notably, students with low social support were seven times more likely to be depressed than those with high support [aOR\u0026thinsp;=\u0026thinsp;7.55, 95%CI (3.64\u0026ndash;15.69)]. All results are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBivariate and multivariable analysis of individual factors associated with depression\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eCrude\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAdjusted\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ecOR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eaOR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndividual factors\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge; 30years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.42(0.79\u0026ndash;2.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.238\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.43 (0.89\u0026ndash;2.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.27(0.74\u0026ndash;2.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.394\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.31 (0.69\u0026ndash;1.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.284\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried/Cohabiting\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced/ Widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.45(0.84\u0026ndash;14.27)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNo of children\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than one\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e163\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.32 (0 .77\u0026ndash;2.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.304\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOne child\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 .8 (0.40\u0026ndash;1.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.528\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAlcohol consumption\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.11 (1.30\u0026ndash;3.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.13 (0.91\u0026ndash;3.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.007*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e232\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTobacco use\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.12 (1.46\u0026ndash;6.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.13 (0.91\u0026ndash;4.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.081\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e247\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePhysical activity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.29 (2.18\u0026ndash;8.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.09 (1.48\u0026ndash;6.49)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.003*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e176\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003e1.79 (0.97\u0026ndash;3.35)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.48 (0.77\u0026ndash;2.85)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.234\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHistory of mental illness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.3 (1.72\u0026ndash;10.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.28 (0.85\u0026ndash;6.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.103\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e357\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePresence chronic illness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.39 (1.60\u0026ndash;7.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.17 (0.95\u0026ndash;4.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.060\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocioeconomic factors\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinancial challenge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.77 (2.73\u0026ndash;8.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.86 (1.57\u0026ndash;5.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot employed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.95(0.53\u0026ndash;1.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.850\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocial support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.61 (5.29\u0026ndash;21.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.55 (3.64\u0026ndash;15.69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.54 (3.03\u0026ndash;10.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.35 (2.32\u0026ndash;8.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eReference\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003ePostgraduate training- related factors associated with depression\u003c/h2\u003e\u003cp\u003eThe postgraduate training-related factors did not have any statistic significant association with depression. However, students in the school of nursing had twice the likelihood of developing depression, but it was not statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to assess the prevalence and factors associated with depression among postgraduate students in Dar es Salaam, Tanzania, using a case study of MUHAS. The study found that nearly one in four postgraduate students had probable depression, which aligns with global findings. Still, in contrast, related studies conducted in countries like Nigeria, China, and the USA showed a lower prevalence than this current study [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Nevertheless, studies conducted in Kenya, South Africa, and Saudi Arabia showed a higher prevalence than the current study [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The difference in depression prevalence could potentially be due to differences in methodology, study setting, and tools used to measure the outcome, which is depression [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Moreover, the variation in depression prevalence observed in this study may stem from using the PHQ-9 scale, a self-reporting instrument. As a result, participants might have underreported or overreported their depressive symptoms, which could cause the prevalence to appear either higher or lower.