An Investigative Study on Depression Among Clinical Medical Students in Private Universities in North Central Nigeria

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Koleoso, Emelda W. Nwenendah-Mpi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4851266/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 23 Oct, 2024 Read the published version in BMC Psychiatry → Version 1 posted 4 You are reading this latest preprint version Abstract Background Depression is among known mental health conditions and students in schools of medicine are not immune to it. In this investigative study, 211 clinical medical students of two private universities from North-Central Nigeria were examined on depression prevalence, the contributory factors and their coping strategies. Methods The Patient Health Questionnaire 9 (PHQ-9), the Medical Student’s Stressor Questionnaire (MSSQ) and identified coping strategies according to Coping Oriented to Problems Experienced Inventory (COPE) were instruments of data collection. Results The results were obtained by both descriptive analysis and test of association between some categorical variables. The depression prevalence amongst the participants was 159 (75.4%). Females (124 (78.0%)) were more depressed than males (35 (22.0%)). Factors identified as contributing to depression were the heavy academic workload (124 (78.5%)), insufficient family time (93 (58.1%)) and financial constraints (54 (34.0%)). The most utilized method of coping with their stress was engaging on social media (133 (84.2%)), followed by talking with relatives or friends (99 (62.7%)) and use of recreational drugs (20 (12.8%)). The findings from this study have shown that more than three-quarters of the respondents suffered from varying degrees of depression from mild, 63 (29.9%), moderate, 53 (25.1%) to severe, 43 (20.4%). Conclusions The heavy academic workload was a major source of depression. Colleges of Medicine should take pro-active steps towards their students’ mental health and academic workload should be well spaced to reduce the stress imposed by the frequency of examinations. Depression Medical Student’s Stressor Questionnaire Patient Health Questionnaire Coping Mechanism Stressors 1.0 Introduction Medical students face high rates of depression than students studying other courses. This is usually as a result of stress that is known to be associated with medical schools [ 1 , 2 ]. A number of factors, including vast curriculum, multiple academic demands, frequent and challenging exams, etc usually contribute to the stress medical students experience [ 3 ]. The mental and physical strain that an individual feels in reaction to pressure or a dangerous circumstance is known as stress (prolonged or excessive). This has been attributed to depression and mental health deterioration [ 3 , 4 , 5 ]. Medical students are pushed by stress during the medical school to acquire coping mechanism to deal with these circumstances. A person’s cognitive and behavioural coping mechanism are described as ways to manage, reduce, or accept the demands of stressful situations [ 6 ]. In accordance with the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition, depression is described to be a time frame of fortnight during which an individual felt low, stopped participating in everyday activities, and displayed some symptoms such as, issues with consuming food, falling asleep, vitality, attention, or esteem. The description does not include grieving following a period of sorrow [ 7 ]. It is a serious mental health condition which usually affect huge number of individuals globally. The rate of prevalence is 4.4% of global population [ 8 ]. Depression has a prevalence of 5.4% in Africa, where it is common in females (5.9%) than males (4.9%) [ 8 ]. According to estimates, about 3.1 percent of Nigeria’s population has depression [ 9 ]. The World Health Organisation (WHO) identified disability to be linked to depression [ 7 ]. A comprehensive study in Europe discovered that medical students have depression (6% − 65.5%) [ 10 ]. The clinical medical students (400 level to 600 level) of Cambridge University were discovered to have depression that varied from 2.2–10% [ 11 ]. It is now understood that as these medical students transition to clinical years, they become more susceptible to psychological disorders owing to some self-imposed demands, like setting excessively high academic achievements, having self-doubt, and associating identity with performance [ 11 – 15 ]. Various studies have also revealed other stressful events in medical school could trigger depression. They include; having limited free time, coming into contact with illness and death, harsh nature of many medical operations, finding it difficult to break bad news to patients’ families, lack of sleep, peer pressure, fear of failing in medical school, desire to be perceived as a capable doctor, student abuse, etc [ 2 , 4 ]. Depression within medical school has been linked to low self-esteem, poor performance in work, as well as social life, academic dishonesty, loss of empathy for patients, suicidal ideation, alcohol and substance abuse, etc [ 2 , 10 , 16 ]. One of the main contributors to the disease burden is mental health disorders. Globally, depression together with anxiety were among the top 25 major causes of disease burden for both sexes. A survey of multistage samples of household across the 36 states in Nigeria (above 17 years), showed life-time and 1-year Major Depressive Disorder (MDD) proportions of 3.1% and 1.1% [ 17 , 18 ]. University students experience substantial mental strain due to the high demands they must meet in both their academic and familial lives. This mental strain can cause serious mental illness, which could substantially worsen over their programmes in the university. Approximately one-third of college students experience depression, making it a serious health issue in this segment of the population. According to epidemiological data, the frequency of depression rose by 18.4% between 2005 and 2015 [ 19 ]. Considering the belief that medical professionals ought to remain invulnerable, that is not the case, as mental health challenges are common [ 20 ]. Depression is brought on by a number of circumstances, including stress. Long-term stress can cause breakdown and mental health problems, which include depression, nerve collapse, cardiovascular disease, etc [ 21 ]. According to studies, medical students experience greater stress than students studying other courses hence, they exhibit more depressive symptoms [ 22 ]. Further, medical students also develop coping mechanisms to get them through these stressful conditions. These could be positive or negative. Problem-solving skills and efficient emotion management are linked to positive coping mechanisms while negative mechanisms are associated with negative appraisal, escape from negative situations and social isolation [ 6 ]. The study conducted in Bayero University showed that 15.1% reported having depression. Mild, moderate, and severe depression rates of incidence were 5.4%, 6.8%, and 2.9%, respectively. Family history serves as a major factor in the mental condition of students. Medical students with family history of depression have higher chances of depression than those without such family history [ 10 ]. A similar study carried out in a New York medical school showed that depression was more than five times greater in them than in controls of the same age [ 23 ]. The research conducted at National University of Singapore revealed a prevalence of 28%. The rate of depression decreases as year of study increases. First-year students had the greatest rate of 33.5% while year 5 was 20.5%. The year of study and academic achievement were linked to depression [ 24 ]. However, medical students have developed coping strategies over the years. A study focused on the primary medical and mental health treatment conducted at Yale University showed students had primary physicians, but few admitted going to the doctors when they were ill (33%). Majority of the students were comfortable with seeking academic support [ 25 ]. A similar research in India showed that depressed medical students had access to mental healthcare. Some never made use of it because of choice, informal consultation, confidentiality worries and a desire for self-diagnoses [ 26 ]. The stigma attached to depression in medical school could hinder students from accepting their depressive state and seeking help, because they may be viewed as less intelligent than others [ 27 ]. A study conducted at University of Saskatchewan, which made use of brief COPE (Coping Oriented to Problems Experienced Inventory) discovered that students make use of mainly adaptive and not maladaptive coping strategies. Emotional support is an example of adaptive coping strategy while substance abuse, venting, blame and self-destruction are examples of maladaptive coping strategy [ 30 ]. There is scarcity of depression research on medical students in universities located in the North-Central Nigeria. Therefore, this research will establish a baseline for future studies on depression amongst medical students. 2.0 Methodology 2.1 Study Objectives The study objectives include: 1. to determine depression prevalence amongst clinical medical students from two private universities in North Central Nigeria; 2. to examine the depression coping strategies utilized by clinical students; 3. to examine variables that contribute to depression amongst the clinical students. 2.2 Study Area The study was conducted in two private universities (Nile University of Nigeria and Bingham University) in North-Central Nigeria. There are twenty-five (25) private tertiary institutions in North-Central Nigeria and only three (3) have established a Medicine and Surgery programme (MBBS). These include Nile University of Nigeria, Bingham University and Baze University. At the time of the study, only the Nile University of Nigeria and Bingham University had been accredited to commence their clinical component and both universities share similar academic curriculum. In their preclinical years, both universities offer the same courses: Anatomy, Physiology, Biochemistry and Community Medicine. In the beginning of their clinical years, 400 level university students of both universities offer Pathology, Pharmacology and begin hospital and community based rotations. In the clinical years (500 and 600 levels), they proceed to Obstetrics and Gynecology, Medicine and Surgery and Pediatrics. The medicine programme in Nigeria is a six-year programme with each year referred to as a level. The preliminary year is the first (100 level), the preclinical years are the second and third (200 and 300 levels) while the clinical periods of training, which includes hospital and community training placements are the fourth, fifth and sixth years (400 to 600 level) [ 28 ]. The Medicine and Surgery (MBBS) programme in Nile University of Nigeria was established in 2016 and attained full accreditation in March/April 2021. The programme currently holds about 346 medical students of which 132 are clinical students [ 29 ]. Amongst the many programmes offered within Bingham University is the MBBS programme which currently has about 850 medical students out of which 483 are clinical students [ 30 ]. 2.3 Study Design And Population The study was both quantitative and institution-based online study. The research included consenting population of clinical students (400 level – 600 level) in Nile University of Nigeria and Bingham University, Abuja, Nigeria. The inclusion criterion was that the study participants must be consented clinical medical students (400–600 level) from Nile University of Nigeria and Bingham University. Students with previous history of mental incapacity were excluded. The Leslie Fisher’s formula for cross sectional descriptive research below was utilized to evaluate the size of the sample for the research [ 31 ]: $$\:n=\frac{{z}^{2}p(1-p)}{{d}^{2}}$$ , as: n → minimum size of sample; z → standardized normal deviation; p → prevalence of problem globally. Using the hypothesis testing method, a previous study conducted revealed that about 15 percent of medical students suffer from depression [ 10 ]. d → desired level of precision = 5% (that is 0.05). Hence, the sample size is calculated as: $$\:n=\frac{{1.96}^{2}\left(0.33\right)(1-0.33)}{{0.05}^{2}}$$ $$\:n=196.$$ The final sample size was 218. This was to account for non-response and was computed by dividing the minimum sample size by 0.90. 2.4 Data Collection And Analyses A pretested self-administered questionnaire was utilized for the purpose of accurate and comprehensive analysis of the research objectives. The questionnaire contained 4 sections and had twenty-eight questions in total. The first section consisted of nine questions covering the respondents’ socio-demographic data such as age, gender, university, school level, relationship status, ethnicity, religion, accommodation arrangements and the number of students in a room. The second section utilized a modified version of the PHQ-9, which contains 9 items to evaluate depression severity and presence in respondents. A 4-point rating was used to score the items on PHQ-9 (0 being not at all, 1 being a few days, 2 being more than half the days, and 3 being virtually every day). Higher degree of depression was indicated by higher scores, which can range from 0 to 27 on the overall scale [ 32 ]. This questionnaire was modified for brevity to a self-administered questionnaire of 7 items with the total now ranging from 0 to 21. Respondents were asked to calculate their scores at the end of this section and those with a score of 4 and above were asked to answer the remaining sections of the questionnaire. Respondents that scored 3 and below were asked to skip to the end of the questionnaire. The items used to assess the severity of depression were ranked on a scale as shown below: 0–3 = no depression; 4–7 = mildly depressed; 8–12 = moderately depressed; 13–16 = moderately severe; 17–21 = severely depressed. The third section assessed coping strategies to depression using dichotomous questions. This section had eight questions that were classified using the coping styles according to Coping Oriented to Problems Experienced Inventory (COPE). The coping is divided into three, which focused on emotion, avoidant and problem. The fourth section contained the medical student’s stressor questionnaire (MSSQ), which were structured questions directed towards assessing the factors that contribute to depressive symptoms of clinical medical students [ 33 ]. A Google form was utilized for the collection of the data for the study. The questionnaire was pretested among a small group of individuals (10–20) from Nile university of Nigeria, but were later not included in the main study. This aided in the identification of unclear issues as well as ensuring that the content of the questionnaire was universally understood by the participants. All participants properly filled out a separate consent section of the online questionnaire to indicate approval. The questionnaire required respondents to fill in their email addresses before taking part in the survey. This was to ensure that a respondent could not respond more than once. Email addresses of respondents were not traced back to their responses to maintain anonymity. The version 22 of SPSS software (IBM Corp.) was utilized for the analyses. The data’s baseline information were described by descriptive analysis. Likewise, association between categorical variables was evaluated by Chi-square test, at 5 percent significant level. 