Symptoms of depression, anxiety and stress in health students and impact on quality of life

Freitas, Pedro Henrique Batista de; Meireles, Adriana Lúcia; Ribeiro, Isabely Karoline da Silva; Abreu, Mery Natali Silva; Paula, Waléria de; Cardoso, Clareci Silva

doi:10.1590/1518-8345.6315.3885

Pedro Henrique Batista de Freitas

Study concept and design

Obtaining data

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de São João Del-Rei, Divinópolis, MG, Brazil.

http://orcid.org/0000-0002-4407-2941

Adriana Lúcia Meireles

Study concept and design

Obtaining data

Obtaining financing

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de Ouro Preto, Departamento de Nutrição Clínica e Social, Ouro Preto, MG, Brazil.

http://orcid.org/0000-0002-1447-953X

Isabely Karoline da Silva Ribeiro

Obtaining data

Data analysis and interpretation

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de São João Del-Rei, Divinópolis, MG, Brazil.

http://orcid.org/0000-0003-0732-7631

Mery Natali Silva Abreu

Data analysis and interpretation

Statistical analysis

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de Minas Gerais, Departamento de Gestão em Saúde, Belo Horizonte, MG, Brazil.

http://orcid.org/0000-0002-6691-3537

Waléria de Paula

Study concept and design

Obtaining data

Obtaining financing

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil.

http://orcid.org/0000-0002-9438-7343

Clareci Silva Cardoso

Study concept and design

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Final version approval)

Universidade Federal de São João Del-Rei, Divinópolis, MG, Brazil.

http://orcid.org/0000-0003-0689-1644

Corresponding author:
Pedro Henrique Batista de Freitas E-mail: pedrohbf@yahoo.com.br https://orcid.org/0000-0002-4407-2941

Conflict of interest:

the authors have declared that there is no conflict of interest.

Associate Editor:

Sueli Aparecida Frari Galera

Variables	Categories	n=321
Variables	Categories	n (%)
Sociodemographic
University 01		93 (28.97)
University 02		109 (33.96)
University 03		119 (37.07)
Major	Medicine	87 (27.1)
Major	Others	234 (72.9)
Semester	1 and 2	67 (20.87)
	3 to 6	152 (47.35)
	7 to 16	102 (31.78)
Skin color	White	173 (53.89)
Skin color	Not white	148 (46.11)
Biological sex	Female	228 (71.03)
Biological sex	Male	93 (28.97)
Gender identity	Cisgender	318 (99.07)
Gender identity	Transgender	3 (0.93)
Sexual Orientation	Heterosexual	255 (79.44)
	Homosexual	33 (10.28)
	Others^* * Bisexual, asexual;	33 (10.28)
Marital status^† † Divorced, stable union, other;	Single	298 (92.83)
	Married	13 (4.05)
	Other^† † Divorced, stable union, other;	10 (3.12)
Children	Yes	17 (5.3)
Education of the head of the household	Illiterate/Primary	57 (17.76)
	High School	101 (31.46)
	College	163 (50.78)
Income of the head of household	Up to 2 minimum wages	100 (31.15)
	From 2 to 4 minimum wages	97 (30.22)
	More than 4 minimum wages	124 (38.63)
Paid work	Yes	41 (12.77)
University scholarship	Yes	87 (27.1)
Housing	Alone	36 (11.21)
	Parents/relatives	85 (26.48)
	Others^‡ ‡ Republic, boarding house, lodging, spouse;	200 (62.31)
Number of residents in the household	1	41 (12.77)
	2 to 3	159 (49.53)
	4 to 5	75 (23.36)
	6 or more	46 (14.33)
Religious beliefs	Catholic	134 (41.74)
	Evangelical	38 (11.84)
	Others^§ § Non-belief, spiritualist, oriental Buddhism, Jewish, Afro-Brazilian, other;	149 (46.42)
Age	(Average and standard deviation)	24.01 (4.04)
Life habits
Use of alcoholic beverages	Yes	233 (72.59)
Drinking in excess^\|\| \|\| Total doses taken on a single occasion (total of five doses for men and four for women on a single occasion);	Yes	134 (47.69)
Smoking	Yes	41 (12.77)
Use of illicit drugs	Has used or uses	146 (45.48)
Drug use after college	Yes	76 (23.68)
Intensified use after college	Yes	44 (15.22)
Physical activity^¶ ¶ Practicing physical activity refers to exercise or any physical activity, such as sport (e.g., soccer, tennis, running, swimming, etc.);	Yes	201 (62.62)
Clinical
Family history of depression	Yes	164 (51.09)
Family history of anxiety disorder	Yes	171 (53.44)
Use of CNTD medication^ CNTD = Chronic Non-Transmissible Chronic Disease;	Yes	37 (11.53)
Antidepressant use	Yes	47 (14.64)
Benzodiazepine use	Yes	31 (9.66)
Psychological therapy	Has gone/goes	169 (52,65)
Self-assessment of health	Very good	37 (11.53)
	Good	47 (14.64)
	Regular	31 (9.66)
	Bad	218 (67.91)
BMI^†† †† BMI = Body mass index	(Average and SD)	23.1 (4.11)
Mental health
Depression Symptoms	Normal	141 (43.93)
	Mild/Moderate	114 (35.51)
	Severe/Very Severe	66 (20.56)
Anxiety symptoms	Normal	149 (46.42)
	Mild/Moderate	71 (22.12)
	Severe/Very Severe	101 (31,46)
Stress symptoms	Normal	110 (34.27)
	Mild/Moderate	136 (42.37)
	Severe/Very Severe	75 (23.36)

