Association between depression, examination-related stressors, and sense of coherence: the Ronin-Sei study

Prevalence of depression and its associated factors among undergraduate admission candidates in Bangladesh: A nation-wide cross-sectional study

BACKGROUND

The undergraduate admission test is one of the most stressful assessments in a student's life, as it is required for admission to any of Bangladesh's public universities or medical colleges. Those taking the admissions test are under a lot of pressure to perform well. This study aimed to determine the prevalence of clinical depression among Bangladeshi admission candidates and the factors that contribute to it.

METHODOLOGY

Patient Health Questionnaire (PHQ-9) and other socio-demographic information were collected from 5263 students from all over Bangladesh. Apart from descriptive statistics and chi-square tests, an ordinal logistic regression model was also applied to determine the factors associated with depression.

RESULTS

The study revealed that among the undergraduate admission applicants, 74% of individuals were affected by depression, while 26% experienced moderate depression, 26% experienced moderately severe depression, and 22% experienced severe depression. The level of depression among females was 1.8 times higher than the male admission candidates. Our analyses found that gender (p <0.001), exercise (p <0.001), pre-marital relationships (p <0.001), daily study time less than 3 hours (p <0.001), practice of religion (p <0.001), victim of blackmail (p <0.001), family unrest (p <0.001), major illness (p <0.001), COVID-19 infection (p <0.001), GPA in higher secondary (p <0.001), mental problem (p <0.001), all categories of the variable confidence level for exam preparation (p <0.001) had a significant impact on increasing depression.

CONCLUSION

The research found a severe rate of depression among Bangladeshi undergraduate admission candidates. Interactive mental health care programs must include family and teachers to tackle the problem. To alleviate mental stress and depression, students should learn to nurture their mental health.

Better Mental Health and Sleep under Behavioral Restrictions Due to COVID-19 in Japanese University Students: A Cross-Sectional Survey

Coronavirus disease (COVID-19) is a global pandemic, which is not only a severe public health issue but also significantly impacts the physical activity, sleep habits, and mental health of university students. Thus, we examined the association between behavioral restrictions due to COVID-19 and sleep patterns and mental health in first-year Japanese university students. Four hundred and twenty-two students (253 males and 169 females; age, 18.7 ± 1.0 years) participated in our questionnaire study. Under the behavioral restrictions due to COVID-19, 193 students (127 males and 66 females) responded to the questionnaire online from home. The participants did not visit the university during the survey period. The data acquired the year before the COVID-19 pandemic (2018 and 2019) were used as control data (126 males and 103 females). The questionnaire consisted of four sections: (1) demographic and lifestyle variables, (2) the Pittsburgh Sleep Quality Index, (3) the Japanese version of the Epworth Sleepiness Scale, and (4) the Patient Health Questionnaire-9. Our data revealed that self-restraint due to COVID-19 was associated with better sleep and mental health. In addition, mental health was independent of sleep, while sleep was related to mental health. These differences were more pronounced in male than in female students. This finding could be due to physical activity at night, part-time work, and long commuting times during the pre-pandemic period.

Relationships between Depression, Daily Physical Activity, Physical Fitness, and Daytime Sleepiness among Japanese University Students

In Japan and other developed countries, the lifestyles of many—particularly the younger generation—have been disrupted in recent years. This disruption may manifest as a decrease in physical activity and deterioration in the quality and quantity of sleep. Depressive tendencies are also increasing among university students. This study examined the relationship between mental health, physical activity, physical fitness, and daytime sleepiness. Eighty-five undergraduate students participated in this study (52 men and 33 women, aged 18.9 (±1.4) years). Physical activity levels were measured using an accelerometer (Lifecorder, Kenz, Nagoya, Japan) for two weeks. To evaluate their level of physical fitness, maximal oxygen uptake (V˙O₂max) was calculated by an indirect method using a cycle ergometer. Depressive tendencies and daytime sleepiness were evaluated using the Patient Health Questionnaire (PHQ-9). The PHQ-9 score was positively correlated with sleepiness (r = 0.35, p = 0.001) and total steps per day (r = 0.39, p < 0.001). Moreover, the PHQ-9 score was positively correlated with V˙O₂max (r = 0.25, p = 0.019). The PHQ-9 score was higher in students with good exercise habits or part-time jobs. An important finding was the positive correlation between depression and variables related to physical activity levels. These results suggest that vigorous physical activity, such as exercise and part-time jobs, might be positively associated with depressive tendencies among university students.

Associations between demographic factors and the academic trajectories of medical students in Japan

BACKGROUND

Group-based trajectory modeling is a useful tool for categorizing students' academic trajectories and their determinants. Using insights gained from the analyses, we can identify students at risk for poor academic performance and monitor them to provide support. To date, studies investigating the associations between demographic factors and academic performance trajectories among medical students are scarce. The study objective was to examine the associations between demographic factors and academic performance trajectories in medical students using group-based trajectory modeling.

METHODS

Participants included all medical students admitted to Tokyo Medical and Dental University in Japan in 2013 and 2014 (n = 202). Academic performance was evaluated by biannual grade point average (GPA) scores in preclinical years. We used group-based trajectory modeling to categorize students into GPA trajectories. Multinomial logistic regression was used to examine the association between the odds of being in a certain GPA trajectory group and demographic factors such as high school type, high school geographical area, admission test type, high school graduation year, whether the student was a biology major, and sex.

