A study to assess depression anxiety stress among the college students in selected college of Goa

 

Stephanie Fernandes¹, Akshada Komarpant¹, Vaishnavi Dessai¹, Mrunali Gaude¹,

Karishma Naik¹, Snehal Gawas¹, Vaishali Naik¹, Qutandy Vaz¹, Shanti Naik¹, Neha Naik¹,

Florine Clara Fernades²*

¹Students, Vrundavan Institute of Nursing Education, Colvale, Bardez, Goa, India.

²Associate Professor and Head of Department, Department of Medical Surgical Nursing,

Vrundavan Institute of Nursing Education, Colvale, Bardez, Goa, India.

 

ABSTRACT:

Common mental health problems seen among the college students are depression, suicide, anxiety disorder, eating disorder, substance use etc. which may rise in young adulthood. This study was done to assess depression anxiety stress (DAS) among the college students in selected area of Goa. The objectives of the study were a) To assess Depression Anxiety stress (DAS) among the college students based on Depression Anxiety Stress Scale – 42 (DASS- 42). b) To associate the level of Depression, Anxiety and Stress (DASS) score with selected demographic variables of the college students. A quantitative approach was used with descriptive research design. Convenient sampling technique was used. Sample size was 85. The investigator used Depression Anxiety Stress Scale (DASS)-42 tool to assess Depression Anxiety Stress (D, A, S) among students. Descriptive and inferential statistics were used to analyze the data. The results revealed that 47(55.3%) had normal level of Depression, 20 (23.5%) had moderate level of Depression yet 2 (2.4%) suffered from severe depression, Majority of the subjects 24 (28.2%) has moderate Anxiety, 15 (17.6%) has severe Anxiety and 6 (7%) has very severe Anxiety. Majority of the subjects 12 (14.1%) has moderate Stress, 2 (2.4%) had severe and none had very severe Stress. The finding of the study showed varied levels of depression, anxiety and stress among the college students. So, screening and creating more awareness and intervention strategies may be needed for the better mental health of the students.

 

 

INTRODUCTION:

In higher education programs the student’s life becomes more stressful as they may be living away from their homes or family or vast syllabus.¹ In addition; they need to cope with separation from their family or may have added responsibility for their family.

 

Therefore, many a times the college students may experience the first onset of mental illness and substance use or an exacerbation of their symptoms.² The global prevalence of depression, anxiety, and stress among adolescents and young adults estimated to range from 5% to 70%.³ According to the 2013 Global Burden of Disease study highlights depression, followed by anxiety, schizophrenia and bipolar disorder as more prevalent among this group.⁴ Depression most commonly can occur at any time, but on average, first appears during the late teens to mid-20s.⁵ Anxiety is one of the major predictors of academic performance. Students with anxiety disorder have very poor attitude in their studies, they have lack of interest in learning, poor performance in exams, and on assignments.⁶ Stress is a natural response to a threatening situation. When an individual perceives a situation as threatening, she is likely to experience stress.⁷

 

A study done to assess the symptoms of depression, anxiety, and stress among undergraduate students studying in a government degree college in India among 133 undergraduate students using the Depression Anxiety, Stress Scale (DASS-21) showed that the level of anxiety was more than depression followed by stress based on DASS 21. The study highlighted need of early interventions to improve the quality of life and reduce the stress among student.⁷ A cross-sectional, observational study aimed to explore the level of stress, anxiety and depression using depression, anxiety and stress scale -42 among the postgraduate medical students among fifty post graduate medical students of Government Medical College, India revealed mild anxiety level and moderate level of stress in postgraduate students.⁸

 

Hence the investigators felt the need to assess depression, anxiety and stress using DASS with a view to prepare a self-instructional booklet on life style modification for college students.

 

PROBLEM STATEMENT:

“A Study to assess Depression Anxiety Stress (D, A, S) among the college students in selected area of Goa”

 

OBJECTIVES:

·       To assess the Depression, Anxiety and Stress (DAS) among the college students based on depression, anxiety and stress scale -42 (DASS-42)

·       To associate the level of depression, anxiety and stress (DAS) score with selected demography variables of the college students.

 

HYPOTHESIS:

The entire hypothesis will be tested at 0.05 level of significance

 

H₁: there will be significantly increased level of depression, anxiety and stress (DAS) than normal among the college students.

