Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya

• Published in: BMC psychiatry 2021-09, Vol.21 (1), p.444-15, Article 444
• Main Authors: Shah, Sayed Shah Nur Hussein, Laving, Ahmed, Okech-Helu, Violet Caroline, Kumar, Manasi
• Format: Article
• Language: English
• Subjects: Adult; Africa; Cross-Sectional Studies; Depression; Depression - epidemiology; Depression, Mental; Drug abuse; Drug use; Epidemiology; Gynecology; Health aspects; Humans; Internal medicine; Internship and Residency; Internships; Kenya; Kenya - epidemiology; Male; Medical errors; Medical personnel; Medical practices; Medical residencies; Medical residents; Mental depression; Mental disorders; Mental health; Mental health care; Multivariate analysis; Obstetrics; Occupational stress; Pediatrics; Perceived stress; Physicians; Psychiatry; Psychological aspects; Questionnaires; Residents (Medicine); Risk Factors; Schools, Medical; Social interactions; Social networks; Social Support; Sociodemographics; Stress (Psychology); Stress, Psychological - epidemiology; Substance abuse; Substance use; Substance use disorder; Substance-Related Disorders - epidemiology; Suicide; Suicides & suicide attempts; Surgery; Surveys; Surveys and Questionnaires; Teaching hospitals; Training
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-021-03439-0

Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = - 0.683, p = 0.002), high perceived stress (β = 0.709, p