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Prevalence and Associated Factors of Depression among Bangladeshi University Students: A Cross-Sectional Study

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Title: Prevalence and Associated Factors of Depression among Bangladeshi University Students: A Cross-Sectional Study
Language: English
Authors: Sayeed, Abu (ORCID 0000-0003-0745-1755), Rahman, Md Hafizur (ORCID 0000-0002-2742-049X), Hassan, Md. Nazmul, deSteiguer, Abby, Kundu, Satyajit (ORCID 0000-0001-9610-1479), Meem, Amatul Elah, Hasan, Al-Riaj, Mallick, Trisha, Sultana, Mst. Sadia, Hasanuzzaman, Md, Sahrin, Sumaia, Hasan, M. Tasdik
Source: Journal of American College Health. 2023 71(5):1381-1386.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 6
Publication Date: 2023
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Foreign Countries, Depression (Psychology), Incidence, Measures (Individuals), Educational Attainment, Suicide, Stress Variables, Student Experience, Parent Financial Contribution, Financial Problems, Symptoms (Individual Disorders), College Students
Geographic Terms: Bangladesh
Assessment and Survey Identifiers: Beck Depression Inventory
DOI: 10.1080/07448481.2021.1944168
ISSN: 0744-8481
1940-3208
Abstract: Objective: The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI = 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1396233
Database: ERIC
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  Value: <anid>AN0165472061;acl01jul.23;2023Jul25.06:02;v2.2.500</anid> <title id="AN0165472061-1">Prevalence and associated factors of depression among Bangladeshi university students: A cross-sectional study </title> <p>Objective: The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI ≥ 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6–7.1), 3.8 times (95% CI: 1.7–8.6), and 3.9 times (95% CI: 1.5–8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7–4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2–7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3–0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.</p> <p>Keywords: Bangladesh; Beck Depression Inventory; Depression; University students</p> <hd id="AN0165472061-2">Introduction</hd> <p>Depression among university students is one of the most common mental health issues and the prevalence is growing.[[<reflink idref="bib1" id="ref1">1</reflink>], [<reflink idref="bib3" id="ref2">3</reflink>]] Worldwide, the total number of people with depression was estimated to be over 264 million and the global prevalence of depressive symptoms among university students stands at 30.6 percent.[<reflink idref="bib1" id="ref3">1</reflink>]</p> <p>University students experience a critical transition during their university life where they go from adolescence to adulthood and make some crucial decisions of life. This may be one of the hardest times in someone's life.[<reflink idref="bib4" id="ref4">4</reflink>],[<reflink idref="bib5" id="ref5">5</reflink>] University students can face many challenges at this crucial point of life, including accommodation, personal relationships, academic stress, financial hardship, and troubles in making a critical decision. As a consequence, widespread mental health issues, particularly depressive symptoms, are prominent among current university students.[<reflink idref="bib5" id="ref6">5</reflink>] Besides, previous studies reported various factors that might increase students' vulnerability to depression,[<reflink idref="bib6" id="ref7">6</reflink>] for example, stressful sociodemographic factors[<reflink idref="bib1" id="ref8">1</reflink>],[<reflink idref="bib5" id="ref9">5</reflink>]; physical activity[<reflink idref="bib7" id="ref10">7</reflink>]; sleep problems.[<reflink idref="bib8" id="ref11">8</reflink>]</p> <p>Depression may exacerbate detrimental effects in life by imposing stress for career and interpersonal relationship at this early stage of life.[<reflink idref="bib1" id="ref12">1</reflink>],[<reflink idref="bib9" id="ref13">9</reflink>] Among university student, depression is significantly linked to unsatisfactory academic performance,[<reflink idref="bib10" id="ref14">10</reflink>] drop-out,[<reflink idref="bib11" id="ref15">11</reflink>] instability in the relationship,[<reflink idref="bib12" id="ref16">12</reflink>] planning and attempting suicide,[<reflink idref="bib10" id="ref17">10</reflink>],[<reflink idref="bib13" id="ref18">13</reflink>],[<reflink idref="bib14" id="ref19">14</reflink>] unsatisfactory work performance,[<reflink idref="bib15" id="ref20">15</reflink>] acute infectious illnesses,[<reflink idref="bib16" id="ref21">16</reflink>] and poor physical and mental health.[<reflink idref="bib17" id="ref22">17</reflink>],[<reflink idref="bib18" id="ref23">18</reflink>]</p> <p>However, in recent years, there has been an increasing interest in early detection of depressive symptoms and the provision of appropriate interventional measures to prevent the adverse effects of depression on the academic performance and career among university students.