Fatima Gul  ( Marxism School of Philosophy, Northeast Forestry University, Harbin, China )
Wang Yuefen  ( Marxism School of Philosophy, Northeast Forestry University, Harbin, China )
Inam Ullah  ( College of Wildlife Resources, Northeast Forestry University. Harbin, China )
Shagufta Zada  ( Marxism School of Philosophy, Northeast Forestry University, Harbin, China )

Objective: To assess the prevalence of depression among university students in Pakistan.

Methods: The descriptive cross-sectional study was conducted from October 1, 2017, to February25, 2018, at Agriculture University, Faisalabad, Gomal University, Dera Ismail Khan, PirMehr Ali Shah Arid Agriculture University, Rawalpindi, University of Peshawar and Qurtuba University, Dera Ismail Khan, Pakistan. Data was collected using a pre-tested, structured questionnaire, and was analysed using SPSS 19.

Results: Of the 1159 subjects, 367(31.6%) were males and 792(68.3%) were females. The overall age range was 19-45 years. Of all the subjects, 986(85%) had some degree of depression, while 173(15%) were normal. Depression in females was significantly higher than males (p<0.05). Depression also had a significant association with academic grades (p<0.001).

Conclusions: Depression was found to be common among university students in Pakistani.

Keywords: Depression, University, Students, Pakistan. (JPMA 70: 650; 2020)

https://doi.org/10.5455/JPMA.15757

 

Introduction

 

Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration. It is one of the emotional problems, and hopelessness and helplessness are its main causes. Commonly, depression is marked by sad feelings among college students which are known as a common mental illness.¹ Depression is a prevalent problem among college students across the world and it affects a students' ability to perform activities of daily life (ADLs). ADLs is a problematical disorder that causes numerous impairments in case of interpersonal, societal and professional functioning.² It is basically a deficiency of positive behaviour that exhibits as a range of symptoms like sleeping disorders, lack of attentiveness, anxiety, deficiency of self-care, and shortage of interest in routine experiences of life. Unattended depression generally affects daily life and persists for a long time.³

It has been estimated that 480 million people all over the world are affected from depression; half of the people also have anxiety.⁴ It has been estimated that more than 90% people in the community suffer from anxiety, depression and co-morbidities are common mental health problems.⁵ Previously mentioned parameters are used as a tool for a measurement of psychological illness in communal life, because in several studies cosmopolitan prevalence of severe types of depression has been recorded.⁶ It is stated that two-third of the sufferers are from the developing nations and this proportion may rise due to factors like increase in population, urban development and strong associations between confrontational socio-environmental factors and prevalence of mental illness.^7,8 There are a total of 151.2 million people worldwide affected by depression. Depression is considered to be the third greatest common cause of disability, and it is predicted that it would top the list by 2030. The cases of depression reported in man are 7-12%, while for women a higher ratio of depression (20-25%) is observed and these proportions are prevailing in all types of races, areas, education and financial or social statuses.⁹ It is one of the most common health problems for university students.¹⁰ Depressed students time and again feel sad, which leads to poor academic performance. According to various studies, depression, anxiety and stress has great impact on the performance of students¹¹ which may damage their educational achievement, lead to weakening in relationships, create problems in married life, and affect their jobs in the future.^12-14 Depression is marked as a predominant issue among the developing countries compared to the developed countries.¹⁵ However, among the developing countries, Pakistan is leading the list by having the highest depression rate because of unemployment, gender discrimination, political uncertainty, insecurity, economic issues, disrupted social settings and stressful working conditions.^16,17

Rate of prevalence of depression, anxiety and stress amongst Turkish university students was found to be as high as 27.1%, 47.1% and 27.0%, respectively.¹⁸ This data is correlated with a number of different findings that showed increased rates of psychosomatic sickness in numerous university students worldwide.^19,20

In Pakistan, 6% population is affected by depression. A study carried out in the country reported that there is a depression-affected person among every four families that took part in the study.²¹ According to the World Health Organisation (WHO), the main victims of depression in Pakistani society are women. The main reasons included divorce, family conflicts, loss of parents in early childhood, stressful family events and lack of awareness about female rights.²² The current study was planned to assess the prevalence of depression among university students in Pakistan.