3.0 Results 3.1 Descriptive Analyses Table 1 Socio-Demographic Characteristics of Respondents Characteristics Frequency (211) Percentage Non-response (NR) Age at last birthday (years) 16–20 21–25 26–30 31–35 36–40 > 40 Total Mean(Standard Deviation) 51 142 18 0 0 0 211 22.2(± 5.2) 24.2 67.3 8.5 0 0 0 100 NR = 0 Gender Male Female Total 51 159 210 24.3 75.7 100 NR = 1 Educational Level 400 level 500 level 600 level Total 81 71 59 211 38.4 33.6 28.0 100 NR = 0 University Nile University of Nigeria Bingham University Total 108 103 211 51.2 48.8 100 NR = 0 Tribe Hausa Idoma Igala Igbo Fulani Yoruba Others Total 50 8 9 29 10 33 68 207 24.2 3.9 4.3 14.0 4.8 15.9 32.9 100 NR = 4 Relationship Status Single In a relationship with boyfriend/girlfriend Married Total 156 48 6 210 74.3 22.8 2.9 100 NR = 1 Religion Christianity Islam Total 138 73 211 65.4 34.6 100 NR = 0 Accommodation On campus Off campus Total 153 58 211 72.5 27.5 100 NR = 0 On campus, number of students in a room One Two Three More than three Total 3 73 30 47 153 2.0 47.7 19.6 30.7 100 NR = 0 The Table 1 above displays the sociodemographic details of study respondents. Age group (21–25 years) had the highest response of 142 (67.3%). The average age of study respondents was 22.2 years (standard deviation = 5.2). Female respondents were 51.4% higher than the male respondents. The highest number of respondents came from 400 level. Table 2 Patient Health Questionnaire (PHQ) Variables Frequency (n = 211) Percentage Non-Response (NR) Little Interest in Doing Things Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 61 93 31 26 211 28.9 44.1 14.7 12.3 100 NR = 0 Feeling Down, Depressed or Hopeless Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 76 84 21 30 211 36.0 39.8 10.0 14.2 100 NR = 0 Trouble Falling Asleep, Staying Asleep or Sleeping Too Much Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 72 59 32 48 211 34.1 28.0 15.2 22.7 100 NR = 0 Feeling Tired or Having Little Energy Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 40 89 38 43 210 19.0 42.4 18.1 20.5 100 NR = 1 Poor Appetite or Overeating Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 80 69 26 35 210 38.1 32.9 12.4 16.7 100 NR = 1 Feeling Bad About Yourself or That You Are a Failure or Have Let Yourself or Your Loved Ones Down Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 98 60 19 33 210 46.7 28.6 9.0 15.7 100 NR = 1 Diminished Ability to Think or Concentrate Not at all Less or equal to seven days More than seven days Nearly every day for two weeks Total 79 68 37 27 211 37.4 32.2 17.5 12.8 100 NR = 0 About a third (68 (32.2%)) of the respondents had diminished ability to think or concentrate. Table 3 Distribution of Respondents’ Patient Health Questionnaire Scores Scale of Depression Frequency Percentage No depression 0–3 52 24.6 Mild 4–7 63 29.9 Moderate 8–12 53 25.1 Moderately severe 13–16 21 10.0 Severe 17–21 22 10.4 Total 211 100 Only 139 (75%) of the respondents had varying degrees of depression in Table 3 . Table 4 Distribution of Respondents’ PHQ Scores According to Socio-Demographic Variables Variables Scales of Depression n(%) Socio-demographic Characteristics 0–3 (None) 4–7 (Mild) 8–12 (Moderate) 13–16 (Moderately severe) 17–21 (Severe) Total Gender Female Male Total 35(22.0) 16(31.4) 51(24.3) 45(28.3) 18(35.3) 63(30.0) 43(27.0) 10(19.6) 53(25.2) 16(10.1) 5(9.8) 21(10.0) 20(12.6) 2(3.9) 22(10.5) 159(75.7) 51(24.3) 210(100) School Level 400 500 600 Total 10(12.3) 17(24.0) 25(42.4) 52(24.6) 21(25.9) 27(38.0) 15(25.4) 63(29.9) 28(34.6) 12(16.9) 13(22.0) 53(25.1) 13(16.1) 5(7.0) 3(5.1) 21(10) 9(11.1) 10(14.1) 3(5.1) 22(10.4) 81(38.4) 71(33.6) 59(28.0) 211(100) Relationship Status Single In a relationship Married Total 37(23.7) 13(27.1) 2(33.3) 52(24.8) 47(30.1) 13(27.1) 2(33.3) 62(29.5) 42(26.9) 10(20.8) 1(16.7) 53(25.2) 13(8.3) 7(14.6) 1(16.7) 21(10.0) 17(11.0) 5(10.4) 0(0.0) 22(10.5) 156(74.3) 48(22.9) 6(2.8) 210(100) Accommodation Status On Campus Off Campus Total 35(22.9) 17(29.3) 52(24.6) 49(32.0) 14(24.1) 63(29.9) 41(26.8) 12(20.7) 53(25.1) 15(9.8) 6(10.4) 21(10.0) 13(8.5) 9(15.5) 22(10.4) 153(72.5) 58(27.5) 211(100) Depression was more prevalent in females than males. There was also more severity seen amongst females with 12.6% of them falling under severe depression as opposed to 3.9% of males. Those in 400 level had the highest percentage with severe depression (11.1%), while those in 600 level had the least (5.1%). Depression was more common in those who were single than those who were in a relationship or married. Of those who were single, 11.0% of them had severe depression while there were no severe depression amongst those who were married. Depression was more prevalent than usual amongst those on campus as opposed to those off campus. Table 5 Presence of Depression Against Socio-demographic Characteristics Depression n(%) Absent (0–3) N1 = 52 Present (4–21) N2 = 159 Total N3 = N1 + N2 = 211 Socio-demographic Characteristics Gender Female Male Total 35(22.0) 16(31.4) 51(24.3) 124(78.0) 35(68.6) 159(75.7) 159(75.7) 51(24.3) 210(100) School Level 400 500 600 Total 10(12.3) 17(24.0) 25(42.4) 52(24.6) 71(87.7) 54(76.0) 34(57.6) 159(75.4) 81(38.4) 71(33.6) 59(28.0) 211(100) Relationship Status Single In a relationship with boyfriend/girlfriend Married Total 37(23.7) 13(27.1) 2(33.3) 52(24.8) 119(76.3) 35(72.9) 4(66.7) 158(75.2) 156(74.3) 48(22.9) 6(2.8) 210(100) Accommodation On Campus Off Campus Total 35(22.9) 17(29.3) 52(24.6) 118(77.1) 41(70.7) 159(75.4) 153(72.5) 58(27.5) 211(100) The prevalence of depression reduced as the academic year increased; 400level (87.7%), 500 level (76.0%) and 600 level (57.6%). The least depressed participants were in 600 level (57.6%). Those whose relationship status was single had the highest percentage of depression (76.3%). There was a higher percentage of depression amongst those on campus (77.1%) as opposed than those off campus (70.7%). Table 6 Association Between School levels and Scales of Depression School Levels (400 level – 600 level) Scales of Depression 400 n(%) 500 n(%) 600 n(%) Total number (%) Chi square P value Mild Moderate 21(33.3) 28(52.8) 27(42.9) 12(22.6) 15(23.8) 13(24.5) 63(39.6) 53(33.4) 6.095 0.047 Moderately severe Severe 13(61.9) 9(40.9) 5(23.8) 10(45.5) 3(14.3) 3(13.6) 21(13.2) 22(13.8) 2.372 0.305 71(44.6) 54(34.0) 34(21.4) 159(100) Table 6 shows the association between school levels and the different scales of depression. There was statistical significance between school levels and, mild and moderate depression (Chi-square value = 6.095, p-value = 0.047) at 5% significance level but no statistical significance between school levels and, moderately severe and severe depression (Chi-square value = 2.372, p = 0.305) at 5% significance level. Table 7 Identified Stressors Among Medical Students using Likert Scale Variables Strongly Agree Agree Neutral Disagree Strongly Disagree Heavy academic workload/getting poor marks/high frequency of examination 78(49.4) 46(29.1) 23(14.6) 7(4.4) 4(2.5) Lack of time for family and friends/relationship problems with partners 51(32.1) 42(26.4) 35(21.7) 19(11.9) 13(8.2) Financial constraints e.g. self sponsored 26(16.4) 28(17.6) 42(26.4) 39(24.5) 24(15.1) Table 7 shows the identified stressors experienced by students. “Heavy academic workload/getting poor marks/high frequency of examinations” were the most prevalent stressors as the majority of respondents either strongly agreed (49.4%) or agreed (29.1%). This was followed by “lack of time for family and friends/relationship problems with partners”, as 32.1% strongly agreed and 26.4% agreed. Table 8 Coping Strategies Utilized by Respondents Frequency(%) n = 159 Variables Yes No Total Non-response Talking/discussing with others e.g. relatives, friends/medical personnels 99(62.7) 59(37.3) 158 1 Going out with friends 57(36.1) 101(63.9) 158 1 Use of streaming platforms e.g. Youtube, Netflix, Spotify 124(78.5) 34(21.5) 158 1 Use of antidepressants under doctor’s prescription 4(2.5) 153(97.5) 157 2 Use of recreational drugs e.g. alcohol, cannabis, tobacco, caffeine 20(12.8) 136(87.2) 156 3 Gastronomical relief e.g. overeating/excessive ordering of food 60(37.7) 99(62.3) 159 0 Sleeping excessively 92(58.2) 66(41.8) 158 1 Use of social media e.g. Instagram, Snapchat, TikTok, X (Twitter), WhatsApp 133(84.2) 25(15.8) 158 1 Respondents in the survey used some coping mechanisms to cope with medical school’s rigour. The most utilized was the social media (84.2%). These include Instagram, Snapchat, TikTok, X (formerly known as Twitter) and Whatsapp, etc. This was followed by the use of streaming platforms (78.5%) such as, Youtube, Netflix, Spotify, etc. Almost two-third of the respondents admitted to talking/discussing with relatives, friends or medical personnel. Approximately thirteen percent admitted to the use of recreational drugs (e.g. alcohol, cannabis, tobacco, caffeine, etc). The least utilized was the use of antidepressants under doctor’s prescription (2.5%). 4.0 Discussion The research revealed both institutions' clinical medical students had significant rate of depression (75.4%). Approximately 30.0% out of this percentage had mild depression, 25.1% had moderate depression, 10.0% had moderately severe and 10.4% had severe depression. The observed prevalence in the research is greater than other similar studies conducted in Nigeria. The observed prevalence in Ebonyi State University was 17.4% [ 28 ], Bayero University was 15.1% [ 10 ], and in a study carried out in both Ekiti State University and Afe Babalola University was 25% [ 34 ]. This gross disparity could be because the research only focused on students in their clinical components, that is, 400 level to 600 level while these other studies focused on all students from 100 level to 600 level. Another reason could be the study environments; as many of the studies conducted were amongst students in Federal universities who are unfortunately, casualties of unionized protests. While this is counted as a loss, it could also be perceived as a stress relieving period or a break from excessive workload. This is far from the case of students in private universities who are exposed to uninterrupted periods of stress and excessive workload. Some other studies conducted outside Nigeria recorded these proportions of depression among medical students: Egypt 60.8% [ 35 ], Cameroun (65.2%) [ 36 ], Brazil (34.6%) [ 37 ], Pakistan (75.5%) [ 38 ], Saudi Arabia (83.4%) [ 39 ], India (44.4%) [ 40 ]. This variation in prevalence may be due to difficult teaching methodologies, difference in curriculum, geographical locations and educational components. The various methods and procedures used for depression screening may be the cause of the slight discrepancies in prevalence. Females showed more depressive symptoms than the males. This supports the research findings done in Bayero University [ 10 ], Al Azhar University Egypt [ 41 ] and from a systematic review research [ 42 ]. This may be due to underreporting in males, owing to the culture amongst males not showing vulnerability. However, other research has found that males have greater chances of experiencing depression than females [ 43 , 44 ]. Although previous research did not detect a significant link between gender and depression [ 45 , 46 ]. None of the married students had severe depression. This could be because of the comfort and support they receive from their partners. The percentage of respondents with depression was highest in 400 level, followed by 500 level while the least proportion was in 600 level. These results from 400 level could be due to 400 level being the period where students transition from preclinical studies to clinical studies and are exposed to hospital and community-based training. The students in their final year (600 level) had the least depression prevalence. It could be due to the anticipation of their graduation and could also be that they have learnt to cope positively with the stress of medical school. This supports the research conducted in Brazil, America and the United Kingdom [ 47 ]. The study further revealed that people who stayed on campus had higher percentage of depression compared to those off campus. This could be because they were far from their families. Although social media could help in communication with families but internet could be challenging. However, those that are off campus have access to their families and friends, and they also enjoy the comfort of their homes. Coping Oriented to Problems Experienced Inventory (COPE) divides coping into three, with focus on emotion, avoidant and problem. In this study, emotion-focused coping included talking and discussing with family/friends/medical personnel, usage of social media, such as X (formerly known as Twitter), Instagram, Snapchat, Whatsapp, use of streaming platforms such as YouTube, Netflix, Animekiss, Spotify, while avoidant coping included self-distraction e.g. going out with friends, use of recreational drugs such as alcohol, cannabis, tobacco, gastronomical relief e.g. excessive eating, excessive sleeping, etc. While comment cannot be made deeply about students managing stress, the results from the research revealed clinical medical students utilized healthy coping strategies and not the dysfunctional ones. It can be inferred that these clinical medical students utilized more adaptive than maladaptive coping strategies. A perfect illustration is a study where medical students utilized ranting, was favourably correlated with several adaptive coping mechanisms, as opposed to the maladaptive ones that have often been linked to self-pity, drug use, etc [ 48 , 49 ]. When a stressor is seen to be overpowering beyond one's control, the avoidant/emotional-focused coping technique may prove to be particularly helpful. Therefore, it is possible to support the hypothesis that certain coping mechanisms that are emotion-focused may be less adaptive depending on the circumstance [ 50 ]. This study revealed that an approximate proportion of 80% of the study participants agreed that heavy academic workload/poor marks/ high frequency of examinations were stressors responsible for depressive symptoms they experienced. A further 58.5% either strongly agreed or agreed that lack of time for family and friends/relationship problems with partners are also stressors responsible for their depressive symptoms while 26.4% were neutral towards financial constraints as a contributing stressor to depressive symptoms they experience. Heavy academic workload/poor marks/high frequency of examination was noted as a significant stressor and this is fairly consistent with other studies done [ 51 , 52 ]. 