[<reflink idref="bib19" id="ref24">19</reflink>] This is particularly important because the most psychiatric conditions in life first appear during the university age.[<reflink idref="bib20" id="ref25">20</reflink>]</p> <p>There has been a very few studies undertaken in Bangladesh regarding the depressive symptoms among university students which indicates a deficit of knowledge.[[<reflink idref="bib21" id="ref26">21</reflink>], [<reflink idref="bib23" id="ref27">23</reflink>]] Most of the study was conducted in the capital of Bangladesh and to the best of our knowledge, there is no study among university students in the southern part of Bangladesh. Therefore, the knowledge gap limits policymakers' efficiency and prevents the implementation of bespoke education.[<reflink idref="bib25" id="ref28">25</reflink>] In light of this research gap, the objective of the study was to assess the prevalence of depression and its associated factors among university students in the southern part of Bangladesh.</p> <hd id="AN0165472061-3">Methodology</hd> <p></p> <hd id="AN0165472061-4">Study respondents</hd> <p>A self-administered cross-sectional study was conducted between February to March 2020 among undergraduate and post-graduate students of Patuakhali Science and Technology University (PSTU) and Barishal University (BU). Both universities were situated in the southern territory of Bangladesh. The sample size was calculated based on a single population proportion formula considering a 95% confidence interval, a 5% margin of error, and a 69.5% proportion of university students with depressive symptoms.[<reflink idref="bib23" id="ref29">23</reflink>]</p> <p>A stratified random sampling method was employed to select the study participants. A total of 215 students from PSTU and 230 students from BU were invited and assembled in classrooms to participate in the study voluntarily. Of these, 41 were excluded due to incomplete survey, and 403 were left for analysis. Questionnaire was translated into native Bengali and were distributed among the participants. Formal permission from the university authority as well as written consent from the participants was obtained before the survey was carried out.</p> <hd id="AN0165472061-5">Measures</hd> <p></p> <hd id="AN0165472061-6">Sociodemographic variables</hd> <p>Sociodemographic variables included questions related to age, gender, residence, religion, socioeconomic status (SES), academic information, parent's education and relation, romantic relation, failure in a romantic relationship, history of domestic violence, and experience of physical and sexual abasement.</p> <hd id="AN0165472061-7">Behavioral variables</hd> <p>Behavioral variables were focused on lifestyle information including daily physical activity (increased heart rate for at least 30 minutes), the average amount of sleep per night (normal: 6–7 hours, short: <6 hours, long: >7 hours),[<reflink idref="bib24" id="ref30">24</reflink>],[<reflink idref="bib26" id="ref31">26</reflink>] and history of smoking and substance use.</p> <hd id="AN0165472061-8">Beck Depression Inventory</hd> <p>The Bengali version of the 21-item self-reported Beck Depression Inventory (BDI) scale was administered to evaluate depressive symptoms which was validated in Bangladesh.[<reflink idref="bib27" id="ref32">27</reflink>] Total scores ranged from 0 to 63 and were calculated by summing individual answer scores. The severity of depression was classified by following: 0 to 4 as normal, 5 to 13 as borderline clinical depression, 14 to 20 as moderate depression, 21 to 63 as severe, and 14 as a cutoff score for depression.[<reflink idref="bib28" id="ref33">28</reflink>],[<reflink idref="bib29" id="ref34">29</reflink>] For this study, the value of Cronbach's alpha of BDI-21 was 0.83.</p> <hd id="AN0165472061-9">Statistical analysis</hd> <p>The data were entered in Microsoft Excel 2013 for editing, sorting, and consistency checking. Descriptive statistic and multivariate binary logistic regression were performed with a 95% confidence interval to determine the significant associations between dependent and independent variables. A <emph>p</emph>-value of less than 0.05 was considered statistically significant. The analysis was performed in IBM SPSS windows version 24.</p> <hd id="AN0165472061-10">Results</hd> <p></p> <hd id="AN0165472061-11">Demographic characteristics of the respondents</hd> <p>Half of the respondents were male (50.6%) and most of the respondents were identified as Muslim (83.4%) (Table 1). The participants' age ranged from 18 to 26 years with an average of 21.02 (standard deviation [SD] = 1.93) years.</p> <p>Table 1. Demographic characteristics of the participants.