98 | KỸ YẾU HỘI THẢO QUỐC TẾ VỀ SỨC KHÔE TÂM THÂN TRỂ EM VIỆT NAM LẦN THỨ V
DEPRESSION, ANXIETY AND STRESS AMONG STUDENTS IN HO CHI MINH CITY
Kieu Thi Thanh Tra’ ABSTRACT
Background: There are many different kinds of stressors in students’ life that may affect their
physical and mental health However, the evidences for mental or psychological problems, such as depression, anxiety and stress, among students in Ho Chi Minh city (HCMC) are limited Objective: The aim of this research was to study depression, anxiety and stress among 500 students in HCMC
Method: The DASS-42 (Lovibond, S.H & Lovibond, P.F., 1995), translated into Vietnamese,
is the main material of this study The reliability index of this scale (Cronbach’s ơ) is 0.953
The sample consisted of 500 students (50.2% males and 49.8% females) from 6 universities
and colleges in HCMC
Results: The mean scores of depression, anxiety and stress among participants were found as 13.37 (SD = 9.30), 15.26 (SD = 8.14), 16.89 (SD = 8.16), which means students had mild depression, severe anxiety and mild stress The results also confirmed significant correlations
between depression - anxiety (r= 0.820, p= 0.00), anxiety - stress (r= 0.821, p = 0.00) and stress - depression (r = 0.802, p = 0.00) There was significant difference in depression score among
males and females (t = 2.280, p = 0.023) as males’ score (M = 14.31; SD = 9.48) were found higher than females’ (M = 12.42; SD = 9.04) Based on students’ major of study, there were significant differences in depression (F = 25.188; p = 0.00), anxiety (F = 13.661; p = 0.00) and stress (F = 9.082; p = 0.00) In detailed, Medicine & Pharmacy students had the highest scores
in both 3 dimensions, compared with whom studied Education and Economics & Services
Conclusion: Overall findings suggested that students in HCMC were at risks of depression, anxiety and stress which means a mental health care program is in need in Vietnamese higher education
Keywords: mental health, depression, anxiety, stress
1 INTRODUCTION
Mental health is known as human’s emotional, psychological and social well-being or an absence of mental illness According to the World Health Organization, mental health includes “subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others”
(WHO, 2001, p.5) Therefore, mental health is really important to buman throughout lifespan
Higher education is an extreme stressful process, so there are many different kinds of
stressors in students? life that may affect their physical and mental health A review of literature
confirms that researches on students’ mental health have been increased in recent years in Viet
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Nam as well as in other countries (Le, 2011; Nguyen, 2017; Bayram & Bilgen, 2008; Ghaderi et al., 2009; Demirbatir, 2012; Balapala, 2017; Kurebayashi et al., 2012; Manpreet & Maheshwari, 2015; Papazisis et al., 2014; Rathnayake & Ekanayaka, 2016; Wong et al., 2006) However, the
evidences for mental or psychological problems, such as depression, anxiety and stress, among students in Ho Chi Minh city are limited The aim of this study was to identify the prevalences of depression, anxiety and stress among 500 students in Ho Chi Minh city by using the DASS-
42, Vietnamese version and to analyze the differences in these psychological problems based on gender and students’ major of study
2 METHODS
2.1 Sample
A total of 500 students from 6 universities and colleges in Ho Chi Minh city (University of Medicine & Pharmacy, Pham Ngoc Thach University of Medicine, University of Education,
National College of Education, University of Economics and Saigontourist Hospitality College) were voluntarily included in this study in 2018 The detailed sample is described in Table 1
Table 1 The description of study sample Aspect Classification Frequency Percentage (%) Male 251 50.2 Gender Female 249 49.8
Medicine and pharmacy 162 32.4
Major of study Education 163 32.6
Economics and services 175 35.0
Total 500 ` 100.0
2.2 Material
The Depression, Anxiety and Stress Scale, 42-item version (Lovibond, S.H & Lovibond, P.E., 1995), which was translated into Vietnamese using the back - translation method to ensure the meaning’s equivalence, is the main material of this study This scale consists of 42 items which was used to measure three dimensions as Depression, Anxiety and Stress Each item was rated on 4-point likert type, ranging from 0 presenting “did not apply to me at all” to 3 presenting “apply to me very much, or most of the time” Subscale scores were separately calculated by summing up points of relevant items Higher scores on each subscale indicate higher levels of depression, anxiety and stress The levels of depression, anxiety and stress based on cut-off points
are presented on Table 2
Table 2 Classification of depression, anxiety and stress based on cut-off points