\u003c/p\u003e\u003cp\u003eRegarding the factors associated with depression, this study found that physically inactive postgraduate students are more likely to experience depression, which is consistent with studies from the USA and Kenya, which suggest that regular physical activity is a protective factor against depression [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Furthermore, physical activity programs are among the preventive programs encouraged in depression prevention as they reduce depression risk by enhancing mood, reducing anxiety, and improving sleep quality [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe findings in this study also showed that there is a significant association between alcohol use and depression, whereby students who use alcohol had an increased risk of depression in comparison to non-users. These findings align with previous studies, which also suggested an increase in the likelihood of depression among alcohol users [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Additionally, the World Health Organization (WHO) indicated that there is a causal relationship between alcohol use and mental health disorders, including depression [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis study found that low and medium social support significantly increased the likelihood of depression, with high social support acting as a protective factor, a pattern also observed in research from various countries like Kenya and South Africa [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], as did studies conducted in the USA [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], the UK [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Among others, WHO also indicated that having social support, including friends and family with whom you can interact with including sharing personal feelings and solving problems, can help to reduce the risk of developing depression or even help in the treatment of those who are already depressed [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFurthermore, the study found a significant link between financial problems and depression, with students facing economic challenges being more likely to develop depression. This finding aligns with the previous research, which also showed increased odds of depression among students with financial problems [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Studies in Australia and Kenya further supported this, attributing the link to the high cost of living, student loans, and limited funding for postgraduate students [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRegarding postgraduate training-related factors, this study found no significant association between the year of study or the specific school attended and depression, with students across all years and schools at similar risk. This aligns with findings from Saudi Arabia and the UK, suggesting that academic challenges are uniformly experienced regardless of year or department [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. In contrast, a study from Serbia found higher depression rates in second-year students, and a Kenyan study indicated varying depression risks among different courses [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The current study\u0026rsquo;s results may be due to the shared academic challenges faced by students across different years and schools.\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eStrengths and Limitations\u003c/h2\u003e\u003cp\u003eIts focus on a specific and vulnerable population within a Tanzanian setting is a key strength. It addresses a critical gap in mental health research by providing context-specific data on postgraduate students who are future health professionals. Moreover, using a validated screening instrument such as the PHQ-9 enhances the reliability of the depression assessment, while incorporating a range of socioeconomic and demographic variables allows for a comprehensive analysis of associated factors. However, the study is limited by the reliance on the PHQ-9 as a self-report tool, which may lead to underreporting or overreporting of depressive symptoms, potentially affecting prevalence estimates. Additionally, the cross-sectional design restricts causal inference between the associated factors and depression, and potential selection bias could influence the sample's representativeness. Lastly, the absence of clinical diagnostic confirmation and limited detail on the mental health service context may constrain the applicability of findings for intervention planning.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study revealed that nearly one in four of the postgraduate students had probable depression, underscoring a significant mental health concern. Physical activity and the use of alcohol were identified as individual factors that have a significant association with depression. Likewise, having financial challenges appeared to have a substantial link with having depression. Additionally, social support emerged as a protective factor, whereby having a high level of social support correlated with a lower depression rate. Therefore, the recommendations include encouraging postgraduate students to engage in regular physical activities and limit alcohol consumption, implementing mental health policies targeting academic institutions, and introducing comprehensive mental health programs at MUHAS. We recommend conducting a qualitative study to explore factors linked to depression among postgraduate students.