title: Depression, stress and anxiety in medical students: A cross-sectional comparison between students from different semesters.
abstract: OBJECTIVE
  To compare the prevalence of anxiety, depression, and stress in medical students from all semesters of a Brazilian medical school and assess their respective associated factors.
  
  
  METHODS
  A cross-sectional study of students from the twelve semesters of a Brazilian medical school was carried out. Students filled out a questionnaire including sociodemographics, religiosity (DUREL - Duke Religion Index), and mental health (DASS-21 - Depression, Anxiety, and Stress Scale). The students were compared for mental health variables (Chi-squared/ANOVA). Linear regression models were employed to assess factors associated with DASS-21 scores.
  
  
  RESULTS
  761 (75.4%) students answered the questionnaire; 34.6% reported depressive symptomatology, 37.2% showed anxiety symptoms, and 47.1% stress symptoms. Significant differences were found for: anxiety - ANOVA: [F = 2.536, p=0.004] between first and tenth (p=0.048) and first and eleventh (p=0.025) semesters; depression - ANOVA: [F = 2.410, p=0.006] between first and second semesters (p=0.045); and stress - ANOVA: [F = 2.968, p=0.001] between seventh and twelfth (p=0.044), tenth and twelfth (p=0.011), and eleventh and twelfth (p=0.001) semesters. The following factors were associated with (a) stress: female gender, anxiety, and depression; (b) depression: female gender, intrinsic religiosity, anxiety, and stress; and (c) anxiety: course semester, depression, and stress.
  
  
  CONCLUSIONS
  Our findings revealed high levels of depression, anxiety, and stress symptoms in medical students, with marked differences among course semesters. Gender and religiosity appeared to influence the mental health of the medical students.
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Ivana Lúcia Damásio
authors.initials: IL
authors.lastname: Moutinho
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Natalia de Castro Pecci
authors.initials: NC
authors.lastname: Maddalena
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Ronald Kleinsorge
authors.initials: RK
authors.lastname: Roland
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Alessandra Lamas Granero
authors.initials: AL
authors.lastname: Lucchetti
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Sandra Helena Cerrato
authors.initials: SH
authors.lastname: Tibiriçá
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Oscarina da Silva
authors.initials: OD
authors.lastname: Ezequiel
authors.affiliation: Núcleo de Apoio às Práticas Educativas, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Lucchetti
mesh_terms: D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012067:Religion; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult