<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_gp-2019-0019_s_007_w2aab3b8c31b1b7b1aab1c14b1Aa"><h3>Objectives</h3><p>This study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.</p></sec><sec id="j_gp-2019-0019_s_008_w2aab3b8c31b1b7b1aab1c14b2Aa"><h3>Methods</h3><p>This observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1<sup>st</sup> January to 31<sup>st</sup> March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.</p></sec><sec id="j_gp-2019-0019_s_009_w2aab3b8c31b1b7b1aab1c14b3Aa"><h3>Results</h3><p>In total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P &lt; 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.</p></sec><sec id="j_gp-2019-0019_s_010_w2aab3b8c31b1b7b1aab1c14b4Aa"><h3>Conclusions</h3><p>According to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.</p></sec></abstract>

ObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.

Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Global Psychiatry

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

ObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school....

Variable	Subcategory	Frequency	Percentage
Stress levels	< 8.00	204	57.8
Stress levels	> 9.00	149	42.2
Subjective sleep quality	Very good	87	24.6
	Good	172	48.7
	Poor	70	19.8
	Very poor	24	6.8
Sleep latency	Very good	127	36.1
	Good	119	33.8
	Poor	72	20.5
	Very poor	34	9.7
Sleep duration	Very good	143	40.6
	Good	94	26.7
	Poor	73	20.7
	Very poor	42	11.9
Habitual sleep efficiency	Very good	207	58.8
	Good	60	17.0
	Poor	33	9.4
	Very poor	52	14.8
Sleep disturbances	Very good	26	7.4
	Good	220	62.3
	Bad	98	27.8
	Severe	9	2.5
Use of sleeping medications	Never in last month	242	68.6
	Less than once in a week	67	19.0
	Once or twice in a week	33	9.3
	More than thrice in a week	11	3.1
Daytime dysfunction	Very good	94	26.6
	Good	137	38.8
	Bad	84	23.8
	Severe	38	10.8
PSQI	< 5.00	148	41.9
PSQI	> 6.00	205	58.1
Severity of depressive symptoms	Minimal	60	17.0
	Mild	104	29.5
	Moderate	104	29.5
	Moderately severe	54	15.3
	Severe	31	8.8

Variable		Count	Percentage (%)
Age	Mean = 20.57
Gender	Male	154	43.6
Gender	Female	199	56.4
Year of study	First	106	30.0
	Second	113	32.0
	Third	17	4.8
	Fourth	117	33.1
Background	Rural	78	22.1
Background	Urban	275	77.9
Residence	Day scholar	189	53.5
Residence	Hostel	164	46.5

Variables	B	Standard error	Beta coefficient	t value	p-value
(Constant)	0.883	5.785		0.153	0.879
Age	0.059	0.279	0.015	0.211	0.833
Gender	0.271	0.568	0.022	0.477	0.633
Year of study	-0.435	0.358	-0.086	-1.217	0.225
Background	0.058	0.687	0.004	0.085	0.932
Residence	0.648	0.547	0.052	1.185	0.237
Subjective sleep quality	1.105	0.393	0.150	2.814	0.005
Sleep latency	1.080	0.319	0.169	3.387	0.001
Sleep duration	-0.196	0.293	-0.033	-0.671	0.503
Habitual sleep efficiency	0.276	0.274	0.049	1.007	0.314
Sleep disturbances	0.593	0.509	0.059	1.166	0.245
Use of sleeping medications	0.039	0.388	0.005	0.099	0.921
Daytime dysfunction	0.812	0.332	0.124	2.446	0.015
Stress	0.739	0.101	0.349	7.295	0.000
Social support	-0.423	0.245	-0.078	-1.723	0.086

Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Published Online: Oct 13, 2019

Page range: 211 - 220

Received: Aug 04, 2019

Accepted: Sep 01, 2019

DOI: https://doi.org/10.2478/gp-2019-0019

Keywords
Sleep, Pittsburgh Sleep Quality Index, stress, depression, social support, patient health questionnaire, medical students, Pakistan

© 2019 Ahmed Waqas et al. published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Stress and poor sleep quality among medical and dental students

Characteristics of the respondents (n = 353)

Predictors of depression among respondents

Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Published Online: Oct 13, 2019

Page range: 211 - 220

Received: Aug 04, 2019

Accepted: Sep 01, 2019

DOI: https://doi.org/10.2478/gp-2019-0019

KeywordsSleep, Pittsburgh Sleep Quality Index, stress, depression, social support, patient health questionnaire, medical students, Pakistan

© 2019 Ahmed Waqas et al. published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Stress and poor sleep quality among medical and dental students

Characteristics of the respondents (n = 353)

Predictors of depression among respondents

Keywords
Sleep, Pittsburgh Sleep Quality Index, stress, depression, social support, patient health questionnaire, medical students, Pakistan