</p> <p> <ephtml> <table><thead><tr><td>Variables</td><td>Category</td><td>Total sample</td><td>Non-depressed</td><td>Depressed</td></tr><tr><td>n</td><td>%</td><td>n</td><td>%</td><td>n</td><td>%</td></tr></thead><tbody valign="top"><tr><td>University</td><td>PSTU</td><td char=".">201</td><td char=".">49.9</td><td char=".">88</td><td char=".">43.8</td><td char=".">113</td><td char=".">56.2</td></tr><tr><td>BU</td><td char=".">202</td><td char=".">50.1</td><td char=".">125</td><td char=".">61.9</td><td char=".">77</td><td char=".">38.1</td></tr><tr><td>Age in years</td><td char=".">≤20 Years</td><td char=".">194</td><td char=".">48.1</td><td char=".">103</td><td char=".">53.1</td><td char=".">91</td><td char=".">46.9</td></tr><tr><td char=".">>21 years</td><td char=".">209</td><td char=".">51.9</td><td char=".">110</td><td char=".">52.6</td><td char=".">99</td><td char=".">47.4</td></tr><tr><td>Gender</td><td>Male</td><td char=".">204</td><td char=".">50.6</td><td char=".">114</td><td char=".">55.9</td><td char=".">90</td><td char=".">44.1</td></tr><tr><td>Female</td><td char=".">199</td><td char=".">49.4</td><td char=".">79</td><td char=".">39.7</td><td char=".">120</td><td char=".">60.3</td></tr><tr><td>Religion</td><td>Hindu</td><td char=".">64</td><td char=".">15.9</td><td char=".">33</td><td char=".">51.6</td><td char=".">31</td><td char=".">48.4</td></tr><tr><td>Muslim</td><td char=".">336</td><td char=".">83.4</td><td char=".">179</td><td char=".">53.3</td><td char=".">157</td><td char=".">46.7</td></tr><tr><td>Others</td><td char=".">3</td><td char=".">7</td><td char=".">1</td><td char=".">33.3</td><td char=".">2</td><td char=".">66.7</td></tr><tr><td>Residence</td><td>Village</td><td char=".">131</td><td char=".">32.5</td><td char=".">73</td><td char=".">55.7</td><td char=".">58</td><td char=".">44.3</td></tr><tr><td>Upazilla/Thana level</td><td char=".">122</td><td char=".">30.3</td><td char=".">63</td><td char=".">51.6</td><td char=".">59</td><td char=".">48.4</td></tr><tr><td>Division/District level</td><td char=".">150</td><td char=".">37.2</td><td char=".">77</td><td char=".">51.3</td><td char=".">73</td><td char=".">48.7</td></tr><tr><td>Family Type</td><td>Nuclear</td><td char=".">323</td><td char=".">80.1</td><td char=".">172</td><td char=".">53.3</td><td char=".">151</td><td char=".">46.7</td></tr><tr><td>Join</td><td char=".">80</td><td char=".">19.9</td><td char=".">41</td><td char=".">51.2</td><td char=".">39</td><td char=".">48.8</td></tr><tr><td>Family monthly Income (BDT)</td><td char=".">≤9000</td><td char=".">20</td><td char=".">5.0</td><td char=".">8</td><td char=".">40.0</td><td char=".">12</td><td char=".">60.0</td></tr><tr><td char=".">10,000–19,000</td><td char=".">44</td><td char=".">10.9</td><td char=".">27</td><td char=".">61.4</td><td char=".">17</td><td char=".">38.6</td></tr><tr><td char=".">20,000–2900</td><td char=".">106</td><td char=".">26.3</td><td char=".">57</td><td char=".">53.8</td><td char=".">49</td><td char=".">46.2</td></tr><tr><td char=".">30,000–39,000</td><td char=".">98</td><td char=".">24.3</td><td char=".">58</td><td char=".">59.2</td><td char=".">40</td><td char=".">40.8</td></tr><tr><td char=".">40,000–49,000</td><td char=".">57</td><td char=".">14.1</td><td char=".">27</td><td char=".">47.4</td><td char=".">30</td><td char=".">52.6</td></tr><tr><td char=".">≥50,000</td><td char=".">78</td><td char=".">19.4</td><td char=".">36</td><td char=".">46.2</td><td char=".">42</td><td char=".">53.8</td></tr><tr><td>Study Year</td><td char=".">1st year</td><td char=".">121</td><td char=".">30.0</td><td char=".">73</td><td char=".">60.3</td><td char=".">48</td><td char=".">39.7</td></tr><tr><td char=".">2nd year</td><td char=".">90</td><td char=".">22.3</td><td char=".">44</td><td char=".">48.9</td><td char=".">46</td><td char=".">51.1</td></tr><tr><td char=".">3rd year</td><td char=".">101</td><td char=".">25.0</td><td char=".">46</td><td char=".">45.5</td><td char=".">55</td><td char=".">54.5</td></tr><tr><td char=".">4th year</td><td char=".">91</td><td char=".">22.6</td><td char=".">36</td><td char=".">39.6</td><td char=".">55</td><td char=".">60.4</td></tr><tr><td>Major Subject</td><td>Science</td><td char=".">168</td><td char=".">41.7</td><td char=".">89</td><td char=".">53.0</td><td char=".">79</td><td char=".">47.0</td></tr><tr><td>Engineering</td><td char=".">29</td><td char=".">7.2</td><td char=".">16</td><td char=".">55.2</td><td char=".">13</td><td char=".">44.8</td></tr><tr><td>Business</td><td char=".">177</td><td char=".">43.9</td><td char=".">94</td><td char=".">53.1</td><td char=".">83</td><td char=".">46.9</td></tr><tr><td>Arts</td><td char=".">29</td><td char=".">7.2</td><td char=".">14</td><td char=".">48.3</td><td char=".">15</td><td char=".">51.7</td></tr><tr><td>Satisfied with major</td><td>Yes</td><td char=".">286</td><td char=".">71.0</td><td char=".">165</td><td char=".">57.7</td><td char=".">121</td><td char=".">42.3</td></tr><tr><td>Moderate</td><td char=".">92</td><td char=".">22.8</td><td char=".">41</td><td char=".">44.6</td><td char=".">51</td><td char=".">55.4</td></tr><tr><td>No</td><td char=".">25</td><td char=".">6.2</td><td char=".">7</td><td char=".">28.0</td><td char=".">18</td><td char=".">72.0</td></tr><tr><td>CGPA</td><td char=".">3.50–4.00</td><td char=".">83</td><td char=".">20.6</td><td char=".">43</td><td char=".">51.8</td><td char=".">40</td><td char=".">48.2</td></tr><tr><td