5.0 Conclusion This study’s findings have revealed the depression prevalence amongst medical students from private universities in North Central Nigeria. The prevalence is high, as about three-quarters of the participating students had varying degrees of depression. The students admitted to utilizing more of adaptive coping strategies mainly; discussing with family, friends and medical personnel, use of streaming platforms such as Netflix, Spotify, YouTube and use of social media platforms, rather than use of recreational drugs such as alcohol, cannabis, etc. They attributed their depressive symptoms to the heavy academic workload, poor marks, high frequency of examinations, lack of time for family, friends and relationship problems with partners, and financial constraints. 6.0 Recommendations Based on the research’s findings, the following recommendations are provided: 1. Medical colleges should provide mental health and counselling interventions for students because of the significant rate of depression that we observed in our research. 2. Universities especially private universities that do not have interruption in their academic calendars should implement flexible schedule for students to address personal and family needs. 3. Universities should provide access to faculty mentors and advisors to assist with time management and work-life balance. 4. The universities should provide communication rooms with functioning devices and uninterrupted network to allow on-campus students communicate adequately with their loved ones. 5. Medical colleges should encourage student associations and health clubs to provide social events such as game night, movie night and other social activities. These will promote bonding and a sense of belonging amongst students, especially those who stay on campus. 6. Universities should have a welfare account to support students who may suffer sudden financial challenges. Declarations Ethics Approval and Consent to Participate The study obtained ethical approval from Health Research Ethics Committee of Federal Capital Territory (Nigeria) with Approval Number: FHREC/2022/01/139/22-07-22. The research was in accordance with the Standard Operating Procedures for Health Research Ethics Committees, Federal Ministry of Health, Nigeria. The consents of participants were obtained before participation in the study. Consent for Publication Not Applicable Availability of Data and Materials The data used in the research have been submitted as supplementary file. Competing Interests No competing interest has been declared by the authors. Funding Not Applicable Authors’ Contribution All authors contributed to the research. TO and EWN contributedto the conception of the work. TO, POK and EWN designed the work, analyzed the data and interpreted the results. TO and POK developed the manuscript and all authors approved the final version of the manuscript. Acknowledgements The supports of Hauwa Samaila and Hassan A. Alimi are highly appreciated during the data collection process. References Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456–68. 10.1111/medu.12962 . Suwalska J, Suwalska A, Szczygiel M, Lojko D. Medical students and stigma of depression. Part 2. Self-stigma. Psychiatr Pol. 2017;51(3):503–13. 10.12740/PP/OnlineFirst/67373 . Almojali AI, Almalki SA, Alothman AS, Masuadi EM, Alaqeel MK. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Global Health. 2017;7(3):169–74. 10.1016/j.jegh.2017.04.005 . Pokhrel NB, Khadayat R, Tulachan P. Depression, anxiety and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC Psychiatry. 2020;20(1):1–18. Moir F, Yielder J, Sanson J, Chen Y. Depression in medical students: current insight. Adv Med Educ Pract. 2018;9:323–33. Silva V, Costa P, Pereira I, Faria R, Salgueira AP, Costa MJ et al. Depression in medical students: insights from a longitudinal study. BMC Med Educ 2017:17(1). Cagliostro D, Depression Central. April, : Tell Me All I Need to Know About Depression.2024. https://www.psycom.net/depression#depressionsigns-amp-symptoms . Accessed: 24th 2024. World Health Organisation. Depression and other common mental disorders: global health estimates. World Health Organization 2017. https://apps.who.int/iris/handle/10665/254610 . Accessed: 24th April, 2024. Gureje O, Uwakwe R, Oladeji B, Makanjuola VO, Esan O. Depression in adult Nigerians: results from the Nigerian survey of mental health an well-being. J Affect Disorder. 2010;120(1–3):158–64. Suraj SS, Umar BI, Gajida AU, Umar MU. Prevalence and factors associated with depression among medical students in Nigeria. Nigerian Postgrad Med J. 2021;28(3):198–203. 10.4103/npmj.npmj_414_21 . Jacob R, Li TY, Martin Z, Burren A, Watson P, Kant R, Davies R, Wood DF. Taking care of our future doctors: a service evaluation of a medical student mental health service. BMC Med Educucation. 2020;20(1):172. 10.1186/s12909-020-02075-8 . Munn F. Medical student and suicide. BMJ: British Medical Journal. 2017: 357. https://doi.org/10.1136/sbmj.j1460 Firth J. Levels and sources of stress in medical students. Br Med J (Clinical Res Education). 1986;292(6529):1177–80. 10.1136/bmj.292.6529.1177 . Slavin S. Medical Student Mental Health: Challenges and Opportunities. Med Sci Educ. 2018;28:13–5. Quince TA, Wood DF, Parker RA, et al. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open. 2012;e001519. 10.1136/bmjopen-2012-001519 . Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-analysis. JAMA. 2016;316(21):2214–36. 10.1001/jama.2016.17324 . Global Health Metrics. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396:1204–22. https://doi.org/10.1016/S0140-6736(20)30925-9 . Global. regional and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.The Lancet Psychiatry. 2022; 9(2). Mirza AA, Baig M, Beyari GM, Halawani MA, Mirza AA. Depression and Anxiety Among Medical Students: a brief overview. Adv Med Educ Pract. 2021;12:393–8. 10.2147/AMEP.S302897 . Hankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students. BMJ Case Rep. 2014. 10.1136/bcr-2014-205226 . Work Related Stress. www.deakin.edu.au. Available from: www. https://www.deakin.edu.au/students/health-and-wellbeing/occupational-health-and-safety/work-related-stress . Accessed: 24th April, 2024. Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516–22. 10.3329/jhpn.v29i5.8906 . Mousa OY, Dhamoon MS, Lander S, Dhamoon AS. The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees. PLoS ONE. 2016;10(6):11. 10.1371/journal.pone.0156554 . Olum R, Nakwagala FN, Odokonyero R. Prevalence and factors associated with depression among medical students at Makerere University, Uganda. Advances in Medical Education and Practice. 2020, 11:853–60. Available from doi.org/ 10.2147/AMEP.S278841 Gold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015;39(1):37–46. 10.1007/s40596-014-0202-z . Arun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety and Suicidal Behaviour: Why Do They Seek Treatment? Indian J Psychol Med. 2022;44(1):10–6. 10.1177/0253717620982326 . Schwenk TL, Davis L, Wimsatt LA. Depression, stigma and suicidal ideation in medical students. JAMA. 2010;15(11):1181–90. 10.100/jama.2010.1300. Ossai EN, Eze II, Onyenakazi RC, Ugebe E, Eze B. Obasi, O. How large is the burden of depression ina medical school? A cross-sectional study among medical students in Nigeria. Pan Afr Med J. 2021;40:1. 10.11604/pamj.2021.40.71.29071 . History of Nile University. 2021. https://www.nileuniversity.edu.ng/history-of-nile-university . Accessed: 24th April, 2024. About us (Bingham University). https://binghamuni.edu.ng/v2/about . Accessed: 24th April, 2024. World Health Organization (WHO). Sample size determination in health studies: a practical manual. Geneva, Switzerland: WHO. https://tbrieder.org/publications/books_english/lemeshow_samplesize.pdf . 1991. Accessed: 24th April, 2024. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. Muhamad SB, Yusoff, Ahmad FA, Rahim, Mohd J, Yaacob. The development and validity of the medical students stressor questionnaire (MSSQ), ASEAN Journal of Psychiatry, Jan-June. 2010: 11(1). Falade J, Oyebanji AH, Babatola AO, Falade OO, Olumuyiwa TO. Prevalence and correlates of psychiatric morbidity, comorbid anxiety and depression among medical students in public and private tertiary institutions in a Nigerian state: a cross-sectional analytical study. Pan Afr Med J. 2020;37:53. 10.11604/pamj.2020.37.53.24994 . Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53(1):77–84. Ngasa SN, Sama CB, Dzekem BS, Nforchu KN, Tindong M, Aroke D, Dimala CA. Prevalence and factors associated with depression among medical students in Cameroun: a cross-sectional study. BMC Psychiatry. 2017;17(1):216. 10.1186/s12888-017-1382-3 . Alharbi H, Almalki A, Alabdan F, Haddad B. Depression among medical students in Saudi medical colleges: a cross-sectional study. Adv Med Educ Pract. 2018;9:887–91. 10.2147/AMEP.S182960 . Sajjad W, Samreen A, Shah SAY, Batool A, Umair M, Ahmad T, Abideen Z. Prevalence of depression among medical students: a cross-sectional study. Prof Med J 2021: 28(12). https://doi.org/10.29309/TPMJ/2021.28.12.6164 Alharbi H, Almalki A, Alabdan F, Haddad B. Depression among medical students in Saudi medical colleges: a cross sectional study. Adv Med Educ Pract. 2018;9:887. doi.org/10.2147/AMEP.S182960 . Agrawal N, Sharma S, Meena R, Uppadhaya SK, Mittal M. Prevalence of depression and its associated factors among students of a Medical College in Western Rajasthan. Natl J Community Medice. 2017;8(1):12–6. Shams Eldin AA, Hassan H, Elkhar OA, Amer S, Kasim K. Prevalence of depression among medical students at Al Azhar University: a cross sectional study. J Community Med Public Health 2017:115:1–8. 10.29011/CMPH 115/100015 Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC Med Edu. 2019;19:327. Lin F, Zhang LL, Luo ZY, Zhao QQ. Depression and its influence in medical students. China J Health Psychol. 2018;26:622–7. Yang XZ, Chen JW, Feng GS. Correlation between sleep quality and anxiety and depression in medical students. Acta Acad Med Weifang. 2005;27:100–2. Tamunosiki CA, Chinawa JM, Aniwada EC, Manyike PC, Ndu I, Nduaguba OC. Determinants of depression among medical students in two medical schools from South East Nigeria: a screening test. Ann Nigerian Med. 2018;11:27–31. Mihailescu AI, Diaconescu LV, Ciobanu AM, Donisan T, Mihailescu C. The impact of anxiety and depression on academic performance in undergraduate medical students. Eur Psychiatry. 2016;33(S1):284. http://doi.org/10.1016/j.eurpsy.2016.01.761 . Moutinho IL, Maddalena NC, Roland RK, Lucchetti AL, Tibirica SH, Ezequiel OD, Lucchetti G. Depression, stress and anxiety in medical students: a cross-sectional comparison between students from different semesters. Rev Assoc Med Bras. 2017;63(1):21–8. 10.1590/1806-9282.63.01.21 . Carver CS. You want to measure coping but your protocol ‘too long’: Consider the brief cope. Int J Behav Med. 1997;4(1):92–100. Tuncay T, Musabak I, Gok D, Kutlu M. The relationship between anxiety, coping strategies and characteristics of patients with diabetes. Health Qual Life Outcomes. 2008;6(1):79. Park CL, Armeli S, Tennen H. Appraisal-Coping Goodness of Fit: A Daily Internet Study. Pers Soc Psychol Bull. 2004;30(5):558–69. Hill MR, Goicochea S, Merlo LJ. In their own words: stressors facing medical students in the millennial generation. Med Educ Online. 2018;23(1):1530558. 10.1080/10872981.2018.1530558 . Satpathy P, Siddiqui N, Parida D, Sutar R. Prevalence of stress, stressors, and coping strategies among medical undergraduate students in a medical college of Mumbai. J Educ Health Promotion. 2021;10:318. 10.4103/jehp.jehp_1395_20 . Additional Declarations No competing interests reported. Supplementary Files mentalhealthquestionnaireResponses.xlsx Cite Share Download PDF Status: Published Journal Publication published 23 Oct, 2024 Read the published version in BMC Psychiatry → Version 1 posted Editorial decision: Revision requested 13 Aug, 2024 Editor assigned by journal 12 Aug, 2024 Submission checks completed at journal 12 Aug, 2024 First submitted to journal 03 Aug, 2024 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-4851266","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":339685374,"identity":"dcf9d943-34c1-498c-8a7e-487bdbc006bd","order_by":0,"name":"Titilola Obilade","email":"","orcid":"","institution":"Nile University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Titilola","middleName":"","lastName":"Obilade","suffix":""},{"id":339685375,"identity":"66293ccd-37c8-4f1b-8e7c-426707d4e8a7","order_by":1,"name":"Peter O. 