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Prevalence of anxiety depression and stress among first year medical students in Tamilnadu



Bama Rajanayagam1, 2, Sundaramahalingam Manikandan*3, Nag Anand4 & Sundaramoorthy Selvaraj5



1Bharath Institute of Higher Education and Research, Selaiyur, Chennai, India; 2Dept. of Physiology, Indira Medical College and Hospital, Thiruvallur, Tamilnadu, India; 3Dept. of Physiology, Tagore Medical College and Hospital, Rathinamangalam, Chennai. India; 4Department of General Medicine, Sree Balaji Medical College and Hospital, Chromepet, Chennai, India; 5Department of Biochemistry, Indira Medical College and Hospital, Thiruvallur, Tamilnadu, India; *Corresponding Author



Bama Rajanayagam - E mail id: pdcbama@gmail.com

S. Manikandan - E mail id:  drsmanikandan@gmail.com

NN Anand - E mail id: anandnmd@gmail.com

S. Selvaraj - E mail id: selvamunom@gmail.com


Article Type

Research Article



Received May 1, 2023; Revised May 31, 2023; Accepted May 31, 2023, Published May 31, 2023



The present study was to evaluate the examination stress of the first year MBBS students, prior to their university exam by assessing the mood parameters and cortisol level. A cross sectional study was conducted in 150 students of Indira Medical College, Thiruvallur from January to February 2022. The assessment methods implemented were Self-administered, pre-designed questionnaire of DASS 10 scale scoring 0-40, and salivary cortisol by using quantitative ELISA on relaxed (before exam) and stressed (on day of exam) students with prior consent. Respondent data were analysed using the independent t-test and Odds ratio logistic regression analysis was done for strength of association by using (SPSS) version 26.0 and the level of significance *p≤0.05. The prevalence of stress (43%), anxiety (35%), depression (22%) and level of cortisol (2.610.41 and 5.140.35) between relaxed and stressed respectively were significantly increased due to examination stress despite any significant change in academic performance. Odds ratio of stress (95% CI 2.153), anxiety (3.038), depression (2.513) and salivary cortisol (2.872) were significantly high in stressed. Female students were found to be more susceptible to stress than male students due to examination (p≤0.001**). This study suggests that the medical education and examination are unavoidable stressor in first year students. This could be prevented by providing stress reduction interventions and orientation programmes which could improve student mental well-being and reduce the psychological distress.



DASS (depression, anxiety and stress); salivary cortisol; medical students; Examination.



Rajanayagam et al. Bioinformation 19(5): 649-654 (2023)


Edited by

P Kangueane






Biomedical Informatics



This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.