char=".">3.00–3.49</td><td char=".">144</td><td char=".">35.7</td><td char=".">76</td><td char=".">52.8</td><td char=".">68</td><td char=".">47.2</td></tr><tr><td char=".">2.50–2.99</td><td char=".">58</td><td char=".">14.4</td><td char=".">27</td><td char=".">46.6</td><td char=".">31</td><td char=".">53.4</td></tr><tr><td char=".">2.00–2.49</td><td char=".">4</td><td char=".">1.0</td><td char=".">1</td><td char=".">25.0</td><td char=".">3</td><td char=".">75.0</td></tr><tr><td>Not Applicable</td><td char=".">114</td><td char=".">28.3</td><td char=".">66</td><td char=".">57.9</td><td char=".">48</td><td char=".">42.1</td></tr><tr><td>Parents' relationship</td><td>Good</td><td char=".">348</td><td char=".">86.4</td><td char=".">190</td><td char=".">54.6</td><td char=".">158</td><td char=".">45.4</td></tr><tr><td>Moderate</td><td char=".">31</td><td char=".">7.7</td><td char=".">10</td><td char=".">32.3</td><td char=".">21</td><td char=".">67.7</td></tr><tr><td>Poor</td><td char=".">9</td><td char=".">2.2</td><td char=".">5</td><td char=".">55.6</td><td char=".">4</td><td char=".">44.4</td></tr><tr><td>Not Applicable</td><td char=".">15</td><td char=".">3.7</td><td char=".">8</td><td char=".">53.3</td><td char=".">7</td><td char=".">46.7</td></tr><tr><td>Mothers educational level</td><td>No-Schooling</td><td char=".">25</td><td char=".">6.2</td><td char=".">8</td><td char=".">32.0</td><td char=".">17</td><td char=".">68.0</td></tr><tr><td>Primary</td><td char=".">50</td><td char=".">12.4</td><td char=".">26</td><td char=".">52.0</td><td char=".">24</td><td char=".">48</td></tr><tr><td>Secondary</td><td char=".">136</td><td char=".">33.7</td><td char=".">76</td><td char=".">55.9</td><td char=".">60</td><td char=".">44.1</td></tr><tr><td>College</td><td char=".">111</td><td char=".">27.5</td><td char=".">64</td><td char=".">57.7</td><td char=".">47</td><td char=".">42.3</td></tr><tr><td>Honors</td><td char=".">81</td><td char=".">20.1</td><td char=".">39</td><td char=".">48.1</td><td char=".">42</td><td char=".">51.9</td></tr><tr><td>Fathers educational level</td><td>No schooling</td><td char=".">10</td><td char=".">2.5</td><td char=".">4</td><td char=".">40.0</td><td char=".">6</td><td char=".">60.0</td></tr><tr><td>Primary</td><td char=".">47</td><td char=".">11.7</td><td char=".">21</td><td char=".">44.7</td><td char=".">26</td><td char=".">55.3</td></tr><tr><td>Secondary</td><td char=".">67</td><td char=".">16.6</td><td char=".">38</td><td char=".">56.7</td><td char=".">29</td><td char=".">43.3</td></tr><tr><td>College</td><td char=".">105</td><td char=".">26.1</td><td char=".">56</td><td char=".">53.3</td><td char=".">49</td><td char=".">46.7</td></tr><tr><td>Honors</td><td char=".">174</td><td char=".">43.2</td><td char=".">94</td><td char=".">54.0</td><td char=".">80</td><td char=".">46.0</td></tr><tr><td>Relationship status</td><td>Single</td><td char=".">298</td><td char=".">73.9</td><td char=".">162</td><td char=".">54.4</td><td char=".">136</td><td char=".">45.6</td></tr><tr><td>In a relationship</td><td char=".">105</td><td char=".">26.1</td><td char=".">51</td><td char=".">48.6</td><td char=".">54</td><td char=".">51.4</td></tr><tr><td>Domestic Violence</td><td>Yes</td><td char=".">45</td><td char=".">11.2</td><td char=".">19</td><td char=".">42.2</td><td char=".">26</td><td char=".">57.8</td></tr><tr><td>No</td><td char=".">358</td><td char=".">88.8</td><td char=".">194</td><td char=".">54.2</td><td char=".">164</td><td char=".">45.8</td></tr><tr><td>Failure in romantic affair</td><td>Yes</td><td char=".">98</td><td char=".">24.3</td><td char=".">42</td><td char=".">42.9</td><td char=".">56</td><td char=".">57.1</td></tr><tr><td>No</td><td char=".">225</td><td char=".">55.8</td><td char=".">126</td><td char=".">56.0</td><td char=".">99</td><td char=".">44.0</td></tr><tr><td>Not applicable</td><td char=".">80</td><td char=".">19.9</td><td char=".">45</td><td char=".">56.3</td><td char=".">35</td><td char=".">43.8</td></tr><tr><td>Sexually abuse</td><td>Yes</td><td char=".">30</td><td char=".">7.4</td><td char=".">8</td><td char=".">26.7</td><td char=".">22</td><td char=".">73.3</td></tr><tr><td>No</td><td char=".">373</td><td char=".">92.6</td><td char=".">205</td><td char=".">55.0</td><td char=".">168</td><td char=".">45.0</td></tr><tr><td>Physically abuse</td><td>Yes</td><td char=".">33</td><td char=".">8.2</td><td char=".">12</td><td char=".">36.4</td><td char=".">21</td><td char=".">63.6</td></tr><tr><td>No</td><td char=".">370</td><td char=".">91.8</td><td char=".">201</td><td char=".">54.3</td><td char=".">169</td><td char=".">45.7</td></tr><tr><td>Separated parents</td><td>Yes</td><td char=".">13</td><td char=".">3.2</td><td char=".">5</td><td char=".">38.5</td><td char=".">8</td><td char=".">61.5</td></tr><tr><td>No</td><td char=".">390</td><td char=".">96.8</td><td char=".">208</td><td char=".">53.3</td><td char=".">182</td><td char=".">46.7</td></tr><tr><td>Smoker parent</td><td>Yes</td><td char=".">69</td><td char=".">17.1</td><td char=".">30</td><td char=".">43.5</td><td char=".">39</td><td