title: Depression in military medicine cadets: a cross-sectional study.
abstract: BACKGROUND
  Military medicine cadets undergo strenuous military training alongside demanding medical studies. This stressful and complex educational environment can lead to the emergence of depressive symptoms. We investigated the prevalence of depressive symptoms in a cohort of military medicine cadets.
  
  
  METHODS
  We conducted a descriptive questionnaire-based cross-sectional study among Greek military medicine cadets in the undergraduate program of the Hellenic Military School of Combat Support Officers. The Greek translation of the Zung self-rating depression scale questionnaire was used to screen for the presence of depressive symptoms. In addition, demographic, academic and dietary information was collected. The Shapiro-Wilk test of normality, Pearson correlation test, Chi-square test, t-test and Mann Whitney U test were employed for statistical analysis.
  
  
  RESULTS
  We enrolled 55 female and 91 male military medicine cadets with a mean age of 19.84 years (SD = 0.99). The mean Zung crude score was 43.32 (SD = 4.55): 42.8 (SD = 4.43) for female cadets and 43.64 (SD = 4.6) for male cadets. Cadets were further subdivided into low and high risk groups for the presence of depressive symptoms. We identified 57 (39 %) cadets with a total Zung crude score of 45 or above: 21 females and 36 males. Statistical analysis did not reveal any significant differences between the two groups based on gender, year of training, academic performance, alcohol consumption, smoking status, vitamin supplementation, dietary habits or BMI.
  
  
  CONCLUSIONS
  We report a high prevalence of depressive symptoms in a cohort of military medicine cadets that underscores the need for effective screening and appropriate and timely interventions. We did not identify any related risk factors. Military medicine cadets are exposed to a challenging military and medical training environment, and thus represent a group at risk for development of depression.
authors.affiliation: Department of Gynaecology, 401 Army General Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Nasioudis
authors.affiliation: Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, New York, USA.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Palaiodimos
authors.affiliation: Naval Hospital of Athens, Athens, Greece.
authors.forename: Matthaios
authors.initials: M
authors.lastname: Dagiasis
authors.affiliation: 251 Hellenic Air Force Hospital, Athens, Greece.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Katsarou
authors.affiliation: Hellenic Military School of Combat Support Officers (SSAS), Thessaloniki, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Ntouros
keywords: Depression; Medical education; Medical students; Military medicine; Military training