 

H₂: there will be significant association of depression score with the selected demographic variables of the college students.

 

H₃: there will be significant association of anxiety score with the selected demographic variables of the college students.

H₄: there will be significant association of stress score with the selected demographic variables of the college students.

 

MATERIALS AND METHODS:

Research approach: A quantitative research approach was adopted for this study.

 

Research design: Descriptive research design was adapted.

 

Research setting: The study was conducted in Shree Vetal Institute of Education and Training.

 

Population: The population of the study consisted of the students of diploma in education from Shree Vetal Institute of education and training, Colvale, Goa.

 

Sample: The sample size for the study consisted of 85 students of diploma in education of Shree Vetal Institute of education and training, Colvale, Goa.

 

Sampling technique: Convenient sampling technique was used.

 

Description of the final tool: The tool consisted of 2 parts.

 

Part 1: Demographic proforma: It consisted of 13 items.

 

Part 2: A standardized self-reporting DASS Tool was used for of gathering information from samples on depression, anxiety and stress.

 

Plan for data analysis: The collected data would be analysed on the basis of objectives and hypothesis.

 

Section 1: Baseline data containing sample characteristics would be presented in the tables using frequency and percentage.

 

Section 2: The level of DAS of students would be analyzed using range, mean, media standard deviation, frequency and cumulative percentage. The same will be presented using diagrams.

 

Section 3: Association between depression, anxiety and stress and demographic variable would be analyzed using chi-square test.

 

RESULTS:

Section I: Description of sample characteristics:

Organisation of the findings:

The analysed data was presented under the following headings:

 

Section I: Description of Sample characteristics of the college students.

 

Section II: The level of DAS of the college students.

 

Section III: The association of level of DAS of the college students with selected demographic variables.

 

Part I: The association of the level of depression of the college students with the selected demographic variables.

 

Part II: The association of the level of anxiety of the college students with the selected demographic variables.

 

Part III: The association of the level of stress of the college students with the selected demographic variables.

 

Section I: Sample Characteristics:

This section describes the demographic variables of the college students of Shree Vetal Institute of Education and Training, Colvale, Goa.

 

Table 1: Frequency and percentage distribution of subjects based on the selected demographic variables

S. No.	Variables	Frequency	%
1.	Age in years
	a.      ≤22 years	20	24
	b.      >22 years	65	76
2.	Gender
	a.      Male	12	14
	b.      Female	73	86
3.	Religion
	a.      Hindu	73	86
	b.      Muslim and Christians	12	14
4.	Marital status
	a.      Single	75	88
	b.      Married	10	12
5.	Family structure
	a.      Single	13	15
	b.      Nuclear	50	59
	c.      Joint	22	26
6.	Type of accommodation
	a.      Living with family	83	98
	b.      Living with friends	2	2
7.	Education of the father
	a.      No school education	3	3
	b.      Primary school	22	26
	c.      Secondary and Higher secondary School	50	59
	d.      Graduation	10	12
8.	Education of the mother
	a.      No school education	5	6
	b.      Primary school	20	23
	c.      Secondary and Higher secondary School	56	66
	d.      Graduation	4	5
9.	Education of Participant
	a.      1st year Diploma in Education	39	46
	b.      2nd year Diploma in Education	46	54
10.	Occupation of father
	a.      unemployed	7	8
	b.      Homemaker andother	19	22
	c.      Government, private employee and business	59	70
11.	Occupation of Mother
	a.      unemployed	1	1
	b.      Homemaker andother	74	87
	c.      Government, private employee and business	10	12
12.	Monthly income in Rupees
	a.      ≥ 10,000	29	34
	b.      >10,000	56	66
13.	Social Support
	a.      Family members	83	93
	b.      Friends(boy/girl)	2	8

 

Table 2: Frequency and Percentage Distribution of Subjects According to the Level of Depression.                                                 n = 85

Depression (D) Range	Inference	Frequency	Percentage	CF%
0-9	Normal	47	55.3	55.3
10-13	Mild	16	18.8	74.1
14-20	Moderate	20	23.5	97.6
21-27	severe	2	2.4	100.0
>28	Very severe	0	0

 

Table 3: Frequency and Percentage Distribution of Subjects According to the level of Anxiety                                                        n = 85