 

Subjects and Methods

 

The descriptive cross-sectional study was conducted from October 1, 2017, to February 25, 2018, at Agriculture University, Faisalabad, Gomal University, Dera Ismail Khan, PirMehr Ali Shah Arid Agriculture University, Rawalpindi, University of Peshawar and Qurtuba University, Dera Ismail Khan, Pakistan. Participants were students of either gender from bachelor to doctorate (Ph.D.) levels. The required permission for conducting the study was obtained from the concerned authorities.

After an extensive literature review on the effects of depression on university students, a questionnaire was designed. To evaluate the rate of depression, the depression screening test was appliedwas applied established by the psychiatrist Ivan Goldberg, M. D 19935. The questionnaire had 18 items and the depression was measured on a 5-point Likert scale according to which, 0 = Not at all, 1 = Just a little, 2 = Somewhat, 3 = Moderately, 4 = Quite a lot, and 5 = Very much.

Data was collected during organised field surveys conducted by the researchers. On pre-determined dates, different universities were visited and the questionnaires were filled from randomly-selected participants. The responses were taken individually while keeping the identities of the students anonymous.

Data were analysed using SPSS19 in preliminary and validation phases. Cross-tabulation with depression level was done of all the variables, including age, body mass index (BMI), weight, height and cumulative grade point average (CGPA). Chi-square test was used to test the significance of the variables. Data was analysed through one-way analysis of variance (ANOVA) to test the mean difference among the variables. P<0.05 was considered significant. Post Hoc test was also employed to validate the results.

 

Results

 

Of the 1159 subjects, 367(31.6%) were males and 792(68.3%) were females. The overall age range was 19-45 years. Of all the subjects, 986(85%) had some degree of depression, while 173(15%) were normal (Figure).

Depression was not significant in gender wise females and males (p=0.846). Depression also had a significant association with academic grades (p<0.001) (Table-1).

There was no significant difference in terms of depression's association with age, weight, height and BMI and depression levels (Table-2).

 

Discussion

 

The current study, to our knowledge, is the largest epidemiological study about depression among university students in Pakistan with an elaborate survey response rate. The study found a depression prevalence rate of 85%. In terms of the four levels of depression, 37.8% of those having depression were in the 'perhaps' category, 20.82% 'mild', 15.78% 'moderate' and 2.68% 'severe'. Realistic prevalence of depression among university students in various countries indicated wide variation. In a Spanish university, for instance, 9% had main type depression and 33% had slight depressive episodes.²³ In Japan, prevalence ranged from 21% for major to 33% for mild depressive symptoms.²⁴ A study among Turkish university students demonstrated 27.1%, 47.1% and 27% rates of depression, anxiety and stress, respectively¹⁸. In another study in Pakistan, prevalence of depression was estimated at 40.9%.²⁵

The current study found depression more prevalent in female students, which is a finding in contrast with literature.²⁶

The prevalence of depression among females was almost double compared to the males.²⁷ A study on two rural groups reported 66% and 72% depression among women in contrast to 25% and 44% of men.²⁸ Similar results were demonstrated by another study in both rural and urban areas.²⁹ The findings of the present study are also in line with these previous studies.

Marriage, irrespective of gender, was another potential depressing factor found among the elite working population of Karachi as single individuals were least depressed compared to divorced and widowed. However, the prevalence of depression among married couples was very low.³⁰

A study has shown no gender difference in the rate of depression.³¹

A variety of factors can be responsible for the prevalence of depression in university students. In general, university life is a transient stage of life, with focus on academics and the consequent financial and social stresses can lead to depression. Lack of expertise in governmental policy-making setup regarding mental illness is a major cause of rising depression prevalence.³²

Also, smoking is taken as a causal factor for depression³³, but it is possible that smoking might be the coping mechanism for the students.

Prospective cohort, multi-centre studies are recommended to provide effective, generalisable information on depression and its effects on patient care.

 

Conclusion

 

The prevalence of depression was found to be considerably high among university students, especially among females. Academic grades also had an association with depression.

 

Disclaimer: None.

Conflict of Interest: None.

Source of Funding: None.

 

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