char=".">56.5</td></tr><tr><td>No</td><td char=".">334</td><td char=".">82.9</td><td char=".">183</td><td char=".">54.8</td><td char=".">151</td><td char=".">45.2</td></tr><tr><td>Monthly expenditure (BDT)</td><td char=".">≤2000</td><td char=".">50</td><td char=".">12.4</td><td char=".">22</td><td char=".">44.0</td><td char=".">28</td><td char=".">56.0</td></tr><tr><td char=".">2001–3000</td><td char=".">61</td><td char=".">15.1</td><td char=".">38</td><td char=".">62.3</td><td char=".">23</td><td char=".">37.7</td></tr><tr><td char=".">3001–4000</td><td char=".">89</td><td char=".">22.1</td><td char=".">45</td><td char=".">50.6</td><td char=".">44</td><td char=".">49.4</td></tr><tr><td char=".">4001–5000</td><td char=".">123</td><td char=".">30.5</td><td char=".">70</td><td char=".">56.9</td><td char=".">53</td><td char=".">43.1</td></tr><tr><td>Is monthly allowance from family enough?</td><td>Yes</td><td char=".">303</td><td char=".">75.2</td><td char=".">174</td><td char=".">57.4</td><td char=".">129</td><td char=".">42.6</td></tr><tr><td>No</td><td char=".">100</td><td char=".">24.8</td><td char=".">39</td><td char=".">39.0</td><td char=".">61</td><td char=".">61.0</td></tr><tr><td>Additional source of income</td><td>Not Applicable</td><td char=".">284</td><td char=".">70.5</td><td char=".">144</td><td char=".">50.7</td><td char=".">140</td><td char=".">49.3</td></tr><tr><td>Tuition</td><td char=".">96</td><td char=".">23.8</td><td char=".">58</td><td char=".">60.4</td><td char=".">38</td><td char=".">39.6</td></tr><tr><td>Business</td><td char=".">10</td><td char=".">2.5</td><td char=".">4</td><td char=".">40.0</td><td char=".">6</td><td char=".">60.0</td></tr></tbody></table> </ephtml> </p> <p>Table 2. Behavioral characteristics of the participants.</p> <p> <ephtml> <table><thead><tr><td>Variables</td><td>Category</td><td>Total sample</td><td>Non-depressed</td><td>Depressed</td></tr><tr><td>n</td><td>%</td><td>n</td><td>%</td><td>n</td><td>%</td></tr></thead><tbody valign="top"><tr><td>Smoking history</td><td>Current smoker</td><td char=".">27</td><td char=".">6.7</td><td char=".">11</td><td char=".">40.7</td><td char=".">16</td><td char=".">59.3</td></tr><tr><td>Ex-smoker</td><td char=".">20</td><td char=".">5.0</td><td char=".">10</td><td char=".">50.0</td><td char=".">10</td><td char=".">50.0</td></tr><tr><td>Sometimes</td><td char=".">37</td><td char=".">9.2</td><td char=".">16</td><td char=".">43.2</td><td char=".">21</td><td char=".">56.8</td></tr><tr><td>Never</td><td char=".">319</td><td char=".">79.2</td><td char=".">176</td><td char=".">55.2</td><td char=".">143</td><td char=".">44.8</td></tr><tr><td>Physical activity</td><td>Yes</td><td char=".">181</td><td char=".">44.9</td><td char=".">102</td><td char=".">56.4</td><td char=".">79</td><td char=".">43.6</td></tr><tr><td>No</td><td char=".">218</td><td char=".">54.1</td><td char=".">111</td><td char=".">50.9</td><td char=".">107</td><td char=".">49.1</td></tr><tr><td>Sleeping status</td><td>Normal</td><td char=".">244</td><td char=".">60.5</td><td char=".">147</td><td char=".">60.2</td><td char=".">97</td><td char=".">39.8</td></tr><tr><td>More than normal</td><td char=".">96</td><td char=".">23.8</td><td char=".">42</td><td char=".">43.8</td><td char=".">54</td><td char=".">56.3</td></tr><tr><td>Less than normal</td><td char=".">63</td><td char=".">15.6</td><td char=".">24</td><td char=".">38.1</td><td char=".">39</td><td char=".">61.9</td></tr><tr><td>Suicidal attempts</td><td>Yes</td><td char=".">35</td><td char=".">8.7</td><td char=".">7</td><td char=".">20.0</td><td char=".">28</td><td char=".">80.0</td></tr><tr><td>No</td><td char=".">367</td><td char=".">91.1</td><td char=".">206</td><td char=".">56.1</td><td char=".">161</td><td char=".">43.9</td></tr><tr><td>Stressful life event</td><td>Yes</td><td char=".">231</td><td char=".">57.3</td><td char=".">94</td><td char=".">47.4</td><td char=".">137</td><td char=".">59.3</td></tr><tr><td>No</td><td char=".">171</td><td char=".">42.4</td><td char=".">119</td><td char=".">69.6</td><td char=".">52</td><td char=".">30.4</td></tr><tr><td>Drug addiction</td><td>Yes</td><td char=".">19</td><td char=".">4.7</td><td char=".">6</td><td char=".">31.6</td><td char=".">13</td><td char=".">68.4</td></tr><tr><td>No</td><td char=".">383</td><td char=".">95.0</td><td char=".">207</td><td char=".">54.0</td><td char=".">176</td><td char=".">46.0</td></tr><tr><td>Physical comorbidity</td><td>Yes</td><td char=".">48</td><td char=".">11.9</td><td char=".">19</td><td char=".">47.4</td><td char=".">29</td><td char=".">52.6</td></tr><tr><td>No</td><td char=".">336</td><td char=".">83.4</td><td char=".">185</td><td char=".">39.6</td><td char=".">151</td><td char=".">60.4</td></tr></tbody></table> </ephtml> </p> <hd id="AN0165472061-12">Prevalence of depression</hd> <p>The average BDI score was 14.63 (SD = 6.1) ranging between 0 and 49. Overall, 213 (52.9%) students showed no depressive symptoms (BDI score ≥ 14), and 190 (47.1%) students showed depressive symptoms (BDI score <14). Among them, 190 (47.14%) students found to have depressive symptoms where 113 students were from PSTU and 77 students were from BU. The majority of students (38.7%) showed clinical depressive symptoms (BDI = 5 to 13) and the prevalence of severe depressive symptoms (BDI = 21 to 63) was slightly higher among PSTU students (29.9%) compared to BU (22.8%) (Figure 1).