Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya

Abstract

Background Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. Methods We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. Results Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = − 2.19, p < 0.001). Conclusions Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.

Suicide in the Construction Industry

“…Two separate studies of U.S. veterans yielded significant results; they found that individuals with a current PTSD diagnosis reported owning significantly more firearms than those without a current PTSD diagnosis (Freeman & Roca, 2001). Depression -Depression in medical residents leads to decreased clinical efficiency and poor academic performance; it can also lead to suicide (Shah et al, 2021). Depressive disorders are characterized by the presence of sad, empty, or irritable moods, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function (Shah et al, 2021).…”

“…Depression -Depression in medical residents leads to decreased clinical efficiency and poor academic performance; it can also lead to suicide (Shah et al, 2021). Depressive disorders are characterized by the presence of sad, empty, or irritable moods, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function (Shah et al, 2021). High levels of perceived social support, adequate sleep, and high income may protect against depression (Shah et al, 2021).…”

“…Depressive disorders are characterized by the presence of sad, empty, or irritable moods, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function (Shah et al, 2021). High levels of perceived social support, adequate sleep, and high income may protect against depression (Shah et al, 2021). Epidemiological studies show a positive correlation between chronic stress, depression, and suicide (Cassano & Fava, 2002).…”

Students stress patterns in a Kenyan socio-cultural and economic context: toward a public health intervention

“…However, of noteworthy is that most of the studies on student stress have been done on medical students 3 , 12 with very few on non-medical students 13 . In Kenya, a study conducted on medical students found 61.6% of the students to have moderate stress 14 while another study on stress and psychosocial adjustment among non-medical students reported that 35.6% had a low score, 27.4% moderate and 37.0% were classified as having high stress levels 13 .…”

“…These variables can influence the stress level with an example of exposure to television which has been found to increase stress levels 34 . Other factors that have been found to be associated with stress in students include: smoking, alcohol consumption, insomnia, drug abuse and other psychiatric disorders such as depression 9 , 14 , 35 – 37 .…”