Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine
Original article

Prevalence of depression among Libyan medical students

Prevalencia de depresión entre los estudiantes de medicina de Libia

Roba F. Sherif, Nagat M. Saeed, Gofran A. Sherif, Khiria S. Rabab, Fathi M. Sherif

Downloads: 2
Views: 394


Introduction: Psychological stress is a common psychiatric disorder in medical students and sometimes is associated with depression. Students at university usually met a great pressure that they face in their study life and to the hard circumstances in the everyday life. The aim of this study is to estimate the prevalence of depression and stress among university medical students in Libya.
Materials and methods: Data was collected by three different questionnaires: the first questionnaire is 6-ITEM Kutcher Adolescent Depression Scale (KADS), the second questionnaire is Patient Health Questionnaire-9 (PHQ-9) which are used to diagnose and to assess the severity of depression. The third questionnaire is a simplified self-scoring test for evaluating stress and tension levels. The three questionnaires have all been distributed to the medical sciences students at University of Tripoli in March and May, 2019. According to the registered students in the academic year, 2018/2019, the sample size was composed of 170 students.
Results: The major finding of screening revealed that 45% of the total students suffering from depression during their study. This high prevalence composed of mild and moderate type of depression among the students (45% and 25%, respectively). On the other hand, about 40% and 50% of the students have identified as mild and moderate stress, respectively. About 10% of the students have detected as severe stress.
Conclusions: This study indicates a high prevalence of mild and moderate depression among medical university students in Libya. Results suggest that university mental health services and programs addressing the students are highly recommended.


Anxiety; Depression; Libya; Medical students; Screening; Stress


Introducción: El estrés psicológico es un trastorno psiquiátrico común en los estudiantes de medicina y, en ocasiones, se asocia con la depresión. Los estudiantes universitarios suelen encontrarse con una gran presión a la que se enfrentan en su vida de estudio y ante las duras circunstancias de la vida cotidiana. El objetivo de este estudio es estimar la prevalencia de depresión y estrés entre estudiantes universitarios de medicina en Libia.
Materiales y métodos: Los datos se recopilaron mediante tres cuestionarios diferentes: el primer cuestionario es la Escala de depresión adolescente de Kutcher de 6 elementos (KADS), el segundo cuestionario es el Cuestionario de salud del paciente-9 (PHQ-9) que se utiliza para diagnosticar y evaluar la gravedad de depresión. El tercer cuestionario es una prueba de autoevaluación simplificada para evaluar los niveles de estrés y tensión. Los tres cuestionarios se han distribuido a los estudiantes de ciencias médicas de la Universidad de Trípoli en marzo y mayo de 2019. Según los estudiantes registrados en el año académico 2018/2019, el tamaño de la muestra estaba compuesto por 170 estudiantes.
Resultados: El principal hallazgo de la evaluación reveló que el 45% del total de estudiantes sufrían depresión durante su estudio. Esta alta prevalencia estaba compuesta por depresión de tipo leve y moderada entre los estudiantes (45% y 25%, respectivamente). Por otro lado, alrededor del 40% y 50% de los estudiantes se han identificado con estrés leve y moderado, respectivamente. Alrededor del 10% de los estudiantes han detectado un estrés severo.
Conclusiones: Este estudio indica una alta prevalencia de depresión leve y moderada entre los estudiantes universitarios de medicina en Libia. Los resultados sugieren que los servicios y programas universitarios de salud mental dirigidos a los estudiantes son altamente recomendados.

