Background: Depression is one of the leading causes of disability worldwide and may affect medical students, who are exposed to various academic and psychosocial stressors. The international literature reported highly variable prevalence estimates, likely influenced by the use of different screening tools and methodological differences among studies. Objectives: To assess the prevalence of depressive symptoms among students in the Master’s Degree Program in Medicine and Surgery at the University of Modena and Reggio Emilia, comparing estimates obtained using different screening tools, and to analyze the main sociodemographic, academic, and behavioral determinants associated with depressive symptoms. Materials and Methods: A cross-sectional observational study was conducted as part of the international MIND-SCOPE project. Between November 2025 and February 2026, an online questionnaire was administered to students in their second through sixth years of the degree program. Sociodemographic data and information were collected using validated psychometric instruments measuring depressive symptoms (Patient Health Questionnaire-9 [PHQ-9], Center for Epidemiologic Studies Depression Scale [CES-D], Depression Anxiety Stress Scales [DASS-D]), academic stress (Higher Educational Stress Inventory [HESI], Medical School Stressors Inventory [MSSI]), lifestyle (Short Multidimensional Inventory Lifestyle Evaluation [U-SMILE]), and perceived social status (MacArthur Subjective Social Status Scale [MSSS]). Data was analyzed using descriptive statistics and multivariate linear regressions to identify factors associated with depression scores. Results: Among 959 eligible students, 241 students participated in the study (response rate: 25.1%), with a mean age of 23.05 years (standard deviation [SD]=2.59); 68.0% were female, and 15.4% reported a non-heterosexual orientation. The prevalence of depressive symptoms varied on the instrument used, ranging from 40.2% as measured by the PHQ-9, to 56.4% with the DASS-D, and up to 61.0% with the CES-D. The highest levels of symptoms were observed in the second and sixth years of the program. In multivariate analyses, male gender was associated with lower depression scores, while being in a romantic relationship emerged as a protective factor in all models. Academic stress, measured using the HESI, emerged as the main positive predictor of depressive symptoms, while healthier lifestyle and a higher perception of subjective social status showed a protective association in some models. Conclusions: The study highlights a moderate prevalence of depressive symptoms among medical students and confirms the considerable variability in depression estimates depending on the screening tool used, underscoring the need for greater methodological standardization in international research. The results also highlight the central role of academic stress as a risk factor and of social support and healthy lifestyles as protective factors, identifying potential targets to implement university-based mental health prevention and promotion programs aimed at improving medical students’ wellbeing.
Background: La depressione rappresenta una delle principali cause di disabilità a livello mondiale e può interessare gli studenti di medicina, esposti a vari fattori di rischio accademici e psico-sociali. La letteratura internazionale riporta stime di prevalenza molto eterogenee, probabilmente influenzate dall'impiego di diversi strumenti di screening e da differenze metodologiche tra gli studi. Obiettivi: Valutare la prevalenza dei sintomi depressivi tra gli studenti del Corso di Laurea Magistrale in Medicina e Chirurgia dell'Università di Modena e Reggio Emilia, confrontando le stime ottenute mediante diversi strumenti di screening, e analizzare i principali determinanti sociodemografici, accademici e comportamentali associati alla sintomatologia depressiva. Materiali e Metodi: È stato condotto uno studio osservazionale trasversale nell'ambito del progetto internazionale MIND-SCOPE. Tra novembre 2025 e febbraio 2026 è stato somministrato un questionario online agli studenti dal secondo al sesto anno del corso di laurea. Sono stati raccolti dati sociodemografici e informazioni mediante strumenti psicometrici validati per la misura dei sintomi depressivi (Patient Health Questionnaire-9 [PHQ-9], Center for Epidemiologic Studies Depression Scale [CES-D], Depression Anxiety Stress Scales [DASS-D]), dello stress accademico (Higher Educational Stress Inventory [HESI], Medical School Stressors Inventory [MSSI]), dello stile di vita (Short Multidimensional Inventory Lifestyle Evaluation [U-SMILE]), e dello status sociale percepito (MacArthur Subjective Social Status Scale [MSSS]). Sono state eseguite analisi descrittive e regressioni lineari multivariate per identificare i fattori associati ai punteggi di depressione. Risultati: Su un totale di 959 studenti eleggibili, 241 hanno partecipato allo