</p> <p>Graph: Figure 1. Classification of depression for BU (Barisal University) and PSTU (Patuakhali Science and Technology University) participants (%).</p> <hd id="AN0165472061-13">Factors associated with depression</hd> <p>Multivariate logistic regression analysis showed that odds of being depressed was 3.4 times (95% CI: 1.6–7.1) among 2nd-year students, 3.8 times (95% CI: 1.7–8.6) among 3rd-year students, and 3.9 times (95% CI: 1.5–8.9) among 4th-year students compared to the 1st-year students. Students who had a history of stressful life events (aOR = 2.7, 95% CI: 1.7–4.4), suicidal attempts (aOR = 3, 95% CI: 1.2–7.9), and who self-reported that monthly allowance from their family wasn't enough (aOR = 0.528, 95% CI: 0.3–0.9) were more likely to have depressive symptoms (Table 3).</p> <p>Table 3. Regression analysis of depressive symptoms among university students in Bangladesh.</p> <p> <ephtml> <table><thead><tr><td>Variable</td><td>Odds Ratio (95% Confidence Interval)</td></tr><tr><td>Crude</td><td><italic>p</italic></td><td>Adjusted</td><td><italic>p</italic></td></tr></thead><tbody valign="top"><tr><td>Study year (Ref.: 1st year)</td><td /><td /><td /><td /></tr><tr><td char=".">2nd year</td><td char=".">3.349 (1.732–6.477)</td><td char=".">0.000</td><td char=".">3.388 (1.615–7.108)</td><td char=".">0.001</td></tr><tr><td char=".">3rd year</td><td char=".">3.411 (1.646–7.070)</td><td char=".">0.001</td><td char=".">3.836 (1.700–8.655)</td><td char=".">0.001</td></tr><tr><td char=".">4th year</td><td char=".">4.432 (2.041–9.624)</td><td char=".">0.000</td><td char=".">3.885 (1.527–8.891)</td><td char=".">0.004</td></tr><tr><td>Sexual abuse (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">3.356 (1.457–7.730)</td><td char=".">0.004</td><td char=".">1.617 (0.624–4.187)</td><td char=".">0.322</td></tr><tr><td>Physical abuse (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">2.081 (0.995–4.354)</td><td char=".">0.052</td><td char=".">1.222 (0.490–3.048)</td><td char=".">0.667</td></tr><tr><td>Is monthly allowance from family enough? (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">0.474 (0.299–0.752)</td><td char=".">0.002</td><td char=".">0.528 (0.312–0.891)</td><td char=".">0.017</td></tr><tr><td>Sleeping status (Ref.: Less than normal)</td><td /><td /><td /><td /></tr><tr><td>Normal</td><td char=".">0.406 (0.230–0.718)</td><td char=".">0.002</td><td char=".">0.551 (0.285–1.064)</td><td char=".">0.076</td></tr><tr><td>More than Normal</td><td char=".">0.791 (0.413–1.514)</td><td char=".">0.479</td><td char=".">1.049 (0.488–2.256)</td><td char=".">0.903</td></tr><tr><td>Suicidal attempts (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">5.118 (2.180–12.02)</td><td char=".">0.000</td><td char=".">3.016 (1.157–7.860)</td><td char=".">0.024</td></tr><tr><td>Stressful live events (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">3.335 (2.195–5.068)</td><td char=".">0.000</td><td char=".">2.720 (1.668–4.438)</td><td char=".">0.000</td></tr><tr><td>Physical comorbidity (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">1.870 (1.009–3.466)</td><td char=".">0.047</td><td char=".">1.246 (0.617–2.516)</td><td char=".">0.539</td></tr><tr><td>Satisfied with major (Ref.: No)</td><td /><td /><td /><td /></tr><tr><td>Yes</td><td char=".">0.285 (0.115–0.704)</td><td char=".">0.007</td><td char=".">0.622 (0.227–1.702)</td><td char=".">0.355</td></tr><tr><td>Moderate</td><td char=".">0.484 (0.184–1.270)</td><td char=".">0.140</td><td char=".">0.913 (0.316–2.674)</td><td char=".">0.868</td></tr></tbody></table> </ephtml> </p> <hd id="AN0165472061-14">Discussion</hd> <p>This study identifies the prevalence of depressive symptoms and its' associated factors among university students in Bangladesh. The present research showed that almost half (47.14 percent) of students had depressive symptoms with a considerable number showing moderate to severe symptoms of depression. The prevalence of depressive symptoms obtained in this study was lower than that reported in a similar survey conducted among students at Jahangirnagar University, Bangladesh.[<reflink idref="bib24" id="ref35">24</reflink>] The present study also revealed a greater prevalence of depressive symptoms among PSTU students compared to BU. This could be attributed to different academic pressure and location of the universities. However, in the present study, the rate of depression among students was higher compared to earlier surveys conducted among university students.[<reflink idref="bib17" id="ref36">17</reflink>],[<reflink idref="bib30" id="ref37">30</reflink>],[<reflink idref="bib31" id="ref38">31</reflink>]</p> <p>Depressive symptoms were significantly higher among students who were in the senior study year, which has been demonstrated previously in some studies.