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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 3  |  Issue : 1  |  Page : 6-10

Depression among students of a Nigerian University: Prevalence and academic correlates


1 Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika, Nigeria
2 Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

Date of Web Publication10-Oct-2018

Correspondence Address:
Dr. Aisha Dabana
Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika, Zaria
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/archms.archms_5_18

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  Abstract 

Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. It is extremely prevalent among university students and is a widespread problem globally. This study was conducted to determine the prevalence of depression and the academic factors that are associated with it among students of Ahmadu Bello University (ABU), Zaria, Nigeria. Methodology: This was a cross-sectional study conducted among 127 undergraduate students of ABU. Data were collected using a structured, self-administered Patient Health Questionnaire-9 (PHQ-9) and were analyzed using IBM-Statistical Software for Social Sciences, version 20.0. Results: Majority of the respondents (58.2%) had depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately-severe, and severe depression, respectively, according to the PHQ-9 scoring system, using a cutoff score of 5. There was no statistically significant association between depression and academic performance of respondents (P = 0.360) nor with interest (or lack thereof) in the course of study (P = 0.266). Conclusion: Depression, at different levels of severity, was noted among respondents. More screening and counseling services should be made easily accessible to students in the study area. Further research on nonacademic factors that could predispose to depression is recommended. This will aid in formulating policies for prevention and control of depression in the study area.

Keywords: Correlates, depression, Nigerian, prevalence, students, university


How to cite this article:
Dabana A, Gobir AA. Depression among students of a Nigerian University: Prevalence and academic correlates. Arch Med Surg 2018;3:6-10

How to cite this URL:
Dabana A, Gobir AA. Depression among students of a Nigerian University: Prevalence and academic correlates. Arch Med Surg [serial online] 2018 [cited 2018 Oct 20];3:6-10. Available from: http://www.archms.org/text.asp?2018/3/1/6/243037


  Introduction Top


Mental health disorders according to the World Health Organization are one of the leading causes of disability worldwide. Three of the ten leading causes of disability in people between the ages of 15 and 44 are mental disorders, and the other causes are often associated with mental disorders.[1] Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability.[2]

Depression is a debilitating and pernicious cluster of symptoms that may persist for a period of weeks, months, or even years. It is an affective 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.[3],[4] It is also characterized by changes in mood status presenting as feelings of sadness which may fluctuate from slight hopelessness to severe feelings of disappointment.[2],[5] It is a disorder that can be reliably diagnosed and treated in primary care.[3] If left untreated in the early age of occurrence, it can lead to different problems such as school failure, conduct disorder, and delinquency, eating disorders such as anorexia and bulimia, school phobia, panic attacks, substance abuse, or even suicide.[4]

University life marks a transitional period for students, during which some students move away from family and home for the first time and lose the traditional adult supervision and the traditional social support. In addition, some students might have to deal with financial difficulties for the first time in their lives. These changes have been recognized as risk factors for developing depression, which is associated with several severe problems in university students, notably academic achievement, suicidal ideation, substance abuse, and acute infectious illnesses.[4],[6],[7]

Researches indicate that there is a negative relationship between depression and academic achievement, that is, when depression is high, academic achievement is low and vice versa. For example, Hysenbegasi et al. in 2005 conducted a study in Western Michigan University and they found that depression has a strong impact on academic productivity among the students. According to their study, of the 121 depressed students who were diagnosed in the campus health center, 14.64% had missed a great number of classes, 5.45% missed assignments, and 1.36% and 0.74% of them missed examinations and dropped a number of courses.[4]

Psychological morbidity in undergraduate students represents a neglected public health problem and holds major implications for campus health services and mental policymaking. In terms of life quality, understanding the impact of this neglected public health phenomenon on one's educational attainment and prospective occupational success is very important.[8] This study was therefore conducted to determine the prevalence and academic risk factors for depression, among students of Ahmadu Bello University (ABU), Zaria, Nigeria.


  Methodology Top


This is a cross-sectional descriptive study conducted in ABU, a federal government university located in Zaria, Kaduna State, Nigeria. The university has two campuses located on 7000 hectares of land; Samaru (main campus) and Kongo in Zaria. It consists of 13 faculties, sixty 60 academic departments, and 12 research institutes and specialized centers. The university offers undergraduate and postgraduate courses in diverse fields such as agriculture, public and business administration, engineering, environmental design, education, biological and physical sciences, medical and pharmaceutical sciences, the humanities, law, and social science. The university has a large medical program with its own ABU Teaching Hospital, located in Shika, Zaria, one of the largest teaching hospitals in Nigeria and Africa.[9] Currently, the university has a total of 42,283 undergraduate students. The distribution of students by faculty is shown below.

A minimum sample size of 117 was obtained using the following formula: n = Z2pq/d2. After correcting for nonresponse rate of 10%, the sample size became 129. However, a sample size of 131 was used for the study. Proportionate allocation method was used to determine the number of students required for the study, per faculty. Simple random sampling was then used to select the students to whom the questionnaires were administered until the desired sample size was achieved.