Symptoms		P-value † p-value < 0.05 †
Symptoms		Physical Domain	Psychological Domain	Social Relationships	Environment
Depression	Normal	-	-	-	-
	Mild/Moderate	0.000	0.000	0.000	0.000
	Severe/Very Severe	0.000	0.000	0.000	0.000
Anxiety	Normal	-	-	-	-
	Mild/Moderate	0.000	0.000	0.049	0.002
	Severe/Very Severe	0.000	0.000	0.000	0.000
Stress	Normal	-	-	-	-
	Mild/Moderate	0.000	0.000	0.010	0.001
	Severe/Very Severe	0.000	0.000	0.000	0.000

	Depression Score r¹ ^† † r1 = Spearman’s correlation coefficient (p-value)	Anxiety Score r¹ ^† † r1 = Spearman’s correlation coefficient (p-value)	Stress Score r¹ ^† † r1 = Spearman’s correlation coefficient (p-value)
Physical Domain	-0.54 (0.000)	-0.45 (0.000)	-0.44 (0.000)
Psychological Domain	-0.68 (0.000)	-0.54 (0.000)	-0.56 (0.000)
Social Relationships	-0.34 (0.000)	-0.25 (0.000)	-0.26 (0.000)
Environment	-0.34 (0.000)	-0.31 (0.000)	-0.29 (0.000)

Scales	QoL Domains ^† † QoL = Quality of life;	Symptoms	Number	Average ^‡ ‡ Kruskal-Wallis. Multiple comparisons, all p-value < 0.001;	SD ^§ § SD = Standard deviation
Depression	Physical	Normal	141	73.02	13.52
		Mild, Moderate	114	61.12	13.26
		Severe, Very Severe	66	51.52	16.23
	Psychological	Normal	141	69.71	12.44
		Mild, Moderate	114	54.39	14.02
		Severe, Very Severe	66	36.87	18.59
	Social Relationships	Normal	141	68.97	18.18
		Mild, Moderate	114	59.36	20.60
		Severe, Very Severe	66	52.02	22.79
	Environment	Normal	141	67.09	13.82
		Mild, Moderate	114	58.96	12.99
		Severe, Very Severe	66	52.89	18.16
Anxiety	Physical	Normal	149	71.48	14.05
		Mild, Moderate	71	62.98	12.51
		Severe, Very Severe	101	54.88	16.83
	Psychological	Normal	149	66.58	15.18
		Mild, Moderate	71	57.69	14.48
		Severe, Very Severe	101	44.02	19.27
	Social Relationships	Normal	149	66.95	19.17
		Mild, Moderate	71	61.15	20.89
		Severe, Very Severe	101	55.53	22.21
	Environment	Normal	149	66.28	13.56
		Mild, Moderate	71	60.52	12.24
		Severe, Very Severe	101	54.46	17.63
Stress	Physical	Normal	110	72.14	13.16
		Mild, Moderate	136	64.42	15.05
		Severe, Very Severe	75	52.90	16.15
	Psychological	Normal	110	68.56	14.12
		Mild, Moderate	136	57.54	16.82
		Severe, Very Severe	75	41.28	17.81
Stress	Social Relationships	Normal	110	67.65	18.23
		Mild, Moderate	136	61.15	21.38
		Severe, Very Severe	75	55.56	22.53
	Environment	Normal	110	66.22	13.04
		Mild, Moderate	136	60.64	14.90
		Severe, Very Severe	75	55.21	17.71

Variables		Quality of life domains
		Physical ^† † Adjustment variables by domains (P-value <0.20 on bivariate): gender, housing, number of household residents, use of CNTD medication, use of benzodiazepines, self-assessment of health, and course;		Psychological ^‡ ‡ Adjustment variables by domains (P-value <0.20 on bivariate): education of head of household, use of antidepressants, self-assessment of health, and course;		Social Relationships ^§ § Adjustment variables by domains (P-value <0.20 on bivariate): household head’s income, housing, alcohol use, self-assessment of health, and course;		Environment ^\|\| \|\| Adjustment variables by domains (P-value <0.20 in the bivariate): household head’s income, self-assessment of health, and course;
		β^¶ ¶ β = Indicates standardized β coefficient;	Valor-p	β^¶ ¶ β = Indicates standardized β coefficient;	Valor-p	β^¶ ¶ β = Indicates standardized β coefficient;	Valor-p	β^¶ ¶ β = Indicates standardized β coefficient;	P-value
D^ D = Depression;	Normal	-	-	-	-	-	-	-	-
	Mild, Moderate	-5.99	0.002	-9.11	0.000	-6.18	0.025	-4.22	0.018
	Severe, Very Severe	-12.26	0.000	-22.45	0.000	-12.31	0.002	-9.09	0.002
A^†† †† A = Anxiety;	Normal	-	-	-	-	-	-	-	-
	Mild, Moderate	-2.10	0.267	-0.13	0.944	-1.41	0.662	-3.76	0.051
	Severe, Very Severe	-3.31	0.192	-2.91	0.291	-2.32	0.549	-5.90	0.015
S^‡‡ ‡‡ E = Stress;	Normal	-	-	-	-	-	-	-	-
	Mild, Moderate	0.19	0.923	-2.75	0.120	0.60	0.821	1.11	0.537
	Severe, Very Severe	-4.00	0.151	-6.47	0.031	0.78	0.855	2.38	0.432
R²^§§ §§ R² = Coefficient of determination		44.27%		51.18%		18.83%		31.47%

[1] Corresponding author:
Pedro Henrique Batista de Freitas E-mail: pedrohbf@yahoo.com.br https://orcid.org/0000-0002-4407-2941

Brasil

Brasil

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