Anxiety (A) Range	Inference	Frequency	Percentage	CF%
0-7	Normal	30	35.3	35.3
8-9	Mild	10	11.8	47.1
10-14	Moderate	24	28.2	75.3
15-19	Severe	15	17.6	92.9
>20	Very severe	6	7.1	100.0

 

Table 4: Frequency and Percentage Distribution of Subjects According to the Level of Stress.                                                        n = 85

Stress (S) Range	Inference	Frequency	Percentage	CF%
0-14	Normal	56	65.9	65.9
15-18	Mild	15	17.6	83.5
19-25	Moderate	12	14.1	97.6
26-33	Severe	2	2.4	100.0
>34	Very severe	0	0

 

It is evident from Table 1, that the majority 65 (76%) of the college students belonged to the age group of more than 22 years and the least 20 (24%) of the college students belonged to the age group of less than 22 years. Most 73 (86%) of the college students were female and least 12 (14%) were males. The majority 73 (86%) of the college students were Hindus and least 12 (14%) were Muslims and Christians. Majority 75 (88%) of the college students were single and least 10 (12%) were married. Most 50 (59%) of the college students belonged to the nuclear family, a few 22 (26%) belonged to the joint family and least 13 (15%) were living single. Majority 83 (98%) of the college students were living with the family and remaining 2 (2%) were living with the friends. Majority 50 (59%) of the college student’s fathers were having secondary and higher secondary school education, few 22(26%) fathers were having primary school education, very few 10(12%) fathers were graduates and least 3 (3%) fathers had no formal school education. Majority 56 (66%) of the college student’s mothers were having secondary and higher secondary school education, few 20 (23%) mothers were having primary school education, very few 5 (6%) mothers had no formal school education and least 4 (5%) mothers were graduates. Majority 46 (54%) of the participants are studying in second year diploma in education and least 39 (46%) are studying in first year diploma in education. Majority 59 (70%) of the college student’s fathers are government and private employee, few 19 (22%) fathers are homemakers and others and least 7 (8%) fathers are unemployed. Majority 74 (87%) of the college student’s mothers are homemakers and least 1 (1%) were unemployed. Most 56 (66%) of the college student’s family income was more than Rs.10,000/. Majority 83 (93%) of the college students have social support by family members.

 

Section II: Description of the level of Depression Anxiety and Stress.

Table 2 shows that more than half of them 47 (55.3%) had normal level of depression and 20 (23.5%) had moderate level of depression yet 2 (2.4%) suffered from severe depression.

 

Table 3 shows that majority of the subjects 24 (28.2%) had moderate anxiety,15 (17.6%) had severe and 6 (7 %) had very severe anxiety.

 

Table 4 shows that the majority of the subjects 12 (14.1%) had moderate stress, 2 (2.4%) had severe and none had very severe stress.

 

Section III: The association of the level of DAS of the college students with the selected demographic variables.

Table 5: The association of the level of depression of the college students with the selected demographic variables

S. No.	Variables	Depression score		c2	df	Inference
		≤9	>9
1.	Age in years
	a.      ≤22 years	11	9	0.0048	1	NS
	b.      >22 years	35	30
2.	Gender			3.01	1	NS
	a.      Male	5	7
	b.      Female	41	32
3.	Religion			2.43	1	NS
	a.      Hindu	37	36
	b.      Muslim and Christians	9	3
4.	Marital status			2.64	1	NS
	a.      Single	43	32
	b.      Married	3	7
5.	Family structure			10.76	2	S
	a.      Single	2	11
	b.      Nuclear	33	17
	c.      Joint	11	11
6.	Type of accommodation			1.7	1	NS
	a.      Living with family	44	39
	b.      Living with friends	2	0
7.	Education of the father			0.047	1	NS
	a.      Primary school	13	12
	b.      Secondary School and above	33	27
8.	Education of the mother			0.047	1	NS
	a.      Primary school	13	12
	b.      Secondary School and above	33	27
9.	Education of Participant			1.57	1	NS
	a.      1st year Diploma in Education	24	15
	b.      2nd year Diploma in Education	22	24
10.	Occupation of father			0.94	1	NS
	a.      Homemakers and others	12	14
	b.      Employed	34	25
11.	Occupation of Mother			0.151	1	NS
	a.      Homemakers and others	40	35
	b.      Employed	6	4
12.	Monthly income in rupees			0.33	1	NS
	a.      ≥ 10,000	17	12
	b.      >10,000	29	27
13.	Social Support			1.7	1	NS
	a.      Family members	44	39

c² ₍₁₎ =3.84, at 5% level, c² ₍₂₎ = 5.991at 5% level S=Significant NS= not significant