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Nwenendah-Mpi","email":"","orcid":"","institution":"Nile University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Emelda","middleName":"W.","lastName":"Nwenendah-Mpi","suffix":""}],"badges":[],"createdAt":"2024-08-03 04:06:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4851266/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4851266/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12888-024-06197-x","type":"published","date":"2024-10-23T15:58:04+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":67681980,"identity":"cc0e82bc-fa7a-4b80-8987-eac3f37bb2ca","added_by":"auto","created_at":"2024-10-28 16:12:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1139593,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4851266/v1/631664a6-a9c8-45b2-bc84-9d201487df06.pdf"},{"id":64189292,"identity":"db321208-5d35-4d1d-bb38-30f3f9b528f4","added_by":"auto","created_at":"2024-09-09 17:33:58","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":28315,"visible":true,"origin":"","legend":"","description":"","filename":"mentalhealthquestionnaireResponses.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-4851266/v1/6779a7c00219370a91a4d69d.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAn Investigative Study on Depression Among Clinical Medical Students in Private Universities in North Central Nigeria\u003c/p\u003e","fulltext":[{"header":"1.0 Introduction","content":"\u003cp\u003eMedical students face high rates of depression than students studying other courses. This is usually as a result of stress that is known to be associated with medical schools [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A number of factors, including vast curriculum, multiple academic demands, frequent and challenging exams, etc usually contribute to the stress medical students experience [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The mental and physical strain that an individual feels in reaction to pressure or a dangerous circumstance is known as stress (prolonged or excessive). This has been attributed to depression and mental health deterioration [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Medical students are pushed by stress during the medical school to acquire coping mechanism to deal with these circumstances. A person\u0026rsquo;s cognitive and behavioural coping mechanism are described as ways to manage, reduce, or accept the demands of stressful situations [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In accordance with the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition, depression is described to be a time frame of fortnight during which an individual felt low, stopped participating in everyday activities, and displayed some symptoms such as, issues with consuming food, falling asleep, vitality, attention, or esteem. The description does not include grieving following a period of sorrow [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. It is a serious mental health condition which usually affect huge number of individuals globally. The rate of prevalence is 4.4% of global population [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Depression has a prevalence of 5.4% in Africa, where it is common in females (5.9%) than males (4.9%) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. According to estimates, about 3.1 percent of Nigeria\u0026rsquo;s population has depression [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The World Health Organisation (WHO) identified disability to be linked to depression [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. A comprehensive study in Europe discovered that medical students have depression (6% \u0026minus;\u0026thinsp;65.5%) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe clinical medical students (400 level to 600 level) of Cambridge University were discovered to have depression that varied from 2.2\u0026ndash;10% [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. It is now understood that as these medical students transition to clinical years, they become more susceptible to psychological disorders owing to some self-imposed demands, like setting excessively high academic achievements, having self-doubt, and associating identity with performance [\u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Various studies have also revealed other stressful events in medical school could trigger depression. They include; having limited free time, coming into contact with illness and death, harsh nature of many medical operations, finding it difficult to break bad news to patients\u0026rsquo; families, lack of sleep, peer pressure, fear of failing in medical school, desire to be perceived as a capable doctor, student abuse, etc [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Depression within medical school has been linked to low self-esteem, poor performance in work, as well as social life, academic dishonesty, loss of empathy for patients, suicidal ideation, alcohol and substance abuse, etc [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. One of the main contributors to the disease burden is mental health disorders. Globally, depression together with anxiety were among the top 25 major causes of disease burden for both sexes. A survey of multistage samples of household across the 36 states in Nigeria (above 17 years), showed life-time and 1-year Major Depressive Disorder (MDD) proportions of 3.1% and 1.1% [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUniversity students experience substantial mental strain due to the high demands they must meet in both their academic and familial lives. This mental strain can cause serious mental illness, which could substantially worsen over their programmes in the university. Approximately one-third of college students experience depression, making it a serious health issue in this segment of the population. According to epidemiological data, the frequency of depression rose by 18.4% between 2005 and 2015 [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Considering the belief that medical professionals ought to remain invulnerable, that is not the case, as mental health challenges are common [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Depression is brought on by a number of circumstances, including stress. Long-term stress can cause breakdown and mental health problems, which include depression, nerve collapse, cardiovascular disease, etc [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. According to studies, medical students experience greater stress than students studying other courses hence, they exhibit more depressive symptoms [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Further, medical students also develop coping mechanisms to get them through these stressful conditions. These could be positive or negative. Problem-solving skills and efficient emotion management are linked to positive coping mechanisms while negative mechanisms are associated with negative appraisal, escape from negative situations and social isolation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study conducted in Bayero University showed that 15.1% reported having depression. Mild, moderate, and severe depression rates of incidence were 5.4%, 6.8%, and 2.9%, respectively. Family history serves as a major factor in the mental condition of students. Medical students with family history of depression have higher chances of depression than those without such family history [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A similar study carried out in a New York medical school showed that depression was more than five times greater in them than in controls of the same age [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The research conducted at National University of Singapore revealed a prevalence of 28%. The rate of depression decreases as year of study increases. First-year students had the greatest rate of 33.5% while year 5 was 20.5%. The year of study and academic achievement were linked to depression [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHowever, medical students have developed coping strategies over the years. A study focused on the primary medical and mental health treatment conducted at Yale University showed students had primary physicians, but few admitted going to the doctors when they were ill (33%). Majority of the students were comfortable with seeking academic support [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A similar research in India showed that depressed medical students had access to mental healthcare. Some never made use of it because of choice, informal consultation, confidentiality worries and a desire for self-diagnoses [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The stigma attached to depression in medical school could hinder students from accepting their depressive state and seeking help, because they may be viewed as less intelligent than others [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. A study conducted at University of Saskatchewan, which made use of brief COPE (Coping Oriented to Problems Experienced Inventory) discovered that students make use of mainly adaptive and not maladaptive coping strategies. Emotional support is an example of adaptive coping strategy while substance abuse, venting, blame and self-destruction are examples of maladaptive coping strategy [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. There is scarcity of depression research on medical students in universities located in the North-Central Nigeria. Therefore, this research will establish a baseline for future studies on depression amongst medical students.\u003c/p\u003e"},{"header":"2.0 Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Objectives\u003c/h2\u003e \u003cp\u003eThe study objectives include:\u003c/p\u003e \u003cp\u003e1. to determine depression prevalence amongst clinical medical students from two private universities in North Central Nigeria;\u003c/p\u003e \u003cp\u003e2. to examine the depression coping strategies utilized by clinical students;\u003c/p\u003e\u003cp\u003e3. to examine variables that contribute to depression amongst the clinical students.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Area\u003c/h2\u003e \u003cp\u003eThe study was conducted in two private universities (Nile University of Nigeria and Bingham University) in North-Central Nigeria. There are twenty-five (25) private tertiary institutions in North-Central Nigeria and only three (3) have established a Medicine and Surgery programme (MBBS). These include Nile University of Nigeria, Bingham University and Baze University. At the time of the study, only the Nile University of Nigeria and Bingham University had been accredited to commence their clinical component and both universities share similar academic curriculum. In their preclinical years, both universities offer the same courses: Anatomy, Physiology, Biochemistry and Community Medicine. In the beginning of their clinical years, 400 level university students of both universities offer Pathology, Pharmacology and begin hospital and community based rotations. In the clinical years (500 and 600 levels), they proceed to Obstetrics and Gynecology, Medicine and Surgery and Pediatrics. The medicine programme in Nigeria is a six-year programme with each year referred to as a level.\u003c/p\u003e \u003cp\u003eThe preliminary year is the first (100 level), the preclinical years are the second and third (200 and 300 levels) while the clinical periods of training, which includes hospital and community training placements are the fourth, fifth and sixth years (400 to 600 level) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The Medicine and Surgery (MBBS) programme in Nile University of Nigeria was established in 2016 and attained full accreditation in March/April 2021. The programme currently holds about 346 medical students of which 132 are clinical students [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Amongst the many programmes offered within Bingham University is the MBBS programme which currently has about 850 medical students out of which 483 are clinical students [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study Design And Population\u003c/h2\u003e \u003cp\u003eThe study was both quantitative and institution-based online study. The research included consenting population of clinical students (400 level \u0026ndash; 600 level) in Nile University of Nigeria and Bingham University, Abuja, Nigeria. The inclusion criterion was that the study participants must be consented clinical medical students (400\u0026ndash;600 level) from Nile University of Nigeria and Bingham University. Students with previous history of mental incapacity were excluded.\u003c/p\u003e \u003cp\u003eThe Leslie Fisher\u0026rsquo;s formula for cross sectional descriptive research below was utilized to evaluate the size of the sample for the research [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]:\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:n=\\frac{{z}^{2}p(1-p)}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e,\u003c/p\u003e \u003cp\u003eas:\u003c/p\u003e \u003cp\u003en \u0026rarr; minimum size of sample;\u003c/p\u003e \u003cp\u003ez \u0026rarr; standardized normal deviation;\u003c/p\u003e \u003cp\u003ep \u0026rarr; prevalence of problem globally.\u003c/p\u003e \u003cp\u003eUsing the hypothesis testing method, a previous study conducted revealed that about 15 percent of medical students suffer from depression [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ed \u0026rarr; desired level of precision\u0026thinsp;=\u0026thinsp;5% (that is 0.05).\u003c/p\u003e \u003cp\u003eHence, the sample size is calculated as:\u003cdiv id=\"Equb\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$\\:n=\\frac{{1.96}^{2}\\left(0.33\\right)(1-0.33)}{{0.05}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Equc\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equc\" name=\"EquationSource\"\u003e\n$$\\:n=196.$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThe final sample size was 218. This was to account for non-response and was computed by dividing the minimum sample size by 0.90.