Prevalence and Factors Associated with Depression, Anxiety, and Stress among Undergraduate Management Students in Kathmandu, Nepal Show Anita Shakya1*, Krishna Sharma2, 3 1Undergraduate Student, Department of Public Health, Kantipur Academy of Health Sciences, Purbanchal University, Kathmandu, Nepal. 2Training/Field Supervisor for Maternal and Neonatal Health, One Heart Worldwide, Lalitpur, Nepal. 3Bachelor of Public Health, National Academy for Medical Science, Faculty of Medical and Allied Sciences, Purbanchal University, Kathmandu, Nepal. *Corresponding Author: Anita Shakya, Undergraduate Student, Department of Public Health, Kantipur Academy of Health Sciences, Purbanchal University, Kathmandu, Nepal. Abstract Methods: Findings: Conclusion: Keywords: Depression, Anxiety, Stress, Mental Health, Kathmandu Introduction An individual's mental health includes cognitive, behavioral, and emotional well-being, as well as their thoughts, feelings, and behaviors, which matter most for mental health. The term "mental health" is sometimes used to refer to the absence of mental disorders [1]. Various conditions can affect mental health and disrupt a person's daily life, including stress, depression, and anxiety [1]. Depression is a common mental disorder characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities, which also disturbs sleep and appetite [2]. Anxiety is a feeling of unease, such as worry or fear, which can be mild or severe [3]. Stress is any change that causes physical, emotional, or psychological strain. Additionally, stress is our body's response to anything that requires attention or action [4]. Depression, anxiety, and stress are the most common mental health disorders globally, and more than 264 million people of all ages suffer from depression [7]. It has been projected that in 2020, suicide accounts for one death every 20 seconds, and the large majority of those occur in low and middle-income countries [8]. Depression is the world's leading cause of disability and contributes significantly to the global disease burden. The previous study shows that the higher level of psychiatric morbidity and depression was 29.9 %, anxiety at 41.1 %, and stress at 27 % among undergraduate medical students [9]. Similarly, among Slovak students, the prevalence rate of somatic complaints, anxiety, and depression was 69.5, 34.6, and 47 %, respectively [6]. Depression is also common among Nepalese medical students, especially in their first year with the high pressure of college studies [5]. However, the mental health issue is still largely ignored and has not been given priority. To our knowledge, no study reported the prevalence and factors associated with depression, anxiety, and stress among undergraduate management students in the Kathmandu district. Since Kathmandu is Nepal's education hub, students from all over the country prefer to come to Kathmandu for higher education. There is also limited information regarding risk factors associated with the causation of depression, anxiety, and stress in Nepal. This research study aimed to assess the prevalence and risk factors associated with depression, anxiety, and stress among undergraduate management students in the Kathmandu District. Methods Study Area: Study
Population: Sample Size: By using formula Sample size = 600 However, we were only able to collect 516 samples for this study since the rest of the students refused to participate. Sampling Techniques: Tools and Techniques for Data Collection: Data Management, Analysis, and Interpretation Procedures: Validity and Reliability of Tools: Inclusion Criteria: Ethical Consideration: Confidentiality: Timeframe of the Study: Operational Definitions: Anxiety Stress Table 1:Cut-off scores table for conventional severity label
Results Table 2: Socio-demographic and academic characteristics of respondents (n=516)
Personal and behavioral characteristics of respondents: Table 3: Personal and Behavioral characteristics of respondents (n=516)
Prevalence of depression, anxiety, and stress among undergraduate management students: Table 4: Prevalence of depression, anxiety, and stress among undergraduate management students (n=516)
Table 5: DAS level among undergraduate management students (n=516)
Association of independent variables with depression, anxiety, and stress: Table 6:Association of depression, anxiety, and stress with independent variables (n=516)
