Prevalence of depressive symptoms among dental students is influenced by sex, academic performance, smoking exposure, and sexual orientation: cross-sectional study

Aim: To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods: The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results: The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36­2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36­0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41­0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21­20.29). Conclusion: Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation

Female and Worst Academic Performance are Associated with Anxiety and Stress among Dental Students / Mulheres e Pior Desempenho Acadêmico Estão Associados com Ansiedade e Estresse em Estudantes de Odontologia

This study aimed to assess the levels and associated factors of stress and anxiety in dental students during the Covid-19 pandemic. This cross-sectional study involved both undergraduate and graduate dental students regularly enrolled in the first semester of 2020 of one University. An online structured questionnaire was applied, and demographical, behavioral, academic performance, fear and anxiety related to the Covid-19 pandemic were collected. The 21-item Depression Anxiety Stress Scale (DASS-21) was applied, but only the subscales of anxiety and stress were considered. Adjusted analyses were performed using Poisson regression with robust variance. To both anxiety and stress, independent analyses were performed considering the different levels of study (undergraduate and graduate dental students). At least moderate anxiety was detected in 42.9% and 24.7% of undergraduate and graduate students, respectively. Meanwhile, at least moderate stress was observed in 41.7% and 29.9% of undergraduate and graduate students, respectively. In the multivariate analyses, female undergraduate dental students presented significantly more anxiety (prevalence ratio [PR]: 1.57; 95% confidence interval [95%CI]: 1.11 ­ 2.22) and stress (PR: 1.54; 95%CI: 1.06 ­ 2.24) when compared to males. Conversely, undergraduate dental students with better academic performance demonstrated lower rates of anxiety (PR: 0.86; 95%CI: 0.75 ­ 0.98). Females undergraduate dental students demonstrate higher rates of anxiety and stress, and the academic performance may influence the levels of anxiety in these individuals. (AU)

O estudo objetivou avaliar os níveis e fatores associados de estresse e ansiedade em estudantes de Odontologia durante a pandemia de Covid-19. Esse estudo transversal envolveu alunos de graduação e pós-graduação em Odontologia regularmente matriculados no primeiro semestre de 2020 de uma Universidade. Um questionário estruturado online foi aplicado, e variáveis demográficas, comportamentais, performance acadêmica, medo e ansiedade relacionados à pandemia de Covid-19 foram coletadas. A "Depression Anxiety Stress Scale" (DASS-21) de 21 itens foi aplicada, mas somente os domínios de ansiedade estresse foram considerados. Análises ajustadas foram realizadas utilizando regressão de Poisson com variância robusta. Para ambos ansiedade e estresse, análises independentes foram realizadas considerando os diferentes níveis de estudo (estudantes de odontologia de graduação e pós-graduação). Pelo menos ansiedade moderada foi detectada em 42,9% e 24,7% dos alunos de graduação e pós-graduação, respectivamente. Já o estresse pelo menos moderado foi observado em 41,7% e 29,9% dos alunos de graduação e pós-graduação, respectivamente. Nas análises multivariadas, mulheres estudantes de graduação apresentaram significativamente mais ansiedade (razão de prevalência [RP]: 1,57; intervalo de confiança de 95% [IC95%]: 1,11 ­ 2,22) e maior estresse (RP: 1,54; IC95%: 1,06 ­ 2,24) quando comparados com homens. Contudo, estudantes de graduação com melhor performance acadêmica demonstraram menores taxas de ansiedade (RP: 0,86; IC95%: 0,75 ­ 0,98). Estudantes de graduação do sexo feminino demonstraram maiores taxas de ansiedade e estresse, e a performance acadêmica pode influenciar os níveis de ansiedade desses indivíduos. (AU)