 

It is evident from Table 5 that the calculated χ² value for family structure (χ² _{1 =}10.76) was more than the table value (χ² _{1 =}3.84; p<0.05), so the research hypothesis was accepted. Hence, there was significant association of depression of the college students with family structure. The calculated χ² value for age (0.0048), gender (3.01), religion (2.43), marital status (2.64), type of accommodation (1.7), education of the father (0.047), education of the mother (0.047), education of participant (1.57), occupation of father (0.94), occupation of mother (0.151), monthly income of family (0.33) and social support (1.7) was lesser than the table value (χ² _{1 =}3.84; p<0.05), so the null hypothesis was accepted. Hence there was no significant association of depression of the college students with these selected demographic variables.

 

Part II: The association of the level of anxiety of the college students with the selected demographic variables.

Table 6: The association of the level of anxiety of the college students with the selected demographic variables

S. No.	Variables	Anxiety Score		c2	df	Inference
		≤10	>10
1.	Age in years			0.002
	≤22 years	10	10		1	NS
	>22 years	33	32
2.	Gender			28.27
	Male	5	7		1	S
	Female	38	35
3.	Religion			0.083	1	NS
	Hindu	33	40
	Muslim and Christians	6	6
4.	Marital status			0.47
	Single	39	36		1	NS
	Married	4	6
5.	Family structure			4.77
	Single	3	10
	Nuclear	27	23		2	S
	Joint	13	9
6.	Type of accommodation			0.0296
	Living with family	42	41		1	NS
	Living with friends	1	1
7.	Education of the father
	Primary school	15	10	1.23	1	NS
	Secondary School and above	28	32
8.	Education of the mother
	Primary school	16	9	2.53	1	NS
	Secondary School and above	27	33
9.	Education of Participant
	1st year Diploma in Education	29	10	16.29	1	S
	2nd year Diploma in Education	14	32
10.	Occupation of father					NS
	Homemakers and others	10	16	2.19	1
	Employed	33	26
11.	Occupation of Mother
	Homemakers and others	38	37	0.25	1	NS
	Employed	5	5
12.	Monthly income in rupees
	≥ 10,000	13	16	0.50	1	NS
	>10,000	30	26
13.	Social Support
	Family members	42	41	0.0296	1	NS
	Friends(boy/girl)	1	1

c² ₍₁₎ =3.84, at 5% level, c² ₍₂₎ = 5.991 at 5% level         S=Significant NS= not significant

 

It is evident from Table 6, that the calculated χc² value for gender (c² _{1 =}28.27) and education of participant (16.29) was more than the table value (χc² _{1 =}3.84; p<0.05), so the research hypothesis was accepted. The calculated χc² value for age (0.002), religion (0.083), marital status (0.47), family structure (4.77), type of accommodation (0.0296), education of the father (1.23), education of the mother (2.53), occupation of father (2.19), occupation of mother (0.25), monthly income of family (0.50) and social support (0.0296) was lesser than the table value (χc² _{1 =}3.84; p<0.05), so the null hypothesis was accepted. Hence, there was no significant association of anxiety of the college students with these selected demographic variables.

 

Part III: The association of level of Stress of the college students with the selected demographic variables.

Table 7: The association of level of Stress of the college students with the selected demographic variables                                        n=85

S. No.	Variables	Stress score		c2	df	Inference
		≤12	>12
1.	Age in years			0.39
	≤22 years	9	11		1	NS
	>22 years	34	31
2.	Gender			0.002
	Male	6	6		1	NS
	Female	37	36
3.	Religion			0.002
	Hindu	37	36		1	NS
	Muslim and Christians	6	6
4.	Marital status			0.0017
	Single	38	37		1	NS
	Married	5	5
5.	Family structure
	Single	4	9	2.16	2	NS
	Nuclear	28	22
	Joint	11	11
6.	Type of accommodation
	Living with family	41	42	1.99	1	NS
	Living with friends	2	0
7.	Education of the father
	Primary school	13	12	0.113	1	NS
	Secondary School and above	30	30
8.	Education of the mother
	Primary school	14	11	0.4	1	NS
	Secondary School and above	29	31
9.	Education of Participant
	1st year Diploma in Education	23	16	2.01	1	NS
	2nd year Diploma in Education	20	26
10.	Occupation of father
	Homemakers and others	11	15	1.01	1	NS
	Employed	32	27
11.	Occupation of Mother
	Homemakers and others	38	37	0.0012	1	NS
	Employed	5	5
12.	Monthly income in Rupees
	≥ 10,000	14	15	0.12	1	NS
	>10,000	29	27
13.	Social Support
	Family members	42	41	0.0296	1	NS
	Friends(boy/girl)	1	1

