Syeda Rubaba Azim, Mukhtiar Baig.
Frequency and perceived causes of depression, anxiety and stress among medical students of a private medical institute in Karachi: a mixed method study..
J Pak Med Assoc Jan ;69(6):840-5.

To determine medical students' level of mental distress, assess their perceptions of its causes, and to gather their suggestions for possible solutions.. The mixed-method qualitative-quantitative study was conducted at Liaquat National Medical College, Karachi, from August 2016 to March 2017, and comprised medical students across years 1 to 5. In phase one, the depression, anxiety and stress scale-21 questionnaire was administered to explore prevalence rates among the subjects. In phase two, focus group discussions were carried out to explore the possible reasons for the students' mental distress. Data was analysed using SPSS 20. Of the 270 students approached, 188(70%) returned the completed questionnaire. The overall mean age of subjects was 21.4}2.2 years (range: 18-25 years). There were 100(53%) females, and 88(47%) males. The prevalence of depression was 134(71%), anxiety 136(72%) and stress 66(35%). Major concerns mentioned by the students in phase two related to academic issues. Students in the focus group also complained of poor lifestyles, financial constraints, lack of support services for stress management, and lack of physical and recreational facilities. Students suggested that their mental distress might be alleviated by curricular innovations such as reducing the number and duration of lectures, increasing small group activities, and pre-scheduling exams. Students also strongly requested proper support services at the institutional level. There was high mental distress among medical students and it was mainly related to academic pressure.

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