[<reflink idref="bib32" id="ref39">32</reflink>],[<reflink idref="bib33" id="ref40">33</reflink>] The results of the present research are different from several other studies reporting that first-year students have the highest depressive symptoms.[<reflink idref="bib5" id="ref41">5</reflink>],[<reflink idref="bib34" id="ref42">34</reflink>] The causes for such elevated rates of depression in senior-year students implicated and indicated both the environment and personal attributes. There are substantial transitions that occur in the last university years, such as worrying about career that they will have after the graduation, which may contribute to the development of depressive symptoms among students.[<reflink idref="bib33" id="ref43">33</reflink>] Starting a career after graduation is a big concern for all students, and can be challenging in the current time in Bangladesh.[<reflink idref="bib35" id="ref44">35</reflink>]</p> <p>In this study, the prevalence of depressive symptoms among students with poor academic performance was consistent with a similar study conducted in Nigeria.[<reflink idref="bib36" id="ref45">36</reflink>] In this particular research, an important protective factor against developing depressive symptoms among university students was the level of interest in their field of study. Depressive symptoms were more prevalent among students reporting dissatisfaction with their major (Table 1). The same result was also found in a study among the students at the University of Gondar.[<reflink idref="bib37" id="ref46">37</reflink>] In Bangladesh, the parents usually decide the major of the student, and students are awarded major according to their merit position in admission exam and previous academic performance.[<reflink idref="bib22" id="ref47">22</reflink>] If a student does not like his/her major, he/she may have disinterest and lack of motivation to learn. Therefore, a student's disappointment with his/her major may lead to depressive symptoms.</p> <p>Literature review revealed that financial stress is a significant risk factor for depressive symptoms and psychological distress among university students,[<reflink idref="bib38" id="ref48">38</reflink>],[<reflink idref="bib39" id="ref49">39</reflink>] and the result of the current study supports this. In the present study, the experience of feeling that "monthly allowance from students' family wasn't enough" was strongly related to the development of depressive symptoms, which suggests that financial worries can be serious concern for public university students in Bangladesh. This study also revealed a higher prevalence of depressive symptoms among female respondents compared to their male counterparts. In Bangladesh, female university students face a higher degree of financial difficulties because of being neglected in the process of economic socialization, negative financial attitude toward women, and influences of secondary socialization factors.[<reflink idref="bib40" id="ref50">40</reflink>] This indicates the need for a multi-level approach that examines systemic issues related to financial stress among university students and their mental health outcomes.</p> <p>Our study revealed that university students with a history of a suicide attempt were more likely to have depressive symptoms (Table 2 and 3). A multi-country study in Southeast Asia among university students also found a significant correlation between depressive symptoms and both suicidal ideation and suicide attempt.[<reflink idref="bib41" id="ref51">41</reflink>] Thus, more comprehensive intervention and outreach programs are required for university students reporting depressive symptoms to determine their degree of suicidal ideation and likelihood of suicide attempts. Regression analysis also showed that stressful life events played a positive role in developing depressive symptoms among university students, which is coherent with previous researches (Table 3).[<reflink idref="bib42" id="ref52">42</reflink>],[<reflink idref="bib43" id="ref53">43</reflink>]</p> <p>Our study had certain limitations. As in all cross-sectional researches, causality between the factors reported and symptoms of depression could not be defined. Consequently, the conditions found are known to be contributing variables, which may be either the causes or effects of depression. Another limitation was the use of self-reported questionnaires, and as a result, the study results may have been affected by recall bias.</p> <hd id="AN0165472061-15">Conclusion</hd> <p>The present study found a high prevalence of depressive symptoms among university students in Southern Bangladesh. Being a senior year student, having insufficient monthly allowance from family, a history of stressful life events, and having a history of suicidal attempts were factors associated with the development of depressive symptoms. This study reported a high level of depressive symptoms in university students needs further discussion, exploration, and calls for designing appropriate interventions.