Data were collected with the aid of structured, self-administered questionnaires with close-ended and open-ended questions, using the Open Data Kit application. The questionnaire has seven sections as follows: section 1 covers sociodemographic profile of respondents, section 2 their anthropometry, section 3 social variables, section 4 academic variables, section 5 past experiences, section 6 religiosity, and section 7 depression assessment. Section 7 is an adaptation of the Patient Health Questionnaire (PHQ-9) which is used to make tentative diagnosis of depression in at-risk populations, for example, those with coronary heart disease or after stroke or university students. It is also used to monitor the severity of depression and response to treatment and it has 61% sensitivity and 94% specificity in adults. The PHQ-9 scores each of the nine DSM-IV criteria as “0” (not at all) to “3” (nearly every day). For each of the nine criteria, respondents are expected to read every detail of the alternatives and to circle the one which applies to them. Depending on the total scores obtained, respondents are assigned into five categories of depression severity: 0–4 none, 5–9 mild depression, 10–14 moderate depression, 15–19 moderately severe depression, and 20–27 severe depression.[10]

A computer-based software, Statistical Package for the Social Sciences (SPSS version 20.0), was used to analyze the data. Data were presented using tables and charts, with the Chi-square test used to test the significance of associations at a level of P < 0.05. Ethical clearance was obtained from the Health Research Ethics Committee of the Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria (Reference No. ABUTHZ/HREC/UG/6). Consent was obtained from the respondents who were assured of strict confidentiality by ensuring anonymity.


  Results Top


A total of 131 questionnaires were administered and 127 were completely answered, giving a response rate of 96.9%.

[Table 1] shows the sociodemographic characteristics of the respondents. As shown in the table, 50.4% of the respondents were male and the rest were female. Majority of the respondents (58.3%) fell within the age group of 17–21 years. The least frequency (0.8%) was in the age group of 32–36 years. The lowest and highest ages of the respondents were 17 and 34, respectively. For the level of study, the highest proportion (33.8%) was 100-level students, while 600-level students had the least representation (2.4%). Most of the respondents (94.5%) were single and the Hausa/Fulani ethnic group had the highest proportion of respondents (41.7%). Most of the respondents (95.3%) reside in an urban setting, while 4.7% reside in a rural setting. Also, while at school, a majority of the respondents (60.6%) reside in university hostels while 39.4% reside offcampus.
Table 1: Sociodemographic characteristics of respondents (n=127)

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[Figure 1] shows the level of depression among respondents. As shown in the figure, 58.2% of the respondents were found to have depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately-severe, and severe depression, respectively, according to the PHQ-9 scoring system.
Figure 1: Severity level of depression among respondents

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[Table 2] shows the association between depression and academic variables. It shows that there is no statistically significant association between depression and any academic characteristic such as academic performance (P = 0.360), interest in the course of study (P = 0.266), and level of study in university (P = 0.467).
Table 2: Association between depression and academic variables of respondents

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  Discussion Top


A descriptive cross-sectional study was carried out among 127 respondents who were all undergraduate students of ABU, Zaria. The study had more male respondents than female. The age range of respondents was 17–34 years, with a mean age of 21.34 years.

The prevalence of depression in this study was found to be 58.2%, with 37.0%, 15.7%, 3.9%, and 1.6% of respondents having mild, moderate, moderately-severe, and severe depression, respectively, using the PHQ-9 as a screening tool for depression. This finding is similar to that of another study that was conducted among students of a private medical college in South India which showed that 58% of students had various forms of depression, with 43%, 12%, and 3% of the students having mild, moderate, and severe degrees of depression, respectively, also using the PHQ-9 to screen for depression.[11] However, it is a bit lower than the findings of a study done in Fayoum University, Egypt, using the Depression, Anxiety and Stress Scale-21 (DASS-21), which showed a 60.8% prevalence of depression among the students, and another study done in Tabriz, Iran, using the Beck's Depression Inventory (BDI), which showed that 62.7% of the students had depression, with 10.9% of them having severe depression.[1],[9] The prevalence in this study is significantly lower than the 70% found among Pakistani university students.[4] The lower prevalence observed in this study may be due to the cultural and religious differences as well as differences in the educational system and lifestyle in the regions where these studies were carried out, as such factors have been shown to affect the manifestation of depression. It may also be due to differences in the screening tool used, as none of the above researches used the PHQ-9, as was used in the present study.

The findings from the study, however, are higher than what obtained in previous studies carried out in Nigeria. One carried out in Western Nigeria using the Center for Epidemiologic Studies Depression Scale (CES-D) showed a prevalence rate of 25.2% and 7% for moderate to severe and severe depression respectively; another study carried out in Enugu showed a prevalence of 23.3%, and a third study showed a prevalence of depression of 8.3% among Nigerian university students, with 5.6% of them having mild-moderate and 2.7% having severe depression.[12]

It is also higher than the prevalence of 37% found in Egyptian university students; 31.7%, 27.7%, and 23.6% among Ethiopian university students (according to different studies); 27.1% among Turkish students; 27.7% among Omani university students; 50% among students of Yazd University, Iran (35.4%, 13.4%, and 1.2% being mild, moderate, and severe, respectively); 39% among Vietnamese university students; 23.8% among Chinese university students; 17.1% among Poland university students, and 13.8% among American students of the University of Michigan.[4],[6],[7],[13]

Possible explanations for the variation in the prevalence of depression found in this present study and that of previous studies conducted among university students are likely due to variation in the instruments used. Instruments used to diagnose depression in other studies include the CES-D, DASS-21, BDI-II, and PHQ-9. There is also variation in cutoff points used for diagnosis, using the various tools for screening. Difference in the time of the study, as well as the difference in culture and lifestyle in the various regions where the studies were carried out, may also account for the variation in results.