c² ₍₁₎ =3.84, at 5% level, c² ₍₂₎ = 5.991, at 5% level        S=Significant NS= not significant

 

It is evident from Table 7, that the calculated χc² value for age (0.39), gender (0.002), religion (0.002), marital status (0.0017), family structure (2.61), type of accommodation (1.99.),  education of the father (0.113), education of the mother (0.4), education of participant (2.01), occupation of father (1.01), occupation of mother (0.0012), monthly income of family (0.12) and social support (0.0296) was lesser than the table value (χc² _{1) =}3.84; p<0.05), so the null hypothesis was accepted. Hence there was no significant association of stress of the college students with these selected demographic variables.

 

DISCUSSION:

In the present study majority of the subjects 47 (55.3%) had normal level of depression, 20 (23.5%) had moderate level of depression, 16 (18.8%) had mild level of depression, 2(2.4%) suffered from severe depression and none had very severe depression. Majority of the subject 30 (35.3%) had normal level of anxiety, 24 (28.2%) had moderate anxiety, 15 (17.6%) had severe anxiety, 10 (11.8%) had mild level of anxiety and 6 (7%) had very severe anxiety. Majority of the subjects 56 (65.9%) had normal level of stress, 15 (17.6%) had a mild level of stress, 12 (14.1%) had moderate stress, 2 (2.4%) had severe stress and none had very severe stress.

 

Similar findings are identified in study that was conducted in Sudanese Medical students showed that majority of the subjects (46.6%) had normal level of Depression, few (21.2%) had moderate levels of depression, (18.2%) had mild level of Depression, (8.9%) had severe level of Depression, (5.1%) had very severe level of Depression. Majority (49%) had normal level of Anxiety, (22.3%) had moderate level of Anxiety, (13.7%) had very severe level of Anxiety, (7.7%) had severe level of Anxiety and (7.3%) had mild level of Anxiety. Majority (49.5%) had normal level of Stress, (16.7%) had severe level of Stress, (16.1%) had moderate levels of Stress, (13.7%) had mild level of Stress and (4.1%) had very severe level of Stress.¹⁷

 

A cross-sectional study was conducted among first and final year medical students in JSS Medical College and Mysore showed that 36.8% had moderate levels of depression and 39.3% had moderate level of anxiety, 35.6% had moderate level of stress.⁹

 

CONCLUSION:

The study showed differing levels of depression, anxiety and stress among the college students. Therefore, educating and intervening strategies may be useful to help the students to gain better mental health status.

 

REFERENCES:

1.          Bhujade, Vijay Mahadeorao. Depression, Anxiety and Academic Stress among the college students: A Brief Review. Indian Journal of Health and Wellbeing. 2017; 11: 748-751.

2.          Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. The college students: Mental Health Problems and Treatment Considerations. Acad Psychiatry. 2015; 39(5): 503-511. doi:10.1007/s40596-014-0205-9

3.          Sahoo, Saddichha, and Christoday R J Khess. “Prevalence of depression, anxiety, and stress among young male adults in India: a dimensional and categorical diagnoses-based study.” The Journal of nervous and mental disease, 2010; 198(12): 901-4. doi:10.1097/ NMD.0b013e3181fe75dc

4.          https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf

5.          https://www.psychiatry.org/patients-families/depression/what-is-depression

6.          Vitasari, P. et al. “The Relationship between Study Anxiety and Academic Performance among Engineering Students.” Procedia - Social and Behavioral Sciences 2010; 8: 490-497.

7.          https://www.samhsa.gov/dtac/dbhis-collections/disaster-response-template-toolkit/organizational-individual-stress-management

 

 

Received on 14.08.2021           Modified on 21.09.2021

Accepted on 07.10.2021          © A&V Publications all right reserved