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data Collection And Analyses\u003c/h2\u003e \u003cp\u003eA pretested self-administered questionnaire was utilized for the purpose of accurate and comprehensive analysis of the research objectives. The questionnaire contained 4 sections and had twenty-eight questions in total. The first section consisted of nine questions covering the respondents\u0026rsquo; socio-demographic data such as age, gender, university, school level, relationship status, ethnicity, religion, accommodation arrangements and the number of students in a room. The second section utilized a modified version of the PHQ-9, which contains 9 items to evaluate depression severity and presence in respondents. A 4-point rating was used to score the items on PHQ-9 (0 being not at all, 1 being a few days, 2 being more than half the days, and 3 being virtually every day). Higher degree of depression was indicated by higher scores, which can range from 0 to 27 on the overall scale [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. This questionnaire was modified for brevity to a self-administered questionnaire of 7 items with the total now ranging from 0 to 21. Respondents were asked to calculate their scores at the end of this section and those with a score of 4 and above were asked to answer the remaining sections of the questionnaire. Respondents that scored 3 and below were asked to skip to the end of the questionnaire. The items used to assess the severity of depression were ranked on a scale as shown below:\u003c/p\u003e \u003cp\u003e0\u0026ndash;3\u0026thinsp;=\u0026thinsp;no depression;\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e4–7 = mildly depressed;\u003c/h3\u003e\n\n\u003ch3\u003e8–12 = moderately depressed;\u003c/h3\u003e\n\u003cp\u003e13\u0026ndash;16\u0026thinsp;=\u0026thinsp;moderately severe;\u003c/p\u003e\n\u003ch3\u003e17–21 = severely depressed.\u003c/h3\u003e\n\u003cp\u003eThe third section assessed coping strategies to depression using dichotomous questions. This section had eight questions that were classified using the coping styles according to Coping Oriented to Problems Experienced Inventory (COPE). The coping is divided into three, which focused on emotion, avoidant and problem. The fourth section contained the medical student\u0026rsquo;s stressor questionnaire (MSSQ), which were structured questions directed towards assessing the factors that contribute to depressive symptoms of clinical medical students [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA Google form was utilized for the collection of the data for the study. The questionnaire was pretested among a small group of individuals (10\u0026ndash;20) from Nile university of Nigeria, but were later not included in the main study. This aided in the identification of unclear issues as well as ensuring that the content of the questionnaire was universally understood by the participants. All participants properly filled out a separate consent section of the online questionnaire to indicate approval. The questionnaire required respondents to fill in their email addresses before taking part in the survey. This was to ensure that a respondent could not respond more than once. Email addresses of respondents were not traced back to their responses to maintain anonymity. The version 22 of SPSS software (IBM Corp.) was utilized for the analyses. The data\u0026rsquo;s baseline information were described by descriptive analysis. Likewise, association between categorical variables was evaluated by Chi-square test, at 5 percent significant level.\u003c/p\u003e"},{"header":"3.0 Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Descriptive Analyses\u003c/h2\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\u003eSocio-Demographic Characteristics of Respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (211)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon-response (NR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at last birthday (years)\u003c/p\u003e \u003cp\u003e16\u0026ndash;20\u003c/p\u003e \u003cp\u003e21\u0026ndash;25\u003c/p\u003e \u003cp\u003e26\u0026ndash;30\u003c/p\u003e \u003cp\u003e31\u0026ndash;35\u003c/p\u003e \u003cp\u003e36\u0026ndash;40\u003c/p\u003e \u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eMean(Standard Deviation)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003cp\u003e142\u003c/p\u003e \u003cp\u003e18\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003cp\u003e22.2(\u0026plusmn;\u0026thinsp;5.2)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.2\u003c/p\u003e \u003cp\u003e67.3\u003c/p\u003e \u003cp\u003e8.5\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003cp\u003e159\u003c/p\u003e \u003cp\u003e210\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.3\u003c/p\u003e \u003cp\u003e75.7\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e \u003cp\u003e400 level\u003c/p\u003e \u003cp\u003e500 level\u003c/p\u003e \u003cp\u003e600 level\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003cp\u003e71\u003c/p\u003e \u003cp\u003e59\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.4\u003c/p\u003e \u003cp\u003e33.6\u003c/p\u003e \u003cp\u003e28.0\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUniversity\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNile University of Nigeria\u003c/p\u003e \u003cp\u003eBingham University\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e108\u003c/p\u003e \u003cp\u003e103\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003cp\u003e48.8\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTribe\u003c/b\u003e\u003c/p\u003e \u003cp\u003eHausa\u003c/p\u003e \u003cp\u003eIdoma\u003c/p\u003e \u003cp\u003eIgala\u003c/p\u003e \u003cp\u003eIgbo\u003c/p\u003e \u003cp\u003eFulani\u003c/p\u003e \u003cp\u003eYoruba\u003c/p\u003e \u003cp\u003eOthers\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e29\u003c/p\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e33\u003c/p\u003e \u003cp\u003e68\u003c/p\u003e \u003cp\u003e207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.2\u003c/p\u003e \u003cp\u003e3.9\u003c/p\u003e \u003cp\u003e4.3\u003c/p\u003e \u003cp\u003e14.0\u003c/p\u003e \u003cp\u003e4.8\u003c/p\u003e \u003cp\u003e15.9\u003c/p\u003e \u003cp\u003e32.9\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship Status\u003c/b\u003e\u003c/p\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eIn a relationship with boyfriend/girlfriend\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003cp\u003e48\u003c/p\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74.3\u003c/p\u003e \u003cp\u003e22.8\u003c/p\u003e \u003cp\u003e2.9\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003cp\u003eIslam\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003cp\u003e73\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.4\u003c/p\u003e \u003cp\u003e34.6\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAccommodation\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOn campus\u003c/p\u003e \u003cp\u003eOff campus\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153\u003c/p\u003e \u003cp\u003e58\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.5\u003c/p\u003e \u003cp\u003e27.5\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOn campus, number of students in a room\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOne\u003c/p\u003e \u003cp\u003eTwo\u003c/p\u003e \u003cp\u003eThree\u003c/p\u003e \u003cp\u003eMore than three\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e73\u003c/p\u003e \u003cp\u003e30\u003c/p\u003e \u003cp\u003e47\u003c/p\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003cp\u003e47.7\u003c/p\u003e \u003cp\u003e19.6\u003c/p\u003e \u003cp\u003e30.7\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;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 \u003cp\u003eThe Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e above displays the sociodemographic details of study respondents. Age group (21\u0026ndash;25 years) had the highest response of 142 (67.3%). The average age of study respondents was 22.2 years (standard deviation\u0026thinsp;=\u0026thinsp;5.2). Female respondents were 51.4% higher than the male respondents. The highest number of respondents came from 400 level.\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\u003ePatient Health Questionnaire (PHQ)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\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 \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;211)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon-Response (NR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLittle Interest in Doing Things\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003cp\u003e93\u003c/p\u003e \u003cp\u003e31\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.9\u003c/p\u003e \u003cp\u003e44.1\u003c/p\u003e \u003cp\u003e14.7\u003c/p\u003e \u003cp\u003e12.3\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFeeling Down, Depressed or Hopeless\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003cp\u003e84\u003c/p\u003e \u003cp\u003e21\u003c/p\u003e \u003cp\u003e30\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003cp\u003e39.8\u003c/p\u003e \u003cp\u003e10.0\u003c/p\u003e \u003cp\u003e14.2\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrouble Falling Asleep, Staying Asleep or Sleeping Too Much\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003cp\u003e59\u003c/p\u003e \u003cp\u003e32\u003c/p\u003e \u003cp\u003e48\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.1\u003c/p\u003e \u003cp\u003e28.0\u003c/p\u003e \u003cp\u003e15.2\u003c/p\u003e \u003cp\u003e22.7\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFeeling Tired or Having Little Energy\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003cp\u003e89\u003c/p\u003e \u003cp\u003e38\u003c/p\u003e \u003cp\u003e43\u003c/p\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003cp\u003e42.4\u003c/p\u003e \u003cp\u003e18.1\u003c/p\u003e \u003cp\u003e20.5\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePoor Appetite or Overeating\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003cp\u003e69\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e35\u003c/p\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.1\u003c/p\u003e \u003cp\u003e32.9\u003c/p\u003e \u003cp\u003e12.4\u003c/p\u003e \u003cp\u003e16.7\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFeeling Bad About Yourself or That You Are a Failure or Have Let Yourself or Your Loved Ones Down\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003cp\u003e60\u003c/p\u003e \u003cp\u003e19\u003c/p\u003e \u003cp\u003e33\u003c/p\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.7\u003c/p\u003e \u003cp\u003e28.6\u003c/p\u003e \u003cp\u003e9.0\u003c/p\u003e \u003cp\u003e15.7\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDiminished Ability to Think or Concentrate\u003c/b\u003e\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003cp\u003eLess or equal to seven days\u003c/p\u003e \u003cp\u003eMore than seven days\u003c/p\u003e \u003cp\u003eNearly every day for two weeks\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003cp\u003e68\u003c/p\u003e \u003cp\u003e37\u003c/p\u003e \u003cp\u003e27\u003c/p\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.4\u003c/p\u003e \u003cp\u003e32.2\u003c/p\u003e \u003cp\u003e17.5\u003c/p\u003e \u003cp\u003e12.8\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u0026thinsp;=\u0026thinsp;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 \u003cp\u003eAbout a third (68 (32.2%)) of the respondents had diminished ability to think or concentrate.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Respondents\u0026rsquo; Patient Health Questionnaire Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScale of Depression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerately severe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOnly 139 (75%) of the respondents had varying degrees of depression in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Respondents\u0026rsquo; PHQ Scores According to Socio-Demographic Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" 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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\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\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eScales of Depression\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocio-demographic Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;3\u003c/p\u003e \u003cp\u003e(None)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026ndash;7\u003c/p\u003e \u003cp\u003e(Mild)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u0026ndash;12\u003c/p\u003e \u003cp\u003e(Moderate)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u0026ndash;16\u003c/p\u003e \u003cp\u003e(Moderately severe)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17\u0026ndash;21\u003c/p\u003e \u003cp\u003e(Severe)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(22.0)\u003c/p\u003e \u003cp\u003e16(31.4)\u003c/p\u003e \u003cp\u003e51(24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(28.3)\u003c/p\u003e \u003cp\u003e18(35.3)\u003c/p\u003e \u003cp\u003e63(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43(27.0)\u003c/p\u003e \u003cp\u003e10(19.6)\u003c/p\u003e \u003cp\u003e53(25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16(10.1)\u003c/p\u003e \u003cp\u003e5(9.8)\u003c/p\u003e \u003cp\u003e21(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20(12.6)\u003c/p\u003e \u003cp\u003e2(3.9)\u003c/p\u003e \u003cp\u003e22(10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e159(75.7)\u003c/p\u003e \u003cp\u003e51(24.3)\u003c/p\u003e \u003cp\u003e210(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSchool Level\u003c/b\u003e\u003c/p\u003e \u003cp\u003e400\u003c/p\u003e \u003cp\u003e500\u003c/p\u003e \u003cp\u003e600\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(12.3)\u003c/p\u003e \u003cp\u003e17(24.0)\u003c/p\u003e \u003cp\u003e25(42.4)\u003c/p\u003e \u003cp\u003e52(24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(25.9)\u003c/p\u003e \u003cp\u003e27(38.0)\u003c/p\u003e \u003cp\u003e15(25.4)\u003c/p\u003e \u003cp\u003e63(29.