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eaOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eAdjusted odds ratio\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003ecOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eCrude odds ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eConfidence interval\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eLMIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eLow- and middle-income countries\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003ePHQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003ePatient Health Questionnaire\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eMUHAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eMuhimbili University of Health and Allied Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eStandard deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eSub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eWHO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWorld Health Organization\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe want to express our heartfelt gratitude to everyone who contributed to this research\u0026apos;s success. We are also thankful to my research participants for their time, cooperation, and willingness to share their experiences; this study would not have been possible without them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSKM and ATK conceptualised the study, collected data, and performed the analysis. SKM, EB, EES, MJM, AAN, IHM, and ATK interpreted the results, drafted the manuscript, and reviewed all versions. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData and materials are available to the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the Institutional Review Board (IRB) of MUHAS (Ref. No. DA.282/298/01.C/2232), and the relevant authority granted permission to continue with the study within the university. This study was conducted in accordance with the principles of the Declaration of Helsinki. Participants were fully informed about the study\u0026apos;s objectives, procedures, risks, and benefits, ensuring informed consent. Participation was voluntary, with the option to withdraw at any time without penalty. To protect confidentiality, numerical codes were used instead of names for all data collection and analysis procedures, and no personally identifiable information was retained in the study records.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare that there is no conflict of interest in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLancet T. Ensuring care for people with depression. The Lancet. 2022;399:885. \u003c/li\u003e\n\u003cli\u003eLimenih G, MacDougall A, Wedlake M, Nouvet E. Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse. Int J Soc Determinants Health Health Serv. 2024;54:95\u0026ndash;107. \u003c/li\u003e\n\u003cli\u003eChisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3:415\u0026ndash;24. \u003c/li\u003e\n\u003cli\u003eWHO. Depressive Disorder (Depression). Int. Immunopharmacol. 2019. \u003c/li\u003e\n\u003cli\u003eWHO. Depression and Other Common Mental Disorders Global Health Estimates. 2017. \u003c/li\u003e\n\u003cli\u003eAkhtar P, Ma L, Waqas A, Naveed S, Li Y, Rahman A, et al. Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis. J. Affect. Disord. Elsevier B.V.; 2020. p. 911\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eMalebari AM, Alamoudi SO, AL-Alawi TI, Alkhateeb AA, Albuqayli AS, Alothmany HN. Prevalence of depression and anxiety among university students in Jeddah, Saudi Arabia: exploring sociodemographic and associated factors. Front Public Health. 2024;12:1441695. \u003c/li\u003e\n\u003cli\u003eSanga SS, Tarimo EAM, Ambikile JS. Factors influencing career preference in mental health among nursing students and intern nurses in Dar es Salaam, Tanzania. PLOS Glob Public Health. 2023;3:e0002108. \u003c/li\u003e\n\u003cli\u003eBarton BA, Bulmer SM. Correlates and Predictors of Depression and Anxiety Disorders in Graduate Students. Health Educ. 2017;49, 2. \u003c/li\u003e\n\u003cli\u003eSatinsky EN, Kimura T, Kiang MV, Abebe R, Cunningham S, Lee H, et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci Rep. 2021;11:14370. \u003c/li\u003e\n\u003cli\u003eGuo L, Fan H, Xu Z, Li J, Chen T, Zhang Z, et al. Prevalence and changes in depressive symptoms among postgraduate students: A systematic review and meta-analysis from 1980 to 2020. Stress Health. 2021;37:835\u0026ndash;47. \u003c/li\u003e\n\u003cli\u003eAlrasheedi J, Rabbani U. Prevalence of Anxiety and Depression among postgraduate trainees in Qassim, Saudi Arabia. World Fam Med J Middle East J Fam Med. 2022;20. \u003c/li\u003e\n\u003cli\u003eZaman S, Rahim M, Khan A, Habib S, Rahman M, Ahsan M, et al. Prevalence of Depression Among Post-Graduate Medical Trainees: A Multi-Centre Survey. BIRDEM Med J. 2014;4:18\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eMilicev J, McCann M, Simpson SA, Biello SM, Gardani M. Evaluating Mental Health and Wellbeing of Postgraduate Researchers: Prevalence and Contributing Factors. Curr Psychol. 2023;42:12267\u0026ndash;80. \u003c/li\u003e\n\u003cli\u003eShah S, Hussein N, Laving A, Okech-helu VC, Kumar M. Depression and its associated factors : perceived stress , social support , substance use and related sociodemographic risk factors in medical school residents in Nairobi , Kenya. 2021;1\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eGu A, Gm O, Mo B, Mn I. Prevalence of Depression among Resident Doctors in a. 2015;3:1\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eMboya IB, John B, Kibopile ES, Mhando L, George J, Ngocho JS. Factors associated with mental distress among undergraduate students in northern Tanzania. 2020;1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eLugata S, Elinisa M, Doshi B, Kashuta RA, Mallosa WJ, Kelly C, et al. Symptoms and predictors of depression among university students in the Kilimanjaro region of Tanzania : a cross-sectional study. J Ment Health. 