Depression, Anxiety and Stress in Medical Students: An Early Observation Analysis

Hajira Ramlan, Norrul Izuhan Shafri, Suzaily Wahab, Mohammad Arif Kamarudin, Roslee Rajikan, Noor Alaudin Abdul Wahab, Hanafi Ahmad Damanhuri


Studying a medical degree can create a stressful environment for students who are in the pre-clinical or clinical phase of their course. This study aims to determine both the effect of a medical programme on levels of depression, anxiety, and stress among Universiti Kebangsaan Malaysia (UKM) medical students before and during the course. A study was conducted with 133 first-year medical students enrolled in the 2018/2019 academic session in UKM. Levels of depression, anxiety and stress were measured using a validated questionnaire—the 21-item Depression Anxiety Stress Scale (DASS-21)—at two different time intervals: during orientation week (time 0) and early in the second semester (time 1). The collected data undergo statistical assessment with Wilcoxon Signed Ranks Test, Mann-Whitney U Test and Kruskal-Wallis H Test using SPSS v25.0. The medical students comprised 25.6% (n = 34) males and 74.4% (n = 99) females. More than half were Malay (60.9%, n = 81), followed by Indian (18%, n = 24), Chinese (12%, n = 16) and other races (9%, n = 12). There was a significant increase in depression (Z = -4.263, p < 0.001), anxiety (Z = -2.235, p = 0.025) and stress (Z = -4.783, p < 0.001) symptoms among UKM medical students after starting the medical programme. Unhealthy level of anxiety was found to be highly prevalent compared with depression and stress, at both time intervals. The association between anxiety and race during the medical programme appeared to be significant (Z = 11.694, p = 0.009). The medical students experienced higher depression, anxiety, and stress symptoms as early as 6 months during the medical programme. Preventive measures should be taken at an early stage to maintain medical students’ good psychological health.


Depression; Anxiety; Stress; Medical program; University students.

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