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Association of Depressive Symptoms and Social Determinants of Health in Medical Students of Four Countries - Czechia, Iran, Kenya, and Venezuela Publisher Pubmed



Zimovjanova A1 ; Wekesah FM2, 3, 4 ; Dehghani Firouzabadi F5, 6, 7 ; Broz J8 ; Urbanova J9 ; Mechanick JI10 ; Sulbaran N11 ; Medina A11 ; Maranhao Neto GA12 ; Nietomartinez R2, 13, 14 ; Babagoli MA10 ; Torres M15 ; Kunzova M12, 16 ; Pesl M12, 17, 18 Show All Authors
Authors
  1. Zimovjanova A1
  2. Wekesah FM2, 3, 4
  3. Dehghani Firouzabadi F5, 6, 7
  4. Broz J8
  5. Urbanova J9
  6. Mechanick JI10
  7. Sulbaran N11
  8. Medina A11
  9. Maranhao Neto GA12
  10. Nietomartinez R2, 13, 14
  11. Babagoli MA10
  12. Torres M15
  13. Kunzova M12, 16
  14. Pesl M12, 17, 18
  15. Medina J19
  16. Ugel E2, 13, 20
  17. Jahandideh H6
  18. Roomiani M6
  19. Deravi N5, 21
  20. Poopak A5
  21. Esteghamati A5
  22. Gonzalezrivas JP2, 12
Show Affiliations
Authors Affiliations
  1. 1. Faculty of Medicine, Masaryk University, Brno, Czech Republic
  2. 2. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  3. 3. African Population and Health Research Centre, Nairobi, Kenya
  4. 4. Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
  5. 5. Endocrinology and Metabolism Research Centre, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. ENT and Head & Neck Research Centre, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, MA, United States
  8. 8. Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
  9. 9. Department of Internal Medicine, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
  10. 10. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  11. 11. Foundation for Clinic, Public Health, Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
  12. 12. International Clinical Research Centre, St Anne's University Hospital Brno, Brno, Czech Republic
  13. 13. LifeDoc Health, Memphis, TN, United States
  14. 14. School of Medicine, Faculty of Medicine, University of the Andes, Venezuela
  15. 15. Ministry of Public Health of Ecuador, Quito, Ecuador
  16. 16. Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
  17. 17. First Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital Brno, Brno, Czech Republic
  18. 18. Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
  19. 19. School of Medicine, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
  20. 20. Department of Social and Preventive Medicine, School of Medicine, Lisandro Alvarado Central Western University, Barquisimeto, Venezuela
  21. 21. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Central European journal of public health Published:2025


Abstract

OBJECTIVES: Medical students experience worse psychological well-being than the general population. Social determinants of health (SDOH) relate to conditions in which people live, work, and age and significantly influence mental health. This study examines the association between depressive symptoms and SDOH in medical students from four countries: Czechia, Iran, Kenya, and Venezuela. METHODS: An online cross-sectional survey was conducted in the spring of 2022. The questionnaire focused on depressive symptoms (using a validated psychiatric scale DASS-21 to assess mental health) and various SDOHs. RESULTS: A total of 2,033 medical students participated in the survey, with a median age of 23.0 years; 64.8% were females; 60.8% of respondents had some degree of depressive symptoms (mild-to-moderate 32.5%, severe-to-extremely severe 28.3%). Several SDOHs, such as low engagement in social life, low personal funds, and low social class, were strongly associated with severe-to-extremely severe depressive symptoms (p < 0.001), and the associations differed among countries. The prevalence of severe-to-extremely severe depressive symptoms varied significantly across the four countries, with Iran having the highest prevalence (OR = 2.1 compared to Czechia), followed by Czechia (OR = 1, reference value), Kenya (OR = 0.9), and Venezuela (OR = 0.6). CONCLUSION: The study demonstrates the high prevalence of depressive symptoms among medical students from four global regions and the significant association with specific SDOH. Notably, the variation in prevalence across countries and differential relationships with SDOH underscore the importance of considering transcultural factors in research and management to improve mental health among medical students.