</p> <hd id="AN0165472061-16">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of Bangladesh and received approval from the Patuakhali Science and Technology University.</p> <hd id="AN0165472061-17">Funding</hd> <p>No funding was used to support this research and/or the preparation of the manuscript.</p> <ref id="AN0165472061-18"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Joint first author: Abu Sayeed and Md Hafizur Rahman</bibtext> </blist> </ref> <ref id="AN0165472061-19"> <title> References </title> <blist> <bibtext> Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013; 47 (3): 391 – 400. doi: 10.1016/j.jpsychires.2012.11.015.</bibtext> </blist> <blist> <bibl id="bib2" type="bt">2</bibl> <bibtext> Lei X-Y, Xiao L-M, Liu Y-N, Li Y-M. 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  Label: Title
  Group: Ti
  Data: Prevalence and Associated Factors of Depression among Bangladeshi University Students: A Cross-Sectional Study
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  Label: Language
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  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Sayeed%2C+Abu%22">Sayeed, Abu</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-0745-1755">0000-0003-0745-1755</externalLink>)<br /><searchLink fieldCode="AR" term="%22Rahman%2C+Md+Hafizur%22">Rahman, Md Hafizur</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-2742-049X">0000-0002-2742-049X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Hassan%2C+Md%2E+Nazmul%22">Hassan, Md. Nazmul</searchLink><br /><searchLink fieldCode="AR" term="%22deSteiguer%2C+Abby%22">deSteiguer, Abby</searchLink><br /><searchLink fieldCode="AR" term="%22Kundu%2C+Satyajit%22">Kundu, Satyajit</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-9610-1479">0000-0001-9610-1479</externalLink>)<br /><searchLink fieldCode="AR" term="%22Meem%2C+Amatul+Elah%22">Meem, Amatul Elah</searchLink><br /><searchLink fieldCode="AR" term="%22Hasan%2C+Al-Riaj%22">Hasan, Al-Riaj</searchLink><br /><searchLink fieldCode="AR" term="%22Mallick%2C+Trisha%22">Mallick, Trisha</searchLink><br /><searchLink fieldCode="AR" term="%22Sultana%2C+Mst%2E+Sadia%22">Sultana, Mst. Sadia</searchLink><br /><searchLink fieldCode="AR" term="%22Hasanuzzaman%2C+Md%22">Hasanuzzaman, Md</searchLink><br /><searchLink fieldCode="AR" term="%22Sahrin%2C+Sumaia%22">Sahrin, Sumaia</searchLink><br /><searchLink fieldCode="AR" term="%22Hasan%2C+M%2E+Tasdik%22">Hasan, M. Tasdik</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2023 71(5):1381-1386.
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  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 6
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2023
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
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  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+%28Psychology%29%22">Depression (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Measures+%28Individuals%29%22">Measures (Individuals)</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Attainment%22">Educational Attainment</searchLink><br /><searchLink fieldCode="DE" term="%22Suicide%22">Suicide</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Variables%22">Stress Variables</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Experience%22">Student Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Financial+Contribution%22">Parent Financial Contribution</searchLink><br /><searchLink fieldCode="DE" term="%22Financial+Problems%22">Financial Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Bangladesh%22">Bangladesh</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Beck+Depression+Inventory%22">Beck Depression Inventory</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2021.1944168
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI = 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.
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  Data: 2023
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  Data: EJ1396233
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1396233
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        Value: 10.1080/07448481.2021.1944168
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      – Text: English
    PhysicalDescription:
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        PageCount: 6
        StartPage: 1381
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      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Depression (Psychology)
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: Measures (Individuals)
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      – SubjectFull: Financial Problems
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      – SubjectFull: College Students
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      – SubjectFull: Bangladesh
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      – SubjectFull: Beck Depression Inventory
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