RESULTS

Students' GPA trajectories were classified into four trajectory groups as well as another group that consisted of students who withdrew or repeated years. We found that students whose high school geographical area was outside the National Capital Region were 7.2 times more likely to withdraw or repeat years in comparison with students whose school was inside the National Capital Region (OR: 7.21, 95% CI: 1.87, 27.76). In addition, admission test type, high school graduation year, and sex were associated with GPA trajectories.

CONCLUSIONS

High school geographical area, admission test type, high school graduation year, and sex were associated with GPA trajectories. These findings provide important insights into identifying students at risk for poor academic performance and strategies for monitoring them to provide adequate and timely support.

Depressive Symptoms and the Link with Academic Performance among Rural Taiwanese Children

Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the distribution of depressive symptoms among children in rural Taiwan and measure the correlation between academic performance, we conducted a survey of 1655 randomly selected fourth and fifth-grade students at 92 sample schools in four relatively low-income counties or municipalities. Using the Center for Epidemiological Studies-Depression Scale (CES-D) we assessed the prevalence of depressive symptoms in this sample, in addition to collecting other data, such as performance on a standardized math test as well as information on a number of individual and household characteristics. We demonstrate that the share of children with clinically significant symptoms is high: 38% of the students were at risk of general depression (depression score ≥ 16) and 8% of the students were at risk of major depression (depression score > 28). The results of the multivariate regression and heterogeneous analysis suggest that poor academic performance is closely associated with a high prevalence of depressive symptoms. Among low-performing students, certain groups were disproportionately affected, including girls and students whose parents have migrated away for work. Results also suggest that, overall, students who had a parent who was an immigrant from another country were at greater risk of depression. These findings highlight the need for greater resource allocation toward mental health services for elementary school students in rural Taiwan, particularly for at-risk groups.

Type C Personality and Depression Among Newly Diagnosed Breast Cancer Patients: The Mediating Role of Sense of Coherence

PURPOSE

This study aims to explore the mediating role of sense of coherence in the relationship of type C personality and depression among newly diagnosed breast cancer patients.

METHODS

A descriptive and correlational survey was conducted in 600 breast cancer patients aged ≥18 years from September 2018 to March 2019 in Zhengzhou, China. The demographic questionnaire, Cancer Behavior Scale, Sense of Coherence Scale and Hamilton Depression Scale were included in this study. Data analysis was performed by correlation analysis, multiple linear regression analysis, and structural equation modeling.

RESULTS

The valid questionnaires were 575 (effective response rate: 95.8%). The score of sense of coherence was negatively correlated with type C personality and depression (r = -0.41, P < 0.01; r = -0.58, P < 0.01); the score of type C personality and depression were positively correlated (r = 0.51, P < 0.01). The results of multiple linear regression analysis revealed that the effect of type C personality on depression was partly mediated by sense of coherence, which was confirmed by structural equation modeling. The mediation effect accounts for 45.2% (0.269/0.594) of the total effect.

CONCLUSION

The results of this study revealed that sense of coherence as a partial mediating role is essential for reducing the influence of type C personality on depression. Early and targeted psychological interventions on sense of coherence are needed to alleviate the symptom of depression in newly diagnosed breast cancer patients.

Quality of Life, Mental Health and Educational Stress of High School Students in the Northeast of Thailand

INTRODUCTION

Majority of high school students in Thailand aim to study at universities. Therefore, they spend a lot of time studying in both classrooms and tutorial classes, that could cause stress, health problems and deteriorate their Quality Of Life (QOL). However, there has been no study on these issues in Thai context.

AIM

To describe the status of QOL, mental health, educational stress, well-being and determine factors associated with QOL among high school students in the Northeast of Thailand.

MATERIALS AND METHODS

This cross-sectional study was conducted in the Northeast of Thailand among 1,112 students of grade 10^th, 11^th and 12^th. Multistage random sampling was used to select high schools in 5 provinces. A self-administered questionnaire was used to assess QOL, educational stress, anxiety, depression and well-being. The association between the covariates was observed by using Generalized Linear Mixed (logistic regression) Model (GLMM).

RESULTS

The prevalence of high level of QOL was 36% (95%CI: 32.30 to 41.69); whereas, 26.18% (95% CI: 16.72 to 35.63) had high level of educational stress and 16.41% (95% CI: 2.20 to 30.71) had severe anxiety. Prevalence of depression was 18.55% (95%CI: 9.86 to 27.23) and low level of well-being was 13.41% (95% CI: 0.18 to 27.14). The factors significantly associated with high QOL were; not having depression (Adj. OR= 3.07; 95%CI: (2.23 to 4.22); p<0.001), had high level of general well-being (Adj. OR=3.19; 95% CI:1.99 to 5.09; p<0.001) and had low to moderate level of anxiety (OR=1.60; 95%CI:1.01 to 2.67).

CONCLUSION

Most of the high school students had low to moderate levels of QOL, educational stress and anxiety. Depression, anxiety and general well-being had influences on QOL of high school students.

Symptoms and health complaints and their association with perceived stressors among students at nine Libyan universities

University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%-60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15-2.02), depressive mood (OR 2.20; 95% CI 1.64-2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19-2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population.