Factors Related to High Anxiety and Depression in Dentistry Students in the Republic of Macedonia

Many studies suggested contribution of various academic and non-academic stressors to the reported higher prevalence of anxiety and mood disorders in medical and dental undergraduate students in different countries (1-3). The highest rates of anxiety and depression have been reported for the first and second-year medical and dental students (first study year) (1,4), as well as for the final study years students (5). The aim of the study was to identify risk factors related to high anxiety and depression among dental students in the Republic of Macedonia. We performed a cross-sectional study on a co-hort of 236 dental students, aged 18 to 25 yr from all study years at Faculty of Dentistry in Skopje, during the second semester of 2012-2013 year. The students anonymously fulfilled self-rating questionnaires regarding stress-provoking factors connected to dental education. They were defined as personal and social problems associated to academic environment (disappointment, financial, interpersonal relations, problems with accommodation, poor quality of education, inadequate social life, lack of opportunities and administrative problems) caused negative experience and have been most irritating for the students (1). Anxiety and depression were assessed by the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). The BAI score >25 was used as a criterion for high anxiety and BDI score >20 was defined as a criterion for manifest depression for logistic regression analysis. The highest mean values of BAI scores were obtained among the first year (20.1± 12.5), while the lowest were documented among the fifth year students (12.1 ± 8.5) (ANOVA F=5.07, P<0.01). The highest mean BDI scores were reported among first year (12 ± 7.8), while the lowest ones were detected among the fourth year students (7.6 ± 4.5) (ANOVA F=3.51, P<0.05). The highest prevalence of high anxiety was found among the first year students (30.7%), while in fifth year students it was 6.25% (χ 2 = 29.442, df=12, P<0.01). Poor quality of education was the most irritating problem for 72% (n=170) of all students. Fifty percent of the fifth year students, compared to 18.7% from the first year students identified the financial problems to be one of the most irritating problems during their education (χ 2 =12.312, df=4, P<0.05). Multiple regression analysis for BDI as dependent variable identified BAI scores (R 2 =0.329, beta= 0.556, P<0.001) and existence of problems (R 2 =0.038, beta= 0.148, P<0.001) as predictor factors for development of depression in dental students.