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28(34.6)\u003c/p\u003e \u003cp\u003e12(16.9)\u003c/p\u003e \u003cp\u003e13(22.0)\u003c/p\u003e \u003cp\u003e53(25.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13(16.1)\u003c/p\u003e \u003cp\u003e5(7.0)\u003c/p\u003e \u003cp\u003e3(5.1)\u003c/p\u003e \u003cp\u003e21(10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9(11.1)\u003c/p\u003e \u003cp\u003e10(14.1)\u003c/p\u003e \u003cp\u003e3(5.1)\u003c/p\u003e \u003cp\u003e22(10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e81(38.4)\u003c/p\u003e \u003cp\u003e71(33.6)\u003c/p\u003e \u003cp\u003e59(28.0)\u003c/p\u003e \u003cp\u003e211(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eStatus\u003c/b\u003e\u003c/p\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eIn a relationship\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(23.7)\u003c/p\u003e \u003cp\u003e13(27.1)\u003c/p\u003e \u003cp\u003e2(33.3)\u003c/p\u003e \u003cp\u003e52(24.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(30.1)\u003c/p\u003e \u003cp\u003e13(27.1)\u003c/p\u003e \u003cp\u003e2(33.3)\u003c/p\u003e \u003cp\u003e62(29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(26.9)\u003c/p\u003e \u003cp\u003e10(20.8)\u003c/p\u003e \u003cp\u003e1(16.7)\u003c/p\u003e \u003cp\u003e53(25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13(8.3)\u003c/p\u003e \u003cp\u003e7(14.6)\u003c/p\u003e \u003cp\u003e1(16.7)\u003c/p\u003e \u003cp\u003e21(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17(11.0)\u003c/p\u003e \u003cp\u003e5(10.4)\u003c/p\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003cp\u003e22(10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e156(74.3)\u003c/p\u003e \u003cp\u003e48(22.9)\u003c/p\u003e \u003cp\u003e6(2.8)\u003c/p\u003e \u003cp\u003e210(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAccommodation\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eStatus\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOn Campus\u003c/p\u003e \u003cp\u003eOff Campus\u003c/p\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(22.9)\u003c/p\u003e \u003cp\u003e17(29.3)\u003c/p\u003e \u003cp\u003e52(24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(32.0)\u003c/p\u003e \u003cp\u003e14(24.1)\u003c/p\u003e \u003cp\u003e63(29.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(26.8)\u003c/p\u003e \u003cp\u003e12(20.7)\u003c/p\u003e \u003cp\u003e53(25.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15(9.8)\u003c/p\u003e \u003cp\u003e6(10.4)\u003c/p\u003e \u003cp\u003e21(10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13(8.5)\u003c/p\u003e \u003cp\u003e9(15.5)\u003c/p\u003e \u003cp\u003e22(10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e153(72.5)\u003c/p\u003e \u003cp\u003e58(27.5)\u003c/p\u003e \u003cp\u003e211(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDepression was more prevalent in females than males. There was also more severity seen amongst females with 12.6% of them falling under severe depression as opposed to 3.9% of males. Those in 400 level had the highest percentage with severe depression (11.1%), while those in 600 level had the least (5.1%). Depression was more common in those who were single than those who were in a relationship or married. Of those who were single, 11.0% of them had severe depression while there were no severe depression amongst those who were married. Depression was more prevalent than usual amongst those on campus as opposed to those off campus.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePresence of Depression Against Socio-demographic Characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eDepression n(%)\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\u003eAbsent (0\u0026ndash;3)\u003c/p\u003e \u003cp\u003eN1\u0026thinsp;=\u0026thinsp;52\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePresent (4\u0026ndash;21)\u003c/p\u003e \u003cp\u003eN2\u0026thinsp;=\u0026thinsp;159\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN3\u0026thinsp;=\u0026thinsp;N1\u0026thinsp;+\u0026thinsp;N2\u0026thinsp;=\u0026thinsp;211\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocio-demographic Characteristics\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 \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(22.0)\u003c/p\u003e \u003cp\u003e16(31.4)\u003c/p\u003e \u003cp\u003e51(24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124(78.0)\u003c/p\u003e \u003cp\u003e35(68.6)\u003c/p\u003e \u003cp\u003e159(75.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e159(75.7)\u003c/p\u003e \u003cp\u003e51(24.3)\u003c/p\u003e \u003cp\u003e210(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSchool Level\u003c/b\u003e\u003c/p\u003e \u003cp\u003e400\u003c/p\u003e \u003cp\u003e500\u003c/p\u003e \u003cp\u003e600\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(12.3)\u003c/p\u003e \u003cp\u003e17(24.0)\u003c/p\u003e \u003cp\u003e25(42.4)\u003c/p\u003e \u003cp\u003e52(24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71(87.7)\u003c/p\u003e \u003cp\u003e54(76.0)\u003c/p\u003e \u003cp\u003e34(57.6)\u003c/p\u003e \u003cp\u003e159(75.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(38.4)\u003c/p\u003e \u003cp\u003e71(33.6)\u003c/p\u003e \u003cp\u003e59(28.0)\u003c/p\u003e \u003cp\u003e211(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship Status\u003c/b\u003e\u003c/p\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eIn a relationship with boyfriend/girlfriend\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(23.7)\u003c/p\u003e \u003cp\u003e13(27.1)\u003c/p\u003e \u003cp\u003e2(33.3)\u003c/p\u003e \u003cp\u003e52(24.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119(76.3)\u003c/p\u003e \u003cp\u003e35(72.9)\u003c/p\u003e \u003cp\u003e4(66.7)\u003c/p\u003e \u003cp\u003e158(75.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e156(74.3)\u003c/p\u003e \u003cp\u003e48(22.9)\u003c/p\u003e \u003cp\u003e6(2.8)\u003c/p\u003e \u003cp\u003e210(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAccommodation\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOn Campus\u003c/p\u003e \u003cp\u003eOff Campus\u003c/p\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(22.9)\u003c/p\u003e \u003cp\u003e17(29.3)\u003c/p\u003e \u003cp\u003e52(24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118(77.1)\u003c/p\u003e \u003cp\u003e41(70.7)\u003c/p\u003e \u003cp\u003e159(75.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e153(72.5)\u003c/p\u003e \u003cp\u003e58(27.5)\u003c/p\u003e \u003cp\u003e211(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe prevalence of depression reduced as the academic year increased; 400level (87.7%), 500 level (76.0%) and 600 level (57.6%). The least depressed participants were in 600 level (57.6%). Those whose relationship status was single had the highest percentage of depression (76.3%). There was a higher percentage of depression amongst those on campus (77.1%) as opposed than those off campus (70.7%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation Between School levels and Scales of Depression\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" 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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eSchool Levels (400 level \u0026ndash; 600 level)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScales of Depression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e400 n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e500 n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e600 n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal number (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eChi square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMild\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eModerate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(33.3)\u003c/p\u003e \u003cp\u003e28(52.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(42.9)\u003c/p\u003e \u003cp\u003e12(22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15(23.8)\u003c/p\u003e \u003cp\u003e13(24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63(39.6)\u003c/p\u003e \u003cp\u003e53(33.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerately severe\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eSevere\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(61.9)\u003c/p\u003e \u003cp\u003e9(40.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(23.8)\u003c/p\u003e \u003cp\u003e10(45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(14.3)\u003c/p\u003e \u003cp\u003e3(13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21(13.2)\u003c/p\u003e \u003cp\u003e22(13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54(34.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34(21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e159(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e shows the association between school levels and the different scales of depression. There was statistical significance between school levels and, mild and moderate depression (Chi-square value\u0026thinsp;=\u0026thinsp;6.095, p-value\u0026thinsp;=\u0026thinsp;0.047) at 5% significance level but no statistical significance between school levels and, moderately severe and severe depression (Chi-square value\u0026thinsp;=\u0026thinsp;2.372, p\u0026thinsp;=\u0026thinsp;0.305) at 5% significance level.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIdentified Stressors Among Medical Students using Likert Scale\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=\"char\" char=\".\" 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=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" 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 \u003cp\u003eStrongly Agree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrongly Disagree\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHeavy academic workload/getting poor marks/high frequency of examination\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78(49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46(29.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23(14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7(4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4(2.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLack of time for family and friends/relationship problems with partners\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51(32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42(26.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35(21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19(11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13(8.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFinancial constraints e.g. self sponsored\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26(16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28(17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42(26.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39(24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e24(15.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e shows the identified stressors experienced by students. \u0026ldquo;Heavy academic workload/getting poor marks/high frequency of examinations\u0026rdquo; were the most prevalent stressors as the majority of respondents either strongly agreed (49.4%) or agreed (29.1%). This was followed by \u0026ldquo;lack of time for family and friends/relationship problems with partners\u0026rdquo;, as 32.1% strongly agreed and 26.4% agreed.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCoping Strategies Utilized by Respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" 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=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eFrequency(%)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;159\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNon-response\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTalking/discussing with others e.g. relatives, friends/medical personnels\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99(62.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59(37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGoing out with friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57(36.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101(63.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of streaming platforms e.g. Youtube, Netflix, Spotify\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124(78.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of antidepressants under doctor\u0026rsquo;s prescription\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e153(97.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of recreational drugs e.g. alcohol, cannabis, tobacco, caffeine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136(87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGastronomical relief e.g. overeating/excessive ordering of food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60(37.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(62.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleeping excessively\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92(58.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(41.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of social media e.g. Instagram, Snapchat, TikTok, X (Twitter), WhatsApp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e133(84.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRespondents in the survey used some coping mechanisms to cope with medical school\u0026rsquo;s rigour. The most utilized was the social media (84.2%). These include Instagram, Snapchat, TikTok, X (formerly known as Twitter) and Whatsapp, etc. This was followed by the use of streaming platforms (78.5%) such as, Youtube, Netflix, Spotify, etc. Almost two-third of the respondents admitted to talking/discussing with relatives, friends or medical personnel. Approximately thirteen percent admitted to the use of recreational drugs (e.g. alcohol, cannabis, tobacco, caffeine, etc). The least utilized was the use of antidepressants under doctor\u0026rsquo;s prescription (2.5%).\u003c/p\u003e \u003c/div\u003e"},{"header":"4.0 Discussion","content":"\u003cp\u003eThe research revealed both institutions' clinical medical students had significant rate of depression (75.4%). Approximately 30.0% out of this percentage had mild depression, 25.1% had moderate depression, 10.0% had moderately severe and 10.4% had severe depression. The observed prevalence in the research is greater than other similar studies conducted in Nigeria. The observed prevalence in Ebonyi State University was 17.4% [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], Bayero University was 15.1% [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and in a study carried out in both Ekiti State University and Afe Babalola University was 25% [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. This gross disparity could be because the research only focused on students in their clinical components, that is, 400 level to 600 level while these other studies focused on all students from 100 level to 600 level. Another reason could be the study environments; as many of the studies conducted were amongst students in Federal universities who are unfortunately, casualties of unionized protests. While this is counted as a loss, it could also be perceived as a stress relieving period or a break from excessive workload. This is far from the case of students in private universities who are exposed to uninterrupted periods of stress and excessive workload. Some other studies conducted outside Nigeria recorded these proportions of depression among medical students: Egypt 60.8% [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], Cameroun (65.2%) [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], Brazil (34.6%) [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], Pakistan (75.5%) [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], Saudi Arabia (83.4%) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], India (44.4%) [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. This variation in prevalence may be due to difficult teaching methodologies, difference in curriculum, geographical locations and educational components. The various methods and procedures used for depression screening may be the cause of the slight discrepancies in prevalence.\u003c/p\u003e \u003cp\u003eFemales showed more depressive symptoms than the males. This supports the research findings done in Bayero University [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], Al Azhar University Egypt [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] and from a systematic review research [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This may be due to underreporting in males, owing to the culture amongst males not showing vulnerability. However, other research has found that males have greater chances of experiencing depression than females [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Although previous research did not detect a significant link between gender and depression [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. None of the married students had severe depression. This could be because of the comfort and support they receive from their partners.\u003c/p\u003e \u003cp\u003eThe percentage of respondents with depression was highest in 400 level, followed by 500 level while the least proportion was in 600 level. These results from 400 level could be due to 400 level being the period where students transition from preclinical studies to clinical studies and are exposed to hospital and community-based training. The students in their final year (600 level) had the least depression prevalence. It could be due to the anticipation of their graduation and could also be that they have learnt to cope positively with the stress of medical school. This supports the research conducted in Brazil, America and the United Kingdom [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. The study further revealed that people who stayed on campus had higher percentage of depression compared to those off campus. This could be because they were far from their families. Although social media could help in communication with families but internet could be challenging. However, those that are off campus have access to their families and friends, and they also enjoy the comfort of their homes.\u003c/p\u003e \u003cp\u003eCoping Oriented to Problems Experienced Inventory (COPE) divides coping into three, with focus on emotion, avoidant and problem. In this study, emotion-focused coping included talking and discussing with family/friends/medical personnel, usage of social media, such as X (formerly known as Twitter), Instagram, Snapchat, Whatsapp, use of streaming platforms such as YouTube, Netflix, Animekiss, Spotify, while avoidant coping included self-distraction e.g. going out with friends, use of recreational drugs such as alcohol, cannabis, tobacco, gastronomical relief e.g. excessive eating, excessive sleeping, etc. While comment cannot be made deeply about students managing stress, the results from the research revealed clinical medical students utilized healthy coping strategies and not the dysfunctional ones. It can be inferred that these clinical medical students utilized more adaptive than maladaptive coping strategies. A perfect illustration is a study where medical students utilized ranting, was favourably correlated with several adaptive coping mechanisms, as opposed to the maladaptive ones that have often been linked to self-pity, drug use, etc [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. When a stressor is seen to be overpowering beyond one's control, the avoidant/emotional-focused coping technique may prove to be particularly helpful. Therefore, it is possible to support the hypothesis that certain coping mechanisms that are emotion-focused may be less adaptive depending on the circumstance [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. This study revealed that an approximate proportion of 80% of the study participants agreed that heavy academic workload/poor marks/ high frequency of examinations were stressors responsible for depressive symptoms they experienced. A further 58.5% either strongly agreed or agreed that lack of time for family and friends/relationship problems with partners are also stressors responsible for their depressive symptoms while 26.4% were neutral towards financial constraints as a contributing stressor to depressive symptoms they experience. Heavy academic workload/poor marks/high frequency of examination was noted as a significant stressor and this is fairly consistent with other studies done [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e"},{"header":"5.0 Conclusion","content":"\u003cp\u003eThis study\u0026rsquo;s findings have revealed the depression prevalence amongst medical students from private universities in North Central Nigeria. The prevalence is high, as about three-quarters of the participating students had varying degrees of depression.\u003c/p\u003e \u003cp\u003eThe students admitted to utilizing more of adaptive coping strategies mainly; discussing with family, friends and medical personnel, use of streaming platforms such as Netflix, Spotify, YouTube and use of social media platforms, rather than use of recreational drugs such as alcohol, cannabis, etc.\u003c/p\u003e \u003cp\u003eThey attributed their depressive symptoms to the heavy academic workload, poor marks, high frequency of examinations, lack of time for family, friends and relationship problems with partners, and financial constraints.\u003c/p\u003e"},{"header":"6.0 Recommendations","content":"\u003cp\u003eBased on the research\u0026rsquo;s findings, the following recommendations are provided:\u003c/p\u003e\n\u003cp\u003e1. Medical colleges should provide mental health and counselling interventions for students because of the significant rate of depression that we observed in our research.\u003c/p\u003e\n\u003cp\u003e2. Universities especially private universities that do not have interruption in their academic calendars should implement flexible schedule for students to address personal and family needs.\u003c/p\u003e\n\u003cp\u003e3. Universities should provide access to faculty mentors and advisors to assist with time management and work-life balance.\u003c/p\u003e\n\u003cp\u003e4. The universities should provide communication rooms with functioning devices and uninterrupted network to allow on-campus students communicate adequately with their loved ones.\u003c/p\u003e\n\u003cp\u003e5. Medical colleges should encourage student associations and health clubs to provide social events such as game night, movie night and other social activities. These will promote bonding and a sense of belonging amongst students, especially those who stay on campus.\u003c/p\u003e\n\u003cp\u003e6. Universities should have a welfare account to support students who may suffer sudden financial challenges.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study obtained ethical approval from Health Research Ethics Committee of Federal Capital Territory (Nigeria) with Approval Number: FHREC/2022/01/139/22-07-22. The research was in accordance with the Standard Operating Procedures for Health Research Ethics Committees, Federal Ministry of Health, Nigeria. The consents of participants were obtained before participation in the study.\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\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used in the research \u0026nbsp;have been submitted as supplementary file.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing interest has been declared by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the research. \u003cstrong\u003eTO\u0026nbsp;\u003c/strong\u003eand\u003cstrong\u003e\u0026nbsp; \u0026nbsp;EWN\u003c/strong\u003e contributedto the conception of the work. \u003cstrong\u003eTO, POK\u003c/strong\u003e and \u003cstrong\u003eEWN\u0026nbsp;\u003c/strong\u003edesigned the work, analyzed the data and interpreted the results. \u003cstrong\u003eTO and POK\u003c/strong\u003e developed the manuscript and all authors approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe supports of Hauwa Samaila and Hassan A. Alimi are highly appreciated during the data collection process.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePuthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456\u0026ndash;68. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/medu.12962\u003c/span\u003e\u003cspan address=\"10.1111/medu.12962\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuwalska J, Suwalska A, Szczygiel M, Lojko D. Medical students and stigma of depression. Part 2. Self-stigma. Psychiatr Pol. 2017;51(3):503\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.12740/PP/OnlineFirst/67373\u003c/span\u003e\u003cspan address=\"10.12740/PP/OnlineFirst/67373\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlmojali AI, Almalki SA, Alothman AS, Masuadi EM, Alaqeel MK. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Global Health. 2017;7(3):169\u0026ndash;74. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jegh.2017.04.005\u003c/span\u003e\u003cspan address=\"10.1016/j.jegh.2017.04.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePokhrel NB, Khadayat R, Tulachan P. Depression, anxiety and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC Psychiatry. 2020;20(1):1\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoir F, Yielder J, Sanson J, Chen Y. Depression in medical students: current insight. Adv Med Educ Pract. 2018;9:323\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilva V, Costa P, Pereira I, Faria R, Salgueira AP, Costa MJ et al. Depression in medical students: insights from a longitudinal study. BMC Med Educ 2017:17(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCagliostro D, Depression Central. April, : Tell Me All I Need to Know About Depression.2024. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.psycom.net/depression#depressionsigns-amp-symptoms\u003c/span\u003e\u003cspan address=\"https://www.psycom.net/depression#depressionsigns-amp-symptoms\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed: 24th 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organisation. Depression and other common mental disorders: global health estimates. World Health Organization 2017. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://apps.who.int/iris/handle/10665/254610\u003c/span\u003e\u003cspan address=\"https://apps.who.int/iris/handle/10665/254610\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed: 24th April, 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGureje O, Uwakwe R, Oladeji B, Makanjuola VO, Esan O. Depression in adult Nigerians: results from the Nigerian survey of mental health an well-being. J Affect Disorder. 2010;120(1\u0026ndash;3):158\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuraj SS, Umar BI, Gajida AU, Umar MU. Prevalence and factors associated with depression among medical students in Nigeria. Nigerian Postgrad Med J. 2021;28(3):198\u0026ndash;203. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/npmj.npmj_414_21\u003c/span\u003e\u003cspan address=\"10.4103/npmj.npmj_414_21\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacob R, Li TY, Martin Z, Burren A, Watson P, Kant R, Davies R, Wood DF. Taking care of our future doctors: a service evaluation of a medical student mental health service. BMC Med Educucation. 2020;20(1):172. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12909-020-02075-8\u003c/span\u003e\u003cspan address=\"10.1186/s12909-020-02075-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMunn F. Medical student and suicide. BMJ: British Medical Journal. 2017: 357. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/sbmj.j1460\u003c/span\u003e\u003cspan address=\"10.1136/sbmj.j1460\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFirth J. Levels and sources of stress in medical students. Br Med J (Clinical Res Education). 1986;292(6529):1177\u0026ndash;80. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmj.292.6529.1177\u003c/span\u003e\u003cspan address=\"10.1136/bmj.292.6529.1177\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSlavin S. Medical Student Mental Health: Challenges and Opportunities. Med Sci Educ. 2018;28:13\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQuince TA, Wood DF, Parker RA, et al. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open. 2012;e001519. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2012-001519\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2012-001519\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-analysis. JAMA. 2016;316(21):2214\u0026ndash;36. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.2016.17324\u003c/span\u003e\u003cspan address=\"10.1001/jama.2016.17324\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGlobal Health Metrics. Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u0026ndash;2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396:1204\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/S0140-6736(20)30925-9\u003c/span\u003e\u003cspan address=\"10.1016/S0140-6736(20)30925-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGlobal. regional and national burden of 12 mental disorders in 204 countries and territories, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019.The Lancet Psychiatry. 2022; 9(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMirza AA, Baig M, Beyari GM, Halawani MA, Mirza AA. Depression and Anxiety Among Medical Students: a brief overview. Adv Med Educ Pract. 2021;12:393\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/AMEP.S302897\u003c/span\u003e\u003cspan address=\"10.2147/AMEP.S302897\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students. BMJ Case Rep. 2014. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bcr-2014-205226\u003c/span\u003e\u003cspan address=\"10.1136/bcr-2014-205226\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWork Related Stress. www.deakin.edu.au. Available from: www.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.deakin.edu.au/students/health-and-wellbeing/occupational-health-and-safety/work-related-stress\u003c/span\u003e\u003cspan address=\"https://www.deakin.edu.au/students/health-and-wellbeing/occupational-health-and-safety/work-related-stress\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed: 24th April, 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3329/jhpn.v29i5.8906\u003c/span\u003e\u003cspan address=\"10.3329/jhpn.v29i5.8906\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMousa OY, Dhamoon MS, Lander S, Dhamoon AS. The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees. PLoS ONE. 2016;10(6):11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0156554\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0156554\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlum R, Nakwagala FN, Odokonyero R. Prevalence and factors associated with depression among medical students at Makerere University, Uganda. Advances in Medical Education and Practice. 2020, 11:853\u0026ndash;60. Available from doi.org/\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/AMEP.S278841\u003c/span\u003e\u003cspan address=\"10.2147/AMEP.S278841\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015;39(1):37\u0026ndash;46. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s40596-014-0202-z\u003c/span\u003e\u003cspan address=\"10.1007/s40596-014-0202-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety and Suicidal Behaviour: Why Do They Seek Treatment? Indian J Psychol Med. 2022;44(1):10\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/0253717620982326\u003c/span\u003e\u003cspan address=\"10.1177/0253717620982326\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwenk TL, Davis L, Wimsatt LA. Depression, stigma and suicidal ideation in medical students. JAMA. 2010;15(11):1181\u0026ndash;90. 10.100/jama.2010.1300.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOssai EN, Eze II, Onyenakazi RC, Ugebe E, Eze B. Obasi, O. How large is the burden of depression ina medical school? A cross-sectional study among medical students in Nigeria. Pan Afr Med J. 2021;40:1. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.11604/pamj.2021.40.71.29071\u003c/span\u003e\u003cspan address=\"10.11604/pamj.2021.40.71.29071\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHistory of Nile University. 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.nileuniversity.edu.ng/history-of-nile-university\u003c/span\u003e\u003cspan address=\"https://www.nileuniversity.edu.ng/history-of-nile-university\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed: 24th April, 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbout us (Bingham University). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://binghamuni.edu.ng/v2/about\u003c/span\u003e\u003cspan address=\"https://binghamuni.edu.ng/v2/about\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed: 24th April, 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO). Sample size determination in health studies: a practical manual. Geneva, Switzerland: WHO. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://tbrieder.org/publications/books_english/lemeshow_samplesize.pdf\u003c/span\u003e\u003cspan address=\"https://tbrieder.org/publications/books_english/lemeshow_samplesize.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 1991. Accessed: 24th April, 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuhamad SB, Yusoff, Ahmad FA, Rahim, Mohd J, Yaacob. The development and validity of the medical students stressor questionnaire (MSSQ), ASEAN Journal of Psychiatry, Jan-June. 2010: 11(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFalade J, Oyebanji AH, Babatola AO, Falade OO, Olumuyiwa TO. Prevalence and correlates of psychiatric morbidity, comorbid anxiety and depression among medical students in public and private tertiary institutions in a Nigerian state: a cross-sectional analytical study. Pan Afr Med J. 2020;37:53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.11604/pamj.2020.37.53.24994\u003c/span\u003e\u003cspan address=\"10.11604/pamj.2020.37.53.24994\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53(1):77\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNgasa SN, Sama CB, Dzekem BS, Nforchu KN, Tindong M, Aroke D, Dimala CA. Prevalence and factors associated with depression among medical students in Cameroun: a cross-sectional study. BMC Psychiatry. 2017;17(1):216. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12888-017-1382-3\u003c/span\u003e\u003cspan address=\"10.1186/s12888-017-1382-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlharbi H, Almalki A, Alabdan F, Haddad B. Depression among medical students in Saudi medical colleges: a cross-sectional study. Adv Med Educ Pract. 2018;9:887\u0026ndash;91. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/AMEP.S182960\u003c/span\u003e\u003cspan address=\"10.2147/AMEP.S182960\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSajjad W, Samreen A, Shah SAY, Batool A, Umair M, Ahmad T, Abideen Z. Prevalence of depression among medical students: a cross-sectional study. Prof Med J 2021: 28(12). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.29309/TPMJ/2021.28.12.6164\u003c/span\u003e\u003cspan address=\"10.29309/TPMJ/2021.28.12.6164\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlharbi H, Almalki A, Alabdan F, Haddad B. Depression among medical students in Saudi medical colleges: a cross sectional study. Adv Med Educ Pract. 2018;9:887. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003edoi.org/10.2147/AMEP.S182960\u003c/span\u003e\u003cspan address=\"10.2147/AMEP.S182960\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAgrawal N, Sharma S, Meena R, Uppadhaya SK, Mittal M. Prevalence of depression and its associated factors among students of a Medical College in Western Rajasthan. Natl J Community Medice. 2017;8(1):12\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShams Eldin AA, Hassan H, Elkhar OA, Amer S, Kasim K. Prevalence of depression among medical students at Al Azhar University: a cross sectional study. J Community Med Public Health 2017:115:1\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.29011/CMPH 115/100015\u003c/span\u003e\u003cspan address=\"10.29011/CMPH 115/100015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC Med Edu. 2019;19:327.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin F, Zhang LL, Luo ZY, Zhao QQ. Depression and its influence in medical students. China J Health Psychol. 2018;26:622\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang XZ, Chen JW, Feng GS. Correlation between sleep quality and anxiety and depression in medical students. Acta Acad Med Weifang. 2005;27:100\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTamunosiki CA, Chinawa JM, Aniwada EC, Manyike PC, Ndu I, Nduaguba OC. Determinants of depression among medical students in two medical schools from South East Nigeria: a screening test. Ann Nigerian Med. 2018;11:27\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMihailescu AI, Diaconescu LV, Ciobanu AM, Donisan T, Mihailescu C. The impact of anxiety and depression on academic performance in undergraduate medical students. Eur Psychiatry. 2016;33(S1):284. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://doi.org/10.1016/j.eurpsy.2016.01.761\u003c/span\u003e\u003cspan address=\"10.1016/j.eurpsy.2016.01.761\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoutinho IL, Maddalena NC, Roland RK, Lucchetti AL, Tibirica SH, Ezequiel OD, Lucchetti G. Depression, stress and anxiety in medical students: a cross-sectional comparison between students from different semesters. Rev Assoc Med Bras. 2017;63(1):21\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1590/1806-9282.63.01.21\u003c/span\u003e\u003cspan address=\"10.1590/1806-9282.63.01.21\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarver CS. You want to measure coping but your protocol \u0026lsquo;too long\u0026rsquo;: Consider the brief cope. Int J Behav Med. 1997;4(1):92\u0026ndash;100.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuncay T, Musabak I, Gok D, Kutlu M. The relationship between anxiety, coping strategies and characteristics of patients with diabetes. Health Qual Life Outcomes. 2008;6(1):79.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePark CL, Armeli S, Tennen H. Appraisal-Coping Goodness of Fit: A Daily Internet Study. Pers Soc Psychol Bull. 2004;30(5):558\u0026ndash;69.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHill MR, Goicochea S, Merlo LJ. In their own words: stressors facing medical students in the millennial generation. Med Educ Online. 2018;23(1):1530558. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/10872981.2018.1530558\u003c/span\u003e\u003cspan address=\"10.1080/10872981.2018.1530558\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSatpathy P, Siddiqui N, Parida D, Sutar R. Prevalence of stress, stressors, and coping strategies among medical undergraduate students in a medical college of Mumbai. J Educ Health Promotion. 2021;10:318. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jehp.jehp_1395_20\u003c/span\u003e\u003cspan address=\"10.4103/jehp.jehp_1395_20\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Depression, Medical Student’s Stressor Questionnaire, Patient Health Questionnaire, Coping Mechanism, Stressors","lastPublishedDoi":"10.21203/rs.3.rs-4851266/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4851266/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDepression is among known mental health conditions and students in schools of medicine are not immune to it. In this investigative study, 211 clinical medical students of two private universities from North-Central Nigeria were examined on depression prevalence, the contributory factors and their coping strategies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe Patient Health Questionnaire 9 (PHQ-9), the Medical Student\u0026rsquo;s Stressor Questionnaire (MSSQ) and identified coping strategies according to Coping Oriented to Problems Experienced Inventory (COPE) were instruments of data collection.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results were obtained by both descriptive analysis and test of association between some categorical variables. The depression prevalence amongst the participants was 159 (75.4%). Females (124 (78.0%)) were more depressed than males (35 (22.0%)). Factors identified as contributing to depression were the heavy academic workload (124 (78.5%)), insufficient family time (93 (58.1%)) and financial constraints (54 (34.0%)). The most utilized method of coping with their stress was engaging on social media (133 (84.2%)), followed by talking with relatives or friends (99 (62.7%)) and use of recreational drugs (20 (12.8%)). The findings from this study have shown that more than three-quarters of the respondents suffered from varying degrees of depression from mild, 63 (29.9%), moderate, 53 (25.1%) to severe, 43 (20.4%).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe heavy academic workload was a major source of depression. Colleges of Medicine should take pro-active steps towards their students\u0026rsquo; mental health and academic workload should be well spaced to reduce the stress imposed by the frequency of examinations.\u003c/p\u003e","manuscriptTitle":"An Investigative Study on Depression Among Clinical Medical Students in Private Universities in North Central Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-09 17:33:53","doi":"10.21203/rs.3.rs-4851266/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-13T11:22:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-12T12:45:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-12T12:45:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2024-08-03T04:05:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"05ea09df-1597-4ddc-b3a4-c663594d97b9","owner":[],"postedDate":"September 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-10-28T16:04:32+00:00","versionOfRecord":{"articleIdentity":"rs-4851266","link":"https://doi.org/10.1186/s12888-024-06197-x","journal":{"identity":"bmc-psychiatry","isVorOnly":false,"title":"BMC Psychiatry"},"publishedOn":"2024-10-23 15:58:04","publishedOnDateReadable":"October 23rd, 2024"},"versionCreatedAt":"2024-09-09 17:33:53","video":"","vorDoi":"10.1186/s12888-024-06197-x","vorDoiUrl":"https://doi.org/10.1186/s12888-024-06197-x","workflowStages":[]},"version":"v1","identity":"rs-4851266","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4851266","identity":"rs-4851266","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}