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The internal consistency of Vietnamese version of DASS-42 in this study were examined by
the reliability coefficients of three subscales The Cronbach’s values were found as a = 0.912 for Depression; o = 0.863 for Anxiety and œ = 0.862 for Stress, indicating these scales were reliable
3 RESULTS AND DISCUSSION
3.1 Prevalence of depression, anxiety and stress among students in Ho Chi Minh city - Table 3 Distribution of depression, anxiety and stress among participants Classification Normal (%) | Mild (%) | Moderate (%) | Severe (6) Extremely severe (%) Depression 213 57 101 92 37 (42.6) (1.4) (20.2) (38.4) (74) Anxiety 98 42 96 113 151 (19.6) (8.4) (19.2) (22.6) (0.2) Stress 207 88 133 58 14 (41.4) (17.6) (26.6) (11.6) (2.8) As presented in table 3, a majority of participants reported mild to extremely severe depression
(57.4%), anxiety (80.4%) and stress (58.6%) The mean scores of depression, anxiety and stress
among participants were found as 13.37 (SD = 9.30), 15.26 (SD = 8.14), 16.89 (SD = 8.16), which means students had mild depression, severe anxiety and mild stress In comparison with
findings from previous researches conducted in other countries such as Malaysia (mean scores
were found as 11.04 for depression, 11.77 for anxiety and 13.85 for stress) (Shamsuddin et al, 2013), Turkey (participants had mean score as 10.03 for depression, 9.83 for anxiety and 14.92 for
stress) (Bayram & Bilgen, 2008) or Hongkong (the mean scores of 3 mental problems were 8.66; 9,36 and 13.97) (Wong et al, 2006), it can be seen that students in Ho Chi Minh city had higher scores in all three dimensions
Moreover, 19.8% had two types of mental problem and nearly half of students (47.0%) had all
3 types of psychological morbidities These findings indicated that the prevalence of these mental
problems, especially anxiety, among students in Hochiminh city was high, alarming the increased risk of mental health in Vietnamese youths Noticeably, in this research, the prevalence of anxiety was the highest in compared with others; therefore, more researches are needed to be conducted to point out the possible factors associated with high risk of mental problems, especially severe anxiety symptoms among these students
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Table 4 presented the findings on correlation analysis, which confirmed the significantly strong positive correlations among depression, anxiety and stress scores of participants These
strong correlations also pointed out increasing risks of mental problems among students in Ho Chi Minh city
3.3 Comparison of depression, anxiety and stress between male and female students in Ho
Chi Minh city
Table 5 Descriptive analysis and t-test value of depression, anxiety and stress scores by gender Dimension Gender Mean SD t-test Male 14.31 9.48 Depression t = 2.280; p = 0.023 Female 12.42 9.04 Male 17.56 8.37 Anxiety t= 1.607; p= 0.109 Female 16.22 7.91 Male 15.85 8.39 Stress t= 1.831; p = 0.068 Female 14.68 7.86
In general, male students had higher score than female in all three dimensions T-test results
confirmed significant difference in depression score among males and females (t = 2.280, p =
0.023) as males’ score (M = 14.31; SD = 9.48) were found higher than females’ (M = 12.42; SD =
9.04) while no significant difference in anxiety and stress was recorded (p > 0.05) between male
and female students
3.4 Comparison of depression, anxiety and stress among students with different majors of study
Table 6 Descriptive analysis and Anova test value of depression, anxiety and stress scores among students with different majors of study
Dimension Majors of study Mean SD ANOVA (at = 2)
Medicine and pharmacy 17.16 8.56 oy
Depression Education 12.86 9.28 F = 25.188; p = 0.00
Economics and services 10.33 8.79
Medicine and pharmacy 17.75 7.47
Anxiety Education 14.95 8.19 F = 13.661; p = 0.00
Economics and services 13.25 8.12
Medicine and pharmacy 18.88 6.59
Stress Education 16.78 8.61 F = 9.082; p = 0.00
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Medicine & Pharmacy ; -
Economics & Services | 4.49979* | 0.867 | 0.000 - Medicine & Pharmacy | -2.79599* | 0.881 | 0.005
Anxiety Education - -
Economics & Services 1.70379 | 0.866 | 0.149
Medicine & Pharmacy | -4.49979* | 0.867 | 0.000
Economics & Services
Education -1.70379 | 0.865 | 0.149
¬ Education 2.10015 | 0.894 | 0.058
Medicine & Pharmacy R -
Economics & Services | 3.73781* | 0.878 | 0.000
Medicine & Pharmacy | -2.10015 | 0.894 | 0.058 Stress Education Economics & Services 163767 | 0.879 | 0.190
Medicine & Pharmacy | -3.73781* | 0.878 | 0.000 Economics & Services Education -1.63767 | 0.879 | 0.190 Education 4.30160* | 0.985 | 0.000
Medicine & Pharmacy - -
Economics & Services | 6.82716* | 0.969 | 0.000 Medicine & Pharmacy | -4.30160* | 0.985 | 0.000 Economics & Services | 2.52556* | 0.968 | 0.028 Medicine & Pharmacy | -6.82716* | 0.969 | 0.000 Education -2.52556* | 0.968 | 0.028 Depression | Education Economics & Services