Discussion In our study, the prevalence of depression (57.8 %), anxiety (60.9 %), and stress (43 %) are higher in Kathmandu, Nepal, than those found in a recent study conducted among Nepalese undergraduate students in Pokhara, which showed the overall prevalence of depression, anxiety, and stress at 38.2 %, 46. 9 %, and 24.1 %, respectively [10]. In comparison to stress and depression, anxiety is correspondingly more common among undergraduate students in Kathmandu. The prevalence rate of extremely severe depression, anxiety, and stress was about 9.1 %, 23.8 %, and 7 %, respectively. It also revealed moderate levels of depression, anxiety, and stress among undergraduate management students at 22.7 %, 18 %, and 15.3 %, respectively, compared with a previous study that also showed a similar prevalence of 25 %, 17 %, and 9 % of moderate levels of depression, anxiety, and stress [13]. In contrast to males, females are more likely to experience depression (62.8 %), anxiety (64.2 %), and stress (50 %) than males (37.2 %, 57 %, and 35.1 %, respectively). Similarly, our study also found that depression and stress are statistically strongly related to gender (p =0.014 < 0.05 and p =0.001 < 0.05, respectively). The pressure to marry at an early age, the pressure to be self-dependent, and less support from family and friends could be the principal cause, as Nepalese society has distinct psychological insecurities toward female students as they mature with college studies, especially if they live outside their home district. Conversely, a survey among undergraduate students in Shaanxi province during the COVID-19 epidemic in China found that male students had higher rates of depression, anxiety, and stress symptoms than female students, as females get more support from family and friends [12]. The findings further reveal that the prevalence of depression seems to be affected by numerous variables such as family income, courses of study, the death of a family member, break-ups with loved ones, and other personal habits. It also revealed that the possibility of depression increases with age (18–22 years old of 57.2 %, 23–27 of 63.9, and 28–32 of 75 %, respectively). The living status of a student (loneliness) and unfamiliarity with the heavy crowding environment in the city area (most students come from rural villages where there is more competition among individuals) might have affected the prevalence rate. It might be due to the pressure of a better career from family and society with the age maturity of students and an unsecured future by the deteriorating education system in Nepal, as well as financial crisis during student life are the primary causes of depression. Additionally, It might be due to differences in socio-economic background, difficulties in college/university courses, and limited time for self-care among college students. Further in our study, students with a family income of < 20,000 NPR per month have more depressive symptoms than students with a family income of >50000 NPR. On the contrary, in a previous study, financial problems were associated with only anxiety [15]. Similarly, a study among nursing students at Kathmandu University in 2016 showed academic stress at 18.4 % [14]. This is in contrast to the higher prevalence rate of stress in our study, which was 43 %. Another study done in 2013 correspondingly showed a higher prevalence (100 %) among undergraduate dental students at the Tertiary Health Care Centre in Eastern Nepal [16]. Consequently, most Nepalese students feel under pressure to spend the majority of their working hours on education at their colleges, universities, or even at home due to an inappropriate education system, which adds undue pressure to their academic performance and causes unnecessary stress. Additionally, no statistical association between stress and other factors was found, such as the age of students, family income, type of family, death of a family member, worrying about the future, and the student's diagnosis with COVID-19, a family member diagnosed with COVID-19, physical exercise habits, and smoking habits of students. In particular, female students experienced more stress (50 %) than males (35.1 %), whereas a previous study showed that males were more stressed than females regarding financial concerns [15]. Conclusion and Recommendations Limitations Declarations Acknowledgment References
What are the factors that contributes to the heightened risk for anxiety and depression among students?A lack of self-esteem, a lower socioeconomic background of the family and elevated academic workload are strong predictors of anxiety and stress among students. Alcohol consumption is a major risk factor for university students, especially for females.
Which factor contributes most to stress and anxiety among students?Some of the things students commonly cite as causes of stress include:. out of control debts.. poor housing.. overcrowding.. noise.. adjusting to life in a new environment or even country.. difficulties with personal relationships (e.g. splitting up). balancing the demands of a family with studying.. parents or problems at home.. What factors put students at risk for stress and disease?Peer rejection.. Stressful events.. Poor academic achievement.. Poverty.. Community-level stressful or traumatic events.. School-level stressful or traumatic events.. Community violence.. School violence.. What are the risk factors of anxiety and depression?These factors may increase your risk of developing an anxiety disorder:. Trauma. ... . Stress due to an illness. ... . Stress buildup. ... . Personality. ... . Other mental health disorders. ... . Having blood relatives with an anxiety disorder. ... . Drugs or alcohol.. |