American Journal of Educational Research, 2016, Vol. 4, No. 13, 937-942
Available online at http://pubs.sciepub.com/education/4/13/4
©Science and Education Publishing
DOI:10.12691/education-4-13-4
Depression, Anxiety, and Stress in Sudanese Medical
Students: A Cross Sectional Study on Role of Quality of
Life and Social Support
Mohamed Dafaalla
1,*
, Abdulraheem Farah
2
, Shaima Bashir
2
, Ammar Khalil
2
, Rabab Abdulhamid
2
,
Mousab Mokhtar
2
, Mohamed Mahadi
2
, Zulfa Omer
2
, Asgad Suliman
2
, Mohammed Elkhalifa
2
, Hanin Abdelgadir
2
,
Abdelmoneim E.M. Kheir
3
, Ihab Abdalrahman
4
1
Diploma of Statistics, Executive Manager of Soba Centre for Audit and Research, Soba university Hospital, Khartoum, Sudan
2
Fellow of Soba Centre for Audit and Research (SCAR), Khartoum, Sudan
3
Department of Paediatrics, Faculty of Medicine, University of Khartoum and Soba University Hospital
4
Medicine, Faculty of Medicine, University of Khartoum and Soba University Hospital Khartoum, Sudan
*Corresponding author: mdafaallah200@gmail.com
Abstract We aimed to find out the prevalence of depression, anxiety and stress among medical students in a
developing country, and to find the possible role of social support and quality of life in developing depression,
anxiety, and stress.We did a cross sectional study in medical students of faculty of medicine in Khartoum, Sudan.
We did a clustered random sampling in students from the second to sixth year and collected 500 questionnaires of
which 487 were suitable for analysis. The data collection tool composed of three questionnaires; MOS social support
survey, Depression, anxiety, and stress scale (DASS21), and WHO quality of life brief (WHOQOLB) questionnaire.
More than 50% of respondents had different grades of depression, anxiety, and stress where 21%, 22%, and 16%
had moderate degree of depression, anxiety, and stress respectively. Quality of environment and physical health
were the major determinant of depression, anxiety, and stress (R=0.252-0.465, P values <0.001). From the four
domains of social support assessed by MOS survey, there was significant association only between positive social
interaction domain and depression (R=0.354, P<0.001). There was no significant association between social support
and stress and anxiety. There was no significant differences in depression scores among different academic years
(P=0.246). However, stress and anxiety showed significant differences in different academic years, notably between
the middle years, and second and final years (P=0.043 and 0.00 respectively). The quality of environment and
physical health seems to play a key role in student mental health.
Keywords: depression, anxiety, stress, medical students, social support, quality of life, developing country
Cite This Article: Mohamed Dafaalla, Abdulraheem Farah, Shaima Bashir, Ammar Khalil, Rabab
Abdulhamid, Mousab Mokhtar, Mohamed Mahadi, Zulfa Omer, Asgad Suliman, Mohammed Elkhalifa, Hanin
Abdelgadir, Abdelmoneim E.M. Kheir, and Ihab Abdalrahman, “Depression, Anxiety, and Stress in Sudanese
Medical Students: A Cross Sectional Study on Role of Quality of Life and Social Support.” American Journal of
Educational Research, vol. 4, no. 13 (2016): 937-942. doi: 10.12691/education-4-13-4.
1. Introduction
Medical students experience depression, burnout, and
mental illness at a higher rate than the general population,
with mental health deteriorating over the course of
medical training. [1] prevalence of depression among
medical students is high ranging from 30 to 50%, although
in one study it was as low as 14.7%. [2,3,4] Anxiety
prevalence showed high variation between different
studies from 21.9 to 66.9%. [3,5,6,7] Previous studies
showed that depression leads to increased rate of suicide
among medical doctors. [5,8] Studies also found that
stress leads to increased incidence of anxiety and
depression and most commonly a decline in academic
performance among medical students. [9] In the same way,
student distress may influence professional development
and adversely impact academic performance contributing
to academic dishonesty and substance abuse, and may
play a role in attrition from medical school. [10] Moreover,
Medical students are less likely than the general
population to receive appropriate treatment despite
seemingly better access to care, and may engage in
potentially harmful methods of coping, such as excessive
alcohol consumption, and, despite their training, may fail
to recognize that depression is a significant illness that
requires treatment. [1]
Student stress has been associated with a variety of
negative outcomes, including effects on general and
health-related quality of life. Stress may not only impair
the quality of life of medical students but can also
influence patient care and the complex psychodynamics of
the doctor- patient relationship. [11] As a consequence of
increased stress, medical students can experience an
alarming amount of stress-associated anxiety, depression,