Prevalence and associated factors of depressive symptoms among dormitory-residing medical and health sciences students: A cross-sectional study.

Abstract

Background: Depressive symptoms are common among university students and may be particularly relevant in health-professional education, where academic demands, clinical training, and psychosocial stressors coexist. Students living in university dormitories may also experience separation from family, reduced privacy, and concerns about institutional conditions. These pressures may be amplified in southeastern Iran, a region documented to have distinct socioeconomic deprivation and constrained healthcare access relative to national averages.

Objective: To estimate the prevalence of depressive symptoms and examine demographic, academic, psychosocial, health-related, lifestyle, and institutional factors associated with these symptoms among dormitory-residing medical and health sciences students at Iranshahr University of Medical Sciences, southeast Iran.

Methods: This institution-based cross-sectional study used a census approach to invite all eligible male and female students residing in the university dormitories who were willing to participate. After written informed consent was obtained, the self-administered questionnaire was distributed on the same designated holiday/non-working day in the female dormitory by a trained female research assistant and in the male dormitory by a trained male research assistant. Completed questionnaires were collected two hours later on the same day. The study period was 18 February to 4 April 2025.

Results: The mean age of participants was 21.27 ± 3.04 years, and the mean BDI-II score was 13.05 ± 10.54. Overall, 232 students (57.4%; 95% CI, 52.6-62.2%) met the primary study-defined threshold for depressive symptoms. The corresponding prevalence estimates were 40.1% (95% CI, 35.3-44.9%) at a threshold of ≥14 and 16.8% (95% CI, 13.2-20.5%) at a threshold of ≥22. In an exploratory adjusted model, students in semesters 5-8 had lower odds of depressive symptoms than those in semesters 1-4 (aOR 0.41, 95% CI, 0.22-0.78); higher odds were observed among students with a history of depression (aOR 7.95, 95% CI, 2.57-24.62), no leisure time (aOR 4.22, 95% CI, 2.15-8.26), no exercise (aOR 2.65, 95% CI, 1.37-5.10), dissatisfaction with the university (aOR 2.55, 95% CI, 1.14-5.69), being only somewhat satisfied with the field of study (aOR 3.19, 95% CI, 1.81-5.61), and an adverse life event (aOR 2.44, 95% CI, 1.44-4.14). Emotional-relationship status was not associated with the outcome in this adjusted model. The exploratory model showed good apparent discrimination in this sample (AUC = 0.82); the Hosmer-Lemeshow test did not indicate evidence of lack of fit (P = 0.125). A proportional-odds ordinal sensitivity analysis using study-defined BDI-II score categories was broadly consistent in direction with these findings, though this analysis was exploratory.

Conclusions: Depressive symptoms were common under the study-defined threshold in this dormitory-residing student population, in a province independently documented to face substantial socioeconomic deprivation and constrained healthcare access. The lower prevalence estimates obtained with higher BDI-II thresholds highlight the importance of explicitly specifying the cutoff when reporting prevalence. Longitudinal and multicenter studies using diagnostic interviews and population-appropriate thresholds, including studies spanning other institutions within this province, are needed to clarify temporal relationships and clinical significance.