2020;0:1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eNkenguye W. Addressing the silent struggle: adolescent depression in Tanzania. IJS Glob Health. 2024;7:e0425. \u003c/li\u003e\n\u003cli\u003eMuhimbili University. Background History. 2015. \u003c/li\u003e\n\u003cli\u003eCharan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35:121\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eKroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eZimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55:610\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eStata. Statistical software for data science [Internet]. [cited 2025 Apr 4]. Available from: https://www.stata.com/\u003c/li\u003e\n\u003cli\u003eShin C, Kim Y, Park S, Yoon S, Ko Y-H, Kim Y-K, et al. Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014. J Korean Med Sci. 2017;32:1861\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eFang J, Wang TAO, Member S, Li C. Depression Prevalence in Postgraduate Students and Its Association With Gait Abnormality. IEEE Access. 2019;7:174425\u0026ndash;37. \u003c/li\u003e\n\u003cli\u003eJanse van Vuuren C, Bodenstein K, Oberholzer M. Exploring the psychological well-being of postgraduate accounting students at a South African university. South Afr J Account Res. 2021;35:219\u0026ndash;38. \u003c/li\u003e\n\u003cli\u003eHoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49\u0026ndash;59. \u003c/li\u003e\n\u003cli\u003eGarcia-Williams AG, Moffitt L, Kaslow NJ. Mental health and suicidal behavior among graduate students. Acad Psychiatry. 2014;38:554\u0026ndash;60. \u003c/li\u003e\n\u003cli\u003eWHO. Alcohol: Fact Sheet 2015. 2015. \u003c/li\u003e\n\u003cli\u003eCharles ST, Karnaze MM, Leslie FM. Positive factors related to graduate student mental health. J Am Coll Health. 2022;70:1858\u0026ndash;66. \u003c/li\u003e\n\u003cli\u003eFarrer LM, Gulliver A, Bennett K, Fassnacht DB, Griffiths KM. Demographic and psychosocial predictors of major depression and generalised anxiety disorder in Australian university students. BMC Psychiatry. 2016;16. \u003c/li\u003e\n\u003cli\u003eDabbagh R, Alwatban L, Alrubaiaan M, Alharbi S, Aldahkil S, AlMuteb M, et al. Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review. Med Teach. 2023;45:499\u0026ndash;509. \u003c/li\u003e\n\u003cli\u003eSimić-Vukomanović I, Mihajlović G, Kocić S, Djonović N, Banković D, Vukomanović V, et al. Prevalencija i uticaj socioekonomskih faktora na nastanak depresivnosti i anksioznosti na uzorku od 1 940 studenata u Srbiji. Vojnosanit Pregl. 2016;73:169\u0026ndash;77.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Depression, Postgraduate students, Mental health, Tanzania","lastPublishedDoi":"10.21203/rs.3.rs-6578166/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6578166/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepression is a growing global health concern characterized by hopelessness, disinterest in previously enjoyable activities, and potentially suicidal thoughts. Postgraduate university students face a particularly high risk due to the challenges of balancing academics, family responsibilities, and financial pressures. This study investigated depression factors among postgraduate students at Muhimbili University of Health and Allied Sciences, addressing a critical need given this population's unique stressors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study included 377 participants selected through stratified random sampling. Data collection utilized a self-administered questionnaire featuring the Patient Health Questionnaire (PHQ-9) depression scale and the Multidimensional Scale of Perceived Social Support. Analysis was performed using Stata 18, with descriptive statistics and logistic regression employed to identify depression-related factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the respondents, 90 (23.9%) had probable depression, and multivariable logistic regression revealed several factors that independently had an association with depression. Those who consumed alcohol were twice as likely to experience depression compared to non-drinkers [Adjusted odds ratio (aOR) = 2.13, 95%CI (0.91–3.46)], while students who never engaged in physical exercise faced three times higher risk than those exercising regularly [aOR = 3.09, 95%CI (1.48–6.49)]. Financial challenges nearly tripled depression likelihood [aOR = 2.86, 95%CI (1.57–5.22)], and notably, students with low social support were seven times more likely to be depressed than those with high support [aOR = 7.55, 95%CI (3.64–15.69)].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNearly one in four postgraduate students exhibited probable depression. Physical inactivity, alcohol consumption, and financial difficulties significantly increased depression risk, while strong social support served as protection. This study recommends promoting regular physical activity, limiting alcohol use among postgraduate students in Tanzania and other similar contexts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number: \u003c/strong\u003eNot applicable\u003c/p\u003e","manuscriptTitle":"Prevalence and Factors Associated with Depression among Postgraduate Students in Dar- es-Salaam, Tanzania: A Case Study of Muhimbili University of Health and Allied Sciences","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-07 16:53:27","doi":"10.21203/rs.3.rs-6578166/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4605544a-7d53-44e0-8421-57fffd893278","owner":[],"postedDate":"August 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-09T16:38:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-07 16:53:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6578166","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6578166","identity":"rs-6578166","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}