Prioritizing Mental Health: A Cross-Sectional Investigation of Depression Prevalence and Risk Factors among Medical Students in Peshawar, Pakistan




Medical student depression, Risk factors, Mental health, Academic performance, Peshawar, Pakistan, Depression, Medical Students, Prevalence, Cross-Sectional Studies, Hospital Anxiety and Depression Scale (HADS), Mental Health, Socio-Demographic Characteristics, Anxiety Disorders, Health Surveys, Student Health Services, Psychiatric Status Rating Scales, Stress, Psychological, Educational Measurement, Health Promotion, Healthcare Disparities, Social Support, Suicide, Risk Factors, Public Health


Background: Depression is a significant problem among medical students worldwide, affecting their well-being and potentially compromising patient care. This study aimed to determine the prevalence of depression among medical students in Peshawar, Pakistan, and to identify the associated risk factors.

Methods: A cross-sectional study was conducted from April to June 2023, involving medical students from seven colleges in Peshawar. We employed stratified sampling to distribute surveys to students. We collected data on socio-demographic characteristics, prevalence of depression using the Hospital Anxiety and Depression Scale (HADS), and depression risk factors. We used multivariate logistic regression, clustered by university, to assess factors associated with depression.

Results: Out of 400 distributed questionnaires, 324 were returned (response rate: 81%). The participants' mean age was 21.70 ± 1.65 years, with 53.1% being females. The prevalence of depression was 19.4% and 26.2% were borderline cases. No variables were found to be significantly linked to depression in our multivariate regression model. However, male gender, year of study, experiencing discrimination or harassment in medical school, and having negative perceptions of medical school's impact on mental health had odds ratios above 1, with confidence intervals including the null value.

Conclusion: This study reveals a high prevalence of depression among medical students in Peshawar, Pakistan. It emphasizes the need to address risk factors and establish support systems to minimize the impact of depression on students' well-being and academic performance. Further studies are necessary to identify modifiable factors associated with depression in medical students.


Metrics Loading ...


Marcus M, Yasamy MT, van Ommeren MV, Chisholm D, Saxena S. Depression: A global public health concern. 2012:6-8

Islam S, Akter R, Sikder T, Griffiths MD. Prevalence and factors associated with depression and anxiety among first-year university students in Bangladesh: a cross-sectional study. Int J Ment Health Ad. 2020:1-4.

Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214-36.

Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545–602.

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354-73.

Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008 Feb 28;336(7642):488-91.

Supe A. A study of stress in medical students at Seth GS Medical College. J Postgrad Med. 1998;44(1):1.

Sosu EM, Pheunpha P. Trajectory of university dropout: Investigating the cumulative effect of academic vulnerability and proximity to family support. Front Educ. 2019; 4:6.

Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: A systematic review. Med Educ. 2014;48(10):963-79.

Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC Med Educ. 2019;19(1):1-3.

Dwivedi N, Sachdeva S, Taneja N. Depression among medical students of India: Meta-analysis of published research studies using screening instruments. Indian J Soc Psych. 2021;37(2):183-90.

Alharbi H, Almalki A, Alabdan F, Haddad B. Depression among medical students in Saudi medical colleges: a cross-sectional study. Adv Med Educ Pract. 2018:887-91.

Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea. Acad Med. 2010;85(8):1384-90.

Lail RA, Aziz N, Afzal HS, Sabir SH, Waseem T, Qamar I, Bhatti N. Prevalence of depression, anxiety and stress (By DASS 42 Scoring System) among the undergraduate students of Sahiwal Medical College. TPMJ. 2021;28(03):407-14.

Khan MS, Mahmood S, Badshah A, Ali SU, Jamal Y. Prevalence of depression, anxiety and their associated factors among medical students in Karachi, Pakistan. JPMA. 2006;56(12):583.

Quynh AT, Dunne MP, Ngoc HL. Well-being, depression and suicidal ideation among medical students throughout Vietnam. Vietnam J Med Pharm. 2014;6(3):23-30.

Tran QA. Factors associated with mental health of medical students in Vietnam: a national study. Doctoral dissertation, Queensland University of Technology. 2015.

Pukas L, Rabkow N, Keuch L, Ehring E, Fuchs S, Stoevesandt D, et a. Prevalence and predictive factors for depressive symptoms among medical students in Germany–a cross-sectional study. GMS J Med Educ. 2022;39(1):Doc13.

Nkporbu AK, Ayodeji O. Prevalence of Depression and Academic Performance among Medical Students: A Systematic Review. J Biomed Res Environ Sci. 2022;3(6): 714-21.

Iqbal S, Gupta S, Venkatarao E. Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. Indian J Med Res. 2015;141(3):354-7.

Olum R, Nakwagala FN, Odokonyero R. Prevalence and factors associated with depression among medical students at Makerere university, Uganda. Adv Med Educ Pract. 2020:11:853-860.

Zatt WB, Lo K, Tam W. Pooled prevalence of depressive symptoms among medical students: an individual participant data meta-analysis. BMC Psychiatry. 2023;23(1):251.

Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study. South Korea Acad Med. 2010;85(8):1384-90.

Sarokhani D, Delpisheh A, Veisani Y, Sarokhani MT, Manesh RE, Sayehmiri K,et al. Prevalence of depression among university students: a systematic review and meta-analysis study. D Depress Res Treat. 2013:2013:373857.

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross‐sectional study. Med Educ. 2005;39(6):594-604.

Smith EN, Romero C, Donovan B, Herter R, Paunesku D, Cohen GL, et al. Emotion Theories and Adolescent Well-Being: Results of an Online Intervention. Emotion. 2018;18(6):781-788.

Onyekachi, B.N., Aliche, C.J., Mefoh, P.C. et al. Relationship between social support, meaning in life, depression and suicide behaviour among medical students. Curr Psychol. 2023.

Jawed S, Altaf B, Salam RMT, Ijaz F. Frequency of emotional disturbances among hostelites and day scholars medical students. J Pak Med Assoc. 2021;71(1(A)):73-77.

The image is a vertical bar chart displaying the proportion of individuals with varying severity levels of depression. There are five categories on the horizontal axis, from left to right: Minimal Depression, Mild Depression, Moderate Depression, Moderately Severe, and Severe Depression. The vertical axis represents the proportion, ranging from 0 to 35.  The bars indicate the number of individuals in each category. 'Minimal Depression' has the shortest bar, suggesting a lower proportion. 'Mild Depression' has a taller bar, followed by a significantly higher bar for 'Moderate Depression', which appears to be the most common with the tallest bar of all, indicating the highest proportion. The 'Moderately Severe' category's bar drops down, and 'Severe Depression' has the lowest bar similar to 'Minimal Depression', indicating a smaller proportion in these categories. The overall chart shows a clear peak at 'Moderate Depression', highlighting it as the most prevalent severity level among the sample.


2024-03-27 — Updated on 2024-04-12

How to Cite

Nida Gul, Ayaz Ali, Rizwanullah, Khayam, Manahil Saeed Khan, Faiza Gul, Aiysha Gul, Shehriyar, Kashif Ali, & Syed Owais Haseeb. (2024). Prioritizing Mental Health: A Cross-Sectional Investigation of Depression Prevalence and Risk Factors among Medical Students in Peshawar, Pakistan. International Journal of Medical Students, 12(1), 22–28.