Palabras clave

Ansiedad; Depresión; Libia; Estudiantes de medicina; Rastreo; Estrés


1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). 5th ed. American Psychiatric Publishing: 2013.
2. World Health Organization. Suicide prevention. Available from: https://www.who.int/health-topics/suicide#tab=tab_1 (accessed Feb 2021).
3. Fava M, Cassano P. Mood disorders: Major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, editors. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia: Mosby Elsevier; 2008:29.
4. Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry. 2000;157(4 Suppl):1-45.
5. Little A. Treatment-resistant depression. Am Fam Physician. 2009;80(2):167-72.
6. Patel V, Pereira J, Mann AH. Somatic and psychological models of common mental disorder in primary care in India. Psychol Med. 1998;28(1):135-43. doi: 10.1017/s0033291797005941.
7. Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Depression Scale. J Reprod Infant Psychol. 1990;8:99-107. doi: 10.1080/02646839008403615.
8. Sarokhani D, Delpisheh A, Veisani Y, Sarokhani MT, Manesh RE, Sayehmiri K. Prevalence of Depression among University Students: A Systematic Review and Meta-Analysis Study. Depress Res Treat. 2013;2013:373857. doi: 10.1155/2013/373857.
9. Forbes. Study Undermines Case for Antidepressants. Available from: https://www.forbes.com/2010/01/05/antidepressant-paxil-placebo-business-healthcare-depression.html?sh=e08b0a738a39 (accessed Feb 2021).
10. Devane CL, Chiao E, Franklin M, Kruep EJ. Anxiety disorders in the 21st century: status, challenges, opportunities, and comorbidity with depression. Am J Manag Care. 2005;11(12 Suppl):S344-53.
11. Barbee JG. Treatment-Resistant Depression: Advances in Assessment. Psychiat Times. 2008;25(10).
12. Pratt LA, Brody DJ. Depression in the U.S. household population, 2009-2012. NCHS Data Brief. 2014;(172):1-8.
13. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). 2016. Available from http://www.samhsa.gov/data/.
14. Nazroo JY, Edwards AC, Brown GW. Gender differences in the prevalence of depression: artefact, alternative disorders, biology or roles? Sociol Health Illn. 1998;20(3);312-30. doi: 10.1111/1467-9566.00104.
15. Kalibatseva Z, Leong FT. Depression among Asian Americans: Review and Recommendations. Depress Res Treat. 2011;2011:320902. doi: 10.1155/2011/320902.
16. Mental Health America Stress. Available from: https://www.mhanational.org/conditions/stress(accessed Feb 2021).
17. Simandan D. On how much one can take: relocating exploitation and exclusion within the broader framework of allostatic load theory. Health Place. 2010;16(6):1291-3. doi: 10.1016/j.healthplace.2010.08.009.
18. Jones F, Bright J, Clow A. Stress: myth, theory and research. New York: Prentice Hall; 2001.
19. McGonagle KA, Kessler RC. Chronic stress, acute stress, and depressive symptoms. Am J Community Psychol. 1990;18(5):681-706. doi: 10.1007/BF00931237.
20. Sapolsky RM. Why Zebras Don't Get Ulcers. MacMillan USA; 2004.
21. Bowman RE, Beck KD, Luine VN. Chronic stress effects on memory: sex differences in performance and monoaminergic activity. Horm Behav. 2003;43(1):48-59. doi: 10.1016/s0018-506x(02)00022-3.
22. January J, Madhombiro M, Chipamaunga S, Ray S, Chingono A, Abas M. Prevalence of depression and anxiety among undergraduate university students in low- and middle-income countries: a systematic review protocol. Syst Rev. 2018;7(1):57. doi: 10.1186/s13643-018-0723-8.
23. Mahroon ZA, Borgan SM, Kamel C, Maddison W, Royston M, Donnellan C. Factors Associated with Depression and Anxiety Symptoms Among Medical Students in Bahrain. Acad Psychiatry. 2018;42(1):31-40. doi: 10.1007/s40596-017-0733-1.
24. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214-36. doi: 10.1001/jama.2016.17324.
25. Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456-68. doi: 10.1111/medu.12962.
26. Sun Y, Fu Z, Bo Q, Mao Z, Ma X, Wang C. The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry. 2020;20(1):474. doi: 10.1186/s12888-020-02885-6.
27. Tam W, Lo K, Pacheco J. Prevalence of depressive symptoms among medical students: overview of systematic reviews. Med Educ. 2019;53(4):345-54. doi: 10.1111/medu.13770.
28. Quynh AT, Dunne MP, Ngoc HL. Well-being, depression and suicidal ideation among medical students throughout Vietnam. Vietnam J Med Pharm. 2014;6(3):23-30.
29. Azad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety And Depression In Medical Students Of A Private Medical College. J Ayub Med Coll Abbottabad. 2017;29(1):123-7.
30. Ibrahim MB, Abdelreheem MH. Prevalence of anxiety and depression among medical and pharmaceutical students in Alexandria University. Alexandria J Med. 2015;51(2):167-73. doi: 10.1016/j.ajme.2014.06.002.
31. Wahed WYA, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53:77-84. doi: 10.1016/j.ajme.2016.01.005.
32. Elsawy WIH, Sherif AAR, Attia MSED, El-Nimr NA. Depression among medical students in Alexandria, Egypt. Afr Health Sci. 2020;20(3):1416-25. doi: 10.4314/ahs.v20i3.47.
33. Shawahna R, Hattab S, Al-Shafei R, Tab'ouni M. Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students. BMC Psychiatry. 2020;20(1):244. doi: 10.1186/s12888-020-02658-1.
34. Paura L, Arhipova I. Cause analysis of students’ dropout rate in higher education study program. Procedia Soc Behav Sci. 2014;109:1282-6. doi: 10.1016/j.sbspro.2013.12.625.
35. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, Shanafelt TD. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89(3):443-51. doi: 10.1097/ACM.0000000000000134.
36. Jackson WC. Mindfulness and Perfectionism in Dentistry. J Mass Dent Soc. 2017;66(1):12-3.
37. Pham T, Bui L, Nguyen A, Nguyen B, Tran P, Vu P, et al. The prevalence of depression and associated risk factors among medical students: An untold story in Vietnam. PLoS One. 2019;14(8):e0221432. doi: 10.1371/journal.pone.0221432.
38. Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90. doi: 10.1001/jama.2010.1300.
39. Yusoff MSB, Yee LY, Wei LH, Siong TC, Meng LH, Bin LX, et al. A study on stress, stressors and coping strategies among Malaysian medical students. Int J Stud Res. 2011;1:45-50.
40. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-73. doi: 10.1097/00001888-200604000-00009.
41. Elias H, Ping WS, Abdullah MC. Stress and academic achievement among undergraduate students in Universiti Putra Malaysia. Procedia Soc Behav Sci. 2011;29:646-55. doi: 10.1016/j.sbspro.2011.11.288.
42. Seedhom AE, Kamel EG, Mohammed ES, Raouf NR. Predictors of Perceived Stress among Medical and Nonmedical College Students, Minia, Egypt. Int J Prev Med. 2019;10:107. doi: 10.4103/ijpvm.IJPVM_6_18.

Submitted date:

Reviewed date:

Accepted date:

Publication date:

60886339a9539534b90c4b82 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections