Research Article :
Emen Asuquo, Nkporbu A Kennedy, Okechukwu Chibuike, Okafor Nneka T and Onoh Ifeanyinwa Background: The rising prevalence
and burden of Depression among all age groups including medical students have
continued to constitute enormous concern worldwide. Depression has been
associated with cognitive impairment and may impair academic performance. Aim:
To determine the relationship between depression and academic performance among
medical students at the University of Port Harcourt. Methodology: This
descriptive cross-sectional study gained ethical approval . Stratified random
sampling method was used to select the subjects. A well-structured open ended
self-administered socio-demographic questionnaire was administered to the
students. The Zung Self Rated Depression Scale was used to assess the
depression status of each respondent in conjunction with the Diagnostic
Statistical Manual, Version Five (DSM V). The data were analysed using
descriptive and analytical methods. Results: The prevalence of
depression among the medical students was 5.3%. Fourteen students (4.6%) were
mildly depressed while only two respondents had moderate depression. Academic
performance was generally poor among the medical students with depressive
illness compared to those without depression and was worse with increasing
severity of depression(p=0.004). Conclusion: Depression does occur among
medical students at the University of Port Harcourt and significantly affects
academic performance. The
burden of depression and other mental health conditions is on the rise globally
[1], among all age groups including medical students among whom it has
continued to constitute enormous concern, often associated with poor academic
performance, disability and poor quality of life [2-6]. Depression
is a leading contributor to the global burden of disease and is a common
illness with an estimated 350 million people affected worldwide [1]. The World
Mental Health Survey conducted in 17 countries found that an average of 1 in 20
people reported having an episode of depression in the previous year [2].
Prevalence rates of depression vary by country and by region with highest rates
in Afghanistan and lowest in Japan [3]. A
medical school is a tertiary educational institution – or part of such an
institution that teaches medicine, and awards a professional degree that
qualifies one to practice medicine. Although there are several medical schools
in Nigeria, gaining entrance and/or finishing from them is highly competitive
and demanding respectively. It has been found that medical students have a
higher level of depression than their colleagues in other departments as seen
in studies carried out [7-9]. Depression
has been associated with cognitive impairment and may impair academic
performance. Depression is a common disorder that impacts an individual’s
ability to perform life activities [10]. It therefore comes as no surprise that
the depressed medical student performs abysmally; because they lack
self-motivation which is the key ingredient for success. A student who has
consistently performed poorly over a period of time gets depressed, losing the
self-motivation that should have spurred him to try again, further gets
depressed, gives up, feels worthless and academic performance worsens further
and so continues the vicious cycle until the student is at the lowest ebb of
depression. To
determine the relationship between depression and academic performance among
medical students in the University of Port Harcourt. This
study was a descriptive cross-sectional study. Appropriate sample size was
calculated and the stratified random sampling method was used to select the
subjects from all the classes except first year which was considered not a true
medical class and fourth year because there were no medical students in the
class as at the time of the study. A well structured open ended
self-administered socio-demographic questionnaire was administered to the
students. The Zung Self Rated Depression Scale was used to assess the
depression status of each respondent in conjunction with the Diagnostic
Statistical Manual, Version Five (DSM V). Depressive illness was then
correlated with academic performance of the students. The data were analysed
using descriptive and analytical methods. Industrial
actions in the university and hospital affected the continuity of the study.
The sample size was too small and the study is a cross-sectional type, hence,
inadequate for the determination of association between depression and
aforementioned factors. The
prevalence of depression among the medical students was 5.3%. Fourteen students
(4.6%) were mildly depressed while only two respondents had moderate
depression. Year 3 had the highest prevalence with 10.5% followed by final year
with 5.3%, while the only 2 cases of moderate depression were found among
students in year 2 of their medical programme. Academic performance was
generally poor among the medical students with depressive illness compared to
those without depressive illness and academic performance was worse with
increasing severity of depression. Socio-demographic
characteristics of respondents Respondents
within the age group of 20-24 constituted the largest percentage with 146
(47.9%), followed by the age group of 25-29 with 98 (32.1%) while that of 35-39
was the least with 4 (1.3%) (Table 1). Majority
of the respondents were clinical students, constituting about 189 (62.0%) with
the highest proportion of respondents belonging to the year 5 class: 79 (26.0%)
(Table 2).
A
study among undergraduate medical students in the United States of America
found that 23% of the students had clinical depression [6] and it was similar
to the study conducted in the University of Nigeria Teaching Hospital, Enugu
Campus which put the prevalence of depression among medical students at 23.3%
[7]. When compared with a study done by Adewuya et al. on depression
among undergraduate students in universities in Western Nigeria targeting 1206
nonmedical students found that 8.3% of the students met the criteria for major
depressive disorder showing that depression rates are much higher among medical
undergraduates compared with their nonmedical counterparts [8]. Table 1: Socio-Demographic Characteristics and other factors of respondents. Table 2: Academic factors which could lead to depression. In
our study, the prevalence of depression among medical students in the
University of Port Harcourt was 5.3%, with mild depression 4.6%, moderate
depression 0.7% and there were no respondents found with severe depression.
This did not agree with the study done on Mental Depression and coping
strategies among medical students in the University of Nigeria, Enugu Campus by
Nwobi in 2009, which put the prevalence of mild depression at 27.6%, moderate
depression at 8.9% and severe depression 1.6% [11]. It also differed from the
study done by Aniebue et al. also in
the University of Nigeria, Enugu Campus which put the prevalence of depression
at 23.3% [7]. It also differs from findings in other parts of the world which
put the prevalence of depression among medical students between 21-39% [9,12-15]. Possible
reasons for this disparity in findings between our study and others already
done may be that our respondents possibly were not very honest with information
provided in the questionnaires, they have better coping mechanisms and social
support structures as most of our respondents have parents who live together. Also,
the low prevalence of depression found could also be due to the fact that our
study was done at a time when access to the internet, social media and other
forms of relaxation are easier to access. Information is just a click away from
the average medical student, the volume of work to be studied is available as
soft copy on smart phones and the availability of e-library in the institution
of study, thus helping to reduce the burden of learning on the medical student.
This was different from what was obtainable a decade ago. Majority
of our respondents who were found to be depressed were female and there were
more students found to be depressed in the lower classes (basic medical
sciences), though these factors were not statistically significant. However,
in our study, most of those found to be depressed fell into the age bracket of
25 to 29 years with a lower level of depression among the very young (15 -19 years)
and those greater than 30years. In our study, there was no established
relationship between depression and other factors like having mother alive respondents living alone, if
respondents were living on or off campus, if they were coerced into studying
medicine and if they had lost any close friends or relatives in the last two
years. Academic
performance is influenced by mental health, financial background and age. In
this study, it was observed that 78 (25.6%) of the respondents admitted that
their academic performance has dwindled, while admitted that their performance
is not a reflection of efforts put in to academic study. A total of 193 (69.4%)
respondents reported being under constant pressure to perform better. A total
of 16 respondents met the criteria for depression. Previous studies found that
depression was a form of mental health problem, which interferes with daily
life functioning and causes emotional pain to the affected individual as well
as the people around him [16,17]. University medical students face many
problems such as prolonged separation from their families, entrance into a new
environment, academic pressures occasion by programme policies like withdrawal
after certain number of examination attempts and period of stay, and adaption
to educational standards [16,17]. These cumulatively predispose them to having
psychological problems particularly depression and anxiety [16,17]. Depression
remains a major cause of morbidity and reduced productivity the world over. It
is closely associated with anxiety and stressful conditions. Depression was
found to correlate positively with reduced academic performance. Efforts should
be put in place to reduced stress, anxiety and depression and encourage healthy
living among our future doctors. ·
It
is needful for the school authorities, student bodies, religious associations
and families to be aware of the risks of depression and continually reach out
to, and provide loving support and encouragement for those living with
depression. · The
student-advisor-mentorship structure should be improved upon so that students
may be able to relate their academic challenges to their mentors, who in turn
can offer solutions to them.
·
Students
should be encouraged to pursue extracurricular activities of interest to help
ease off the stress of medical training. *Corresponding author:
Nkporbu A Kennedy, Department of Preventive and Social Medicine, University of
Port Harcourt, Nigeria, Email: nakpigi2008@yahoo.com Citation: Asuquo E, Nkporbu AK, Okechukwu C, Onoh I and Okafor T. Correlation of
depressive illness with academic performance among medical students at the
university of port harcourt (2020) Edelweiss Psyi Open Access 4: 18-21. Depression, Academic performance, Medical students,
Uniport..Correlation of Depressive Illness with Academic Performance Among Medical Students at the University of Port Harcourt
Abstract
Full-Text
Introduction
Aim
Methodology
Limitation
Results
Discussion
Conclusion
Recommendations
References
Keywords