* The mean difference is significant at the 0:05 level:
Based on students’ major of study, there were significant differences in depression (F = 25.1 88;
p = 0.00), anxiety (F = 13.661; p = 0.00) and stress (F = 9.082; p = 0.00) In detailed, Medicine & Pharmacy students had the highest scores in all three dimensions, compared with whom studied Education and Economics & Services It can be explained based on the characteristics of each major of study, while students in Medicine and pharmacy had more academic pressures than others which might lead to an increasing risk of mental problems Moreover, health care is always
considered as one of the most stressful proffessions
Using Bonferroni as post hoc test for multiple comparisons showed that students in Medicine
& Pharmacy had significantly high scores in all three kinds of mental problems than the two others while students in Education only got significantly higher depression score than whom in Economics & Services
Hence, Medicine & Pharmacy students are always under academic and career pressures which may lead to negative psychological status In Vietnam as well as in other countries, numerous studies also confirmed the extreme high prevalence of stress, anxiety and depression among medical or nursing students (Le, 2011; Nguyen, 2017; Kurebayashi et al., 2012; Manpreet & Maheshwari,
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4 CONCLUSION
To conclude, it can be said that the prevalence of depression, anxiety and stress among students
in Ho Chi Minh city is high Noticeably, this study reported higher prevalence of all three kinds of psychological morbidity in compared with others in Malaysia, Turkey or HongKong Moreover, there are significantly strong positive correlations between depression, anxiety and stress Gender was found to be correlated to depression while majors of study were related to the prevalences of three mental problems The findings of this study can provide some evidences about mental health among Vietnamese students which confirms that a mental health care program is really in need in
higher education context
REFERENCES
10
1
Balapala KR, Indla D (2017) Depression, Anxiety, and Stress among Health Science Students belonging to Non-affluent Families: A University-based Study Int J Sci Stud 2017; 4(12):99-102 Bayram, N; Bilgel, N (2008) The prevalence and socio-demographic correlations of depression, anxiety
and stress among a group of university students Social Psychiatry and Psychiatric Epidemiology, 43 (8): 667-672
Demirbatir, R.E (2012) Undergraduate music students’ depression, anxiety and stress level: a study
from Turkey Procedia - Social and Behavioral Sciences 46 (2012) 2995 ~ 2999
Ghaderi, A-R., Venkatesh Kumar, G., and Sampath Kumar (2009) Depression, Anxiety and Stress among the Indian and Iranian Students Journal of the Indian Academy of Applied Psychology, January
2009, Vol 35, No.1, 33-37
_ Kurebayashi, L E S., Prado, J M., & Silva, M J P (2012) Correlations between stress and anxiety levels in nursing students Journal of Nursing Education and Practice 2 (3) 128-134
Kuruppuarachchi, K A J M., Somerathna, S., Madurapperuma, B D., & Talagala, I M M (2012) Factors associated with psychological distress among B.Sc undergraduates of the Open University of
Sri Lanka Annual Academic Sesssion, 2012, Open University of Sri Lanka
Le, Minh Thuan (2011) Some psychological problems among students in Ho Chi Minh city Univérsity of Medicine and Pharmacy Master thesis in Psychology HCMC: University of Education
Lovibond, S.H., & Lovibond, P.E (1995) Manual for the Depression Anxiety & Stress Scales (2ndEd.) Sydney: Psychology Foundation
Manpreet, K., & Maheshwari, S$ K (2015) Depression, anxiety and stress among postgraduate nursing students International Journal of Therapeutic Applications 21(2015), 12-18
Nguyen, Thanh Trung (2017) Depression, anxiety, stress and some related factors among students in Hanoi University of Public health Master thesis in Public health science Hanoi: University of
Public health
Trang 7104 | KÝ YẾU HỘI THẢO QUỐC TẾ VỀ SỨC KHỎE TÂM THÂN TRẺ EM VIỆT NAM LẦN THỨ V 12 13 14 15, 16
Rathnayake, S., & Ekanayaka, J (2016) Depression, Anxiety and Stress among Undergraduate
Nursing Students in a Public University in Sri Lanka International Journal of Caring Sciences, Vol
9, Issue 3: 1020-1032
Reeve, K.L., Shumaker, C.J., Yearwood, E L., Crowell, N A., & Riley, J B (2013) Perceived stress
and social support in undergraduate nursing students’ educational experiences Nurse Educ Today 33(4) 419-424
Shamsuddin, K., et al., Correlates of depression, anxiety and stress among Malaysian university students Asian J Psychiatry (2013), http://dx.doi.org/ 10.1016/J.ajp.2013.01.014
Wong JGWS, Cheung EPT, Chan KKC, Ma KKM, Tang SW (2006) Web-based survey of depression, anxiety and stress in first-year tertiary education students in Hong Kong Aus N ZJ
Psychiat, 40(9):771 782