The present study found no significant statistical relationship between depression and academic factors such as academic performance, interest in course of study, satisfaction with education, and worry about future careers. A possible explanation for this is that the academic environment was conducive for learning and did not predispose respondents to depression. Another explanation is that the risk factors for depression in the study area are not related to academics. This is contrary to findings of other studies which showed that some academic variables were risk factors for depression. For example, in another Nigerian study, poor academic performance was found to be associated with depression,[12] while in Turkey, university students who were satisfied with their education had lower depression scores than those who were not.[8] Furthermore, in a study conducted in Yazd, Iran, there was a significant negative association between interest in the selected university course and depression, while, in Tabriz, Iran, statistically significant associations were found between depression and interest in the field of study and worry about future careers.[5],[9]

Further research is recommended to identify other nonacademic risk factors for depression among university students in our study area. This will guide in formulating policies for prevention and control of depression in the study area. It is also recommended that more attention should be given to the identification and management of depression among university students in the study area. Furthermore, health education and counseling on depression and available coping mechanisms should be provided to students in the university, especially during orientation programs.

One limitation of the study is that responses depend on the truthfulness of the respondents since some respondents might not be forthcoming with information. Using PHQ-9 for screening for depression and lengthy questionnaire bias are other limitations.


  Conclusion Top


Depression, at different levels of severity, was noted among respondents. More screening and counseling services should be made easily accessible to students in the study area. Further research on nonacademic factors that could predispose to depression is recommended. This will aid in formulating policies for prevention and control of depression in the study area.

Acknowledgment

We acknowledge all the respondents who participated in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Yusoff MS, Abdul Rahim AF, Baba AA, Ismail SB, Mat Pa MN, Esa AR. Prevalence and associated factors of stress, anxiety and depression among prospective medical students. Asian J Psychiatr 2013;6:128-33.  Back to cited text no. 1
    
2.
Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res 2013;47:391-400.  Back to cited text no. 2
    
3.
Marcus M, Yasamy MT, Mark VO, Dan C, Shekhar S. Depression: A Public Health Concern; 2012. p. 6-8. Available from: http://www.who.int/mentalhealthmangement/depression/whofmh2012.pdf. [Last accessed on 2017 Jun 16].  Back to cited text no. 3
    
4.
Yalemwork G. Depression among Addis Ababa University Students Sidist Kilo Campus : Prevalence, Gender Difference and Other Associated Factors (Masters Thesis on the internet) Addis Ababa University; 2015. Available from: http://www.etd.aau.edu.et/dspace/handle/123456789/7261. [Last accessed on 2017 Jun 16].  Back to cited text no. 4
    
5.
Lotfi MH, Aminian AH, Ghomizadea A, Zarea S. Prevalence of depression amongst students of Shaheed Sadoughi University of Medical Sciences, Yazd, Iran. Iran J Psychiatry Behav Sci 2010;4:51-5.  Back to cited text no. 5
    
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Al-Busaidi Z, Bhargava K, Al-Ismaily A, Al-Lawati H, Al-Kindi R, Al-Shafaee M, et al. Prevalence of depressive symptoms among university students in Oman. Oman Med J 2011;26:235-9.  Back to cited text no. 6
    
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Lei XY, Xiao LM, Liu YN, Li YM. Prevalence of depression among Chinese university students: A meta-analysis. PLoS One 2016;11:e0153454.  Back to cited text no. 7
    
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Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol 2008;43:667-72.  Back to cited text no. 8
    
9.
Ahmadu Bello University. Available from: http://www.en.m.wikipedia.org/wiki/Ahmadu_bello_University. [Last accessed on 2017 Jun 16].  Back to cited text no. 9
    
10.
Patient Health Questionnaire (PHQ-9). Available from: https://www.patient.info/doctor/patient-health-questionnaire-phq. [Last accessed on 2017 Nov 03].  Back to cited text no. 10
    
11.
Rawat R, Kumar S, Manju L. Prevalence of depression and its associated factors among medical students of a private medical college in south India. Int J Community Med Public Health 2016;3:1393-8.  Back to cited text no. 11
    
12.
Peltzer K, Pengpid S, Olowu S, Olasupo M. Depression and Associated factors among university students in Western Nigeria. J Psychol Afr 2013;23:459-66.  Back to cited text no. 12
    
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Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am J Orthopsychiatry 2007;77:534-42.  Back to cited text no. 13
    


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