Cited by 455Healthcare professionals’ stress and burnoutStudent Stress and CopingCOVID-19 and Mental Health

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Prevalence of psychological stress, depression and anxiety among medical students in Egypt

Fawzy, Mohamed, Hamed, Sherifa A.·2017·Psychiatry Research

DOI 10.1016/j.psychres.2017.05.027

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Abstract

Poor psychological health in medical students has been reported nationwide. This study estimated the prevalence of depression, anxiety and stress symptoms among medical students who were enrolled in a public university in Upper Egypt and determine the association of these morbidities with the students' basic socio-demographic variables. This cross-sectional study included 700 students. A self-administered, questionnaire for the socio-demographic characteristics, Depression Anxiety Stress Scale (DASS 21) and Pittsburgh Sleep Quality Index (PSQI) questionnaire were used for assessment. High frequencies of depression (65%), anxiety (73%) and stress (59.9%) were reported. Stress scores were significantly higher than depression and anxiety (P=0.001). 55.7% were poor sleepers. In univarate analysis, females, those living in the University campus/students' residence facility, in the preclinical years and with lower academic achievement had higher scores of DASS and PSQI compared to their comparative partners. Significant correlations were reported between stress with depression, anxiety and PQSI scores (P=0.0001). In multivariate analysis, stress scores were significantly associated with female sex, depression and anxiety scores. We conclude that depression, anxiety and stress symptoms are common in medical students of Assiut University relative to other schools and female gender was significantly correlated with these findings.

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Depression, anxiety and stress associated with fear of COVID-19 in Peruvian dental students: A multivariate analysis with 12 sociodemographic factors
Pérez-Vargas, A. C., Porras, J. C., Junca, L. H. E., Córdova-Limaylla, N. E., López‐Gurreonero, C., Castro‐Mena, M., & Cayo-Rojas, C. F. (2022) · Journal of International Society of Preventive and Community Dentistry · doi:10.4103/jispcd.jispcd_295_21 · Cited by 11
“There are several instruments to measure mood disorders in a reliable way, including the Depression, Anxiety and Stress Scale—21 items (DASS-21), which has been used by numerous researchers in behavioral sciences to measure depression, anxiety, and stress with an acceptable psychometric performance in university popul…”
Method
Sintomas de ansiedade e depressão no ambiente acadêmico: um estudo transversal
Silveira, G. E. L., Viana, L. G., Sena, M. M., Alencar, M. M. S. D. C., Soares, P. R. A. L., Aquino, P. D. S., & Ribeiro, S. G. (2022) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2022ao009766 · Cited by 11
Well-being and health perception of university students in Portugal: the influence of parental support and love relationship
Alves, R., Precioso, J., & Becoña, E. (2020) · Health Psychology Report · doi:10.5114/hpr.2020.94723 · Cited by 12
RETRACTED: Investigation of depression, anxiety and stress levels of health-care students during COVID-19 pandemic
Al‐Maraira, O. A., & Shennaq, S. Z. (2021) · Mental Health Review Journal · doi:10.1108/mhrj-10-2020-0070 · Cited by 11
Retracted
Burnout Syndrome in Medical Students in the Kingdom of Bahrain
Ubaidi, B. A. A., Jassim, G., & Salem, A. (2018) · Global Journal of Health Science · doi:10.5539/gjhs.v10n11p86 · Cited by 10
Poor Sleep Quality among Medical Students in International Islamic University Malaysia (IIUM) and Its Association with Mental Health and other Factors
Said, A. H., Yusof, M. Z., Mohd, F. N., Azmi, M. A. N. H., Mohd Hanapiah, H., & Abdullah, A. W. (2020) · IIUM Medical Journal Malaysia · doi:10.31436/imjm.v19i2.1564 · Cited by 10
“This finding was consistent with the studies done in the Middle East and local setting where the prevalence of poor sleep quality was significantly higher among students with depression.(10,18,19) Additionally