studio (tasso di risposta 25,1%), con età media di 23,05 anni (deviazione standard [DS]=2.59); il 68,0% era di sesso femminile e 15.4% hanno riportato un orientamento non-eterosessuale. La prevalenza dei sintomi depressivi è risultata fortemente dipendente dallo strumento utilizzato, variando dal 40,2% rilevato con il PHQ-9 al 56,4% con il DASS-D fino al 61,0% con il CES-D. I livelli più elevati di sintomatologia sono stati osservati nel secondo e nel sesto anno di corso. Nelle analisi multivariate il sesso maschile è risultato associato a punteggi depressivi inferiori, mentre la presenza di una relazione sentimentale si è rivelata un fattore protettivo in tutti i modelli. Lo stress accademico, misurato mediante HESI, è emerso come il principale predittore positivo della sintomatologia depressiva, mentre migliori abitudini di vita e una maggiore percezione dello status sociale soggettivo hanno mostrato un'associazione protettiva in alcuni modelli. Conclusioni: Lo studio evidenzia una moderata prevalenza di sintomi depressivi tra gli studenti di medicina e conferma la notevole variabilità delle stime in funzione dello strumento di screening utilizzato, sottolineando la necessità di una maggiore standardizzazione metodologica nella ricerca internazionale. I risultati evidenziano inoltre il ruolo centrale dello stress accademico come fattore di rischio e del supporto relazionale e degli stili di vita salutari come fattori protettivi, identificando possibili target di programmi universitari di prevenzione e promozione della salute mentale rivolti agli studenti di medicina per migliorare il loro benessere.
Depressione tra gli studenti di medicina: confronto tra stime di prevalenza e predittori
LAONIGRO, FRANCESCA
2025/2026
Abstract
Background: Depression is one of the leading causes of disability worldwide and may affect medical students, who are exposed to various academic and psychosocial stressors. The international literature reported highly variable prevalence estimates, likely influenced by the use of different screening tools and methodological differences among studies. Objectives: To assess the prevalence of depressive symptoms among students in the Master’s Degree Program in Medicine and Surgery at the University of Modena and Reggio Emilia, comparing estimates obtained using different screening tools, and to analyze the main sociodemographic, academic, and behavioral determinants associated with depressive symptoms. Materials and Methods: A cross-sectional observational study was conducted as part of the international MIND-SCOPE project. Between November 2025 and February 2026, an online questionnaire was administered to students in their second through sixth years of the degree program. Sociodemographic data and information were collected using validated psychometric instruments measuring depressive symptoms (Patient Health Questionnaire-9 [PHQ-9], Center for Epidemiologic Studies Depression Scale [CES-D], Depression Anxiety Stress Scales [DASS-D]), academic stress (Higher Educational Stress Inventory [HESI], Medical School Stressors Inventory [MSSI]), lifestyle (Short Multidimensional Inventory Lifestyle Evaluation [U-SMILE]), and perceived social status (MacArthur Subjective Social Status Scale [MSSS]). Data was analyzed using descriptive statistics and multivariate linear regressions to identify factors associated with depression scores. Results: Among 959 eligible students, 241 students participated in the study (response rate: 25.1%), with a mean age of 23.05 years (standard deviation [SD]=2.59); 68.0% were female, and 15.4% reported a non-heterosexual orientation. The prevalence of depressive symptoms varied on the instrument used, ranging from 40.2% as measured by the PHQ-9, to 56.4% with the DASS-D, and up to 61.0% with the CES-D. The highest levels of symptoms were observed in the second and sixth years of the program. In multivariate analyses, male gender was associated with lower depression scores, while being in a romantic relationship emerged as a protective factor in all models. Academic stress, measured using the HESI, emerged as the main positive predictor of depressive symptoms, while healthier lifestyle and a higher perception of subjective social status showed a protective association in some models. Conclusions: The study highlights a moderate prevalence of depressive symptoms among medical students and confirms the considerable variability in depression estimates depending on the screening tool used, underscoring the need for greater methodological standardization in international research. The results also highlight the central role of academic stress as a risk factor and of social support and healthy lifestyles as protective factors, identifying potential targets to implement university-based mental health prevention and promotion programs aimed at improving medical students’ wellbeing.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.14251/6766