Sociodemographic and Academic Burden Factors Associated with Anxiety and Depression Among Final-Year Health Sciences Undergraduates in Malaysia

Intan Zulyana Zulkefli; Haliza Abdul Rahman; Azrin Shah Abu Bakar

doi:10.55489/njcm.160820255364

Authors

Intan Zulyana Zulkefli Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
Haliza Abdul Rahman Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences; Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
Azrin Shah Abu Bakar Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia

DOI:

https://doi.org/10.55489/njcm.160820255364

Keywords:

Anxiety, Depression, Academic Burden, Sociodemographic Characteristics, Final-year undergraduate health sciences students

Abstract

Introduction: Academic burden is a situation where students feel overwhelmed by the requirements of time and energy to attain certain academic goals, which can potentially contribute to mental disorders such as anxiety and depression. This study aims to assess the level of anxiety and depression and its associated factors with anxiety and depression among final-year health sciences undergraduates in Malaysia.

Methods: This cross-sectional study was conducted at a public a university in Malaysia. Mental disorders in this study, which refer to anxiety and depression were measured using the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The Perceptions of Academic Stress (PAS) scale was used to measure academic burden.

Results: Findings revealed that 42.9% of final-year health sciences undergraduates experienced minimal anxiety and 32.8% experienced mild depression. Time constraints and study program were significantly associated with anxiety and depression, while pressures to perform were significantly associated with depression.

Conclusion: The majority of final-year health sciences undergraduates have a minimal and mild level of anxiety and depression and it’s associated with time constraints, study program and pressures to perform. Therefore, university authorities need to enhance and improve mental disorders of final-year health sciences undergraduates.

References

Miron J, Goldberg X, López-Sola C, Nadal R, Armario A, Andero R, et al. Perceived stress, anxiety and depression among undergraduate students: An online survey study. Journal of Depression and Anxiety. 2019; 8(330): 2167-1044. DOI: https://doi.org/10.4172/2167-1044.1000330

Zhang C, Shi L, Tian T, Zhou Z, Peng X, Shen Y, Li Y, Ou J. Associations between academic stress and depressive symptoms mediated by anxiety symptoms and hopelessness among Chinese college students. Psychology Research and Behavior Management. 2022; 15:547-56. DOI: https://doi.org/10.2147/PRBM.S353778 PMid:35282002 PMCid:PMC8906854

Mohamad NE, Sidik SM, Akhtari-Zavare M, Gani NA. The prevalence risk of anxiety and its associated factors among university students in Malaysia: a national cross-sectional study. BMC public health. 2021;21:1-2. DOI: https://doi.org/10.1186/s12889-021-10440-5 PMid:33663451 PMCid:PMC7931521

Islam MA, Low WY, Tong WT, Yuen CW, Abdullah A. Factors associated with depression among university students in Malaysia: a cross-sectional study. KnE Life Sciences. 2018; 415-27. DOI: https://doi.org/10.18502/kls.v4i4.2302

Nahas AR, Elkalmi RM, Al-Shami AM, Elsayed TM. Prevalence of depression among health sciences students: Findings from a public university in Malaysia. Journal of Pharmacy and Bioallied Sciences. 20;11(2):170-5. DOI: https://doi.org/10.4103/JPBS.JPBS_263_18 PMid:31148894 PMCid:PMC6537646

Cheong WS, Degeras K, Suliman KR, Selvaraju M, Subramaniam K. The prevalence of depression among students in higher education institution: a repeated cross-sectional study. Journal of public mental health. 2022 Oct 13;21(4):331-40. DOI: https://doi.org/10.1108/JPMH-12-2021-0152

Alves JV, Paula WD, Netto PR, Godman B, Nascimento RC, Coura-Vital W. Prevalence and factors associated with anxiety among university students of health sciences in Brazil: findings and implications. Jornal Brasileiro de Psiquiatria. 2021;70(2):99-107. DOI: https://doi.org/10.1590/0047-2085000000322

Fauzi MF, Anuar TS, Teh LK, Lim WF, James RJ, Ahmad R, Mohamed M, Abu Bakar SH, Mohd Yusof FZ, Salleh MZ. Stress, anxiety and depression among a cohort of health sciences undergraduate students: the prevalence and risk factors. International journal of environmental research and public health. 2021;18(6):3269. DOI: https://doi.org/10.3390/ijerph18063269 PMid:33809939 PMCid:PMC8004268

Kathem SH, Al-Jumail AA, Noor-Aldeen M, Najah N, Ali Khalid D. Measuring depression and anxiety prevalence among Iraqi healthcare college students using hospital anxiety and depression scale. Pharmacy Practice (Granada). 2021;19(2):2303. DOI: https://doi.org/10.18549/PharmPract.2021.2.2303 PMid:34035869 PMCid:PMC8118599

Milić J, Skitarelić N, Majstorović D, Zoranić S, Čivljak M, Ivanišević K, Marendić M, Mesarić J, Puharić Z, Neuberg M, Čukljek S. Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study. BMC psychiatry. 2024;24(1):50. DOI: https://doi.org/10.1186/s12888-024-05498-5 PMid:38218757 PMCid:PMC10787412

Liu J, Huang P. Evaluation and analysis of student academic burden: A global perspective. Science Insights Education Frontiers. 2019; 10(2): 1423-1437. DOI: https://doi.org/10.15354/sief.21.or062

Reddy KJ, Menon KR, Thattil A. Academic Stress and its Sources Among University Students. Biomedical and Pharmacology Journal. 2018; 11(1):531-7. DOI: https://doi.org/10.13005/bpj/1404

Thing IS, Zainal ZA, Wahab IA, Alwi MN. Comparison Of Depression Anxiety Stress Scale (Dass) Scores Among University Students In Cyberjaya: An Online Survey. Journal of Positive School Psychology. 2022;6(7):5477-87.

Szepe O, Meszaros A. Assessing well-being of university students and evaluation of its determinants. BMC Public Health. 2024;24(1):2862. DOI: https://doi.org/10.1186/s12889-024-20287-1 PMid:39420337 PMCid:PMC11487700

Wathelet M, Vincent C, Fovet T, Notredame CE, Habran E, Martignène N, Baubet T, Vaiva G, d'Hondt F. Evolution in French University Students' Mental Health One Month After the First COVID-19 Related Quarantine: Results From the COSAMe Survey. Frontiers in psychiatry. 2022 ;13:868369. DOI: https://doi.org/10.3389/fpsyt.2022.868369 PMid:35592379 PMCid:PMC9110762

Bedewy D, Gabriel A. Examining perceptions of academic stress and its sources among university students: The Perception of Academic Stress Scale. Health psychology open. 2015; 2(2)1-9. DOI: https://doi.org/10.1177/2055102915596714 PMid:28070363 PMCid:PMC5193280

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine. 2006; 166(10):1092-7. DOI: https://doi.org/10.1001/archinte.166.10.1092 PMid:16717171

Sherina MS, Arroll B, Goodyear-Smith F. Criterion validity of the PHQ-9 (Malay version) in a primary care clinic in Malaysia. Med J Malaysia. 2012 Jun;67(3):309-315. PMID: 23082424.

Hair Jr JF, Hult GT, Ringle CM, Sarstedt M, Danks NP, Ray S, Hair JF, Hult GT, Ringle CM, Sarstedt M, Danks NP. Evaluation of reflective measurement models. Partial least squares structural equation modeling (PLS-SEM) using R: A workbook. 2021:75-90. DOI: https://doi.org/10.1007/978-3-030-80519-7_4

Wong SS, Wong CC, Ng KW, Bostanudin MF, Tan SF. Depression, anxiety, and stress among university students in Selangor, Malaysia during COVID-19 pandemics and their associated factors. PloS one. 2023;18(1):e0280680. DOI: https://doi.org/10.1371/journal.pone.0280680 PMid:36696454 PMCid:PMC9876377

Limone P, Toto GA. Factors that predispose undergraduates to mental issues: A cumulative literature review for future research perspectives. Frontiers in public health. 2022;10:831349. DOI: https://doi.org/10.3389/fpubh.2022.831349 PMid:35252101 PMCid:PMC8888451

Ediz B, Ozcakir A, Bilgel N. Depression and anxiety among medical students: Examining scores of the beck depression and anxiety inventory and the depression anxiety and stress scale with student characteristics. Cogent Psychology. 2017;4(1):1283829. DOI: https://doi.org/10.1080/23311908.2017.1283829

Ngasa SN, Sama CB, Dzekem BS, Nforchu KN, Tindong M, Aroke D, Dimala CA. Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study. BMC psychiatry. 2017;17:1-7. DOI: https://doi.org/10.1186/s12888-017-1382-3 PMid:28599624 PMCid:PMC5466797

Wang C, Yan S, Jiang H, Guo Y, Gan Y, Lv C, Lu Z. Socio-demographic characteristics, lifestyles, social support quality and mental health in college students: a cross-sectional study. BMC public health. 2022; 22(1):1583. DOI: https://doi.org/10.1186/s12889-022-14002-1 PMid:35987998 PMCid:PMC9392273

Lipson SK, Zhou S, Abelson S, Heinze J, Jirsa M, Morigney J, Patterson A, Singh M, Eisenberg D. Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013-2021. Journal of affective disorders. 2022;306:138-47. DOI: https://doi.org/10.1016/j.jad.2022.03.038 PMid:35307411 PMCid:PMC8995361

Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Layzell G, Patel C, McCart A, Gibney C, Langstaff C, Ayonrinde O, Khalid-Khan S. Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study. BMC public health. 2023;23(1):655. DOI: https://doi.org/10.1186/s12889-023-15452-x PMid:37020282 PMCid:PMC10076091

Fatima F, Naz S, Shabnam N, Ali S, Fatima S. Investigation of Depression and Anxiety in Students due to Burdenized Curriculum and Shortage of Time at University level. Journal of Professional & Applied Psychology. 2021 Jul 5;2(1):21-35. DOI: https://doi.org/10.52053/jpap.v2i1.34

Jangmo A, Stålhandske A, Chang Z, Chen Q, Almqvist C, Feldman I, Bulik CM, Lichtenstein P, D'Onofrio B, Kuja-Halkola R, Larsson H. Attention-deficit/hyperactivity disorder, school performance, and effect of medication. Journal of the American Academy of Child & Adolescent Psychiatry. 2019 ;58(4):423-32. DOI: https://doi.org/10.1016/j.jaac.2018.11.014 PMid:30768391 PMCid:PMC6541488

Poots A, Cassidy T. Academic expectation, self-compassion, psychological capital, social support and student wellbeing. International Journal of Educational Research. 2020;99:101506. DOI: https://doi.org/10.1016/j.ijer.2019.101506

Sangma ZM, Shantibala K, Akoijam S, Maisnam AB, Visi V. Perception of students on parental and teachers' pressure on their academic performance. IOSR J Dental Med Sci. 2018;17(1):67-75.

Zhang J, Peng C, Chen C. Mental health and academic performance of college students: Knowledge in the field of mental health, self-control, and learning in college. Acta Psychologica. 2024;248:104351. DOI: https://doi.org/10.1016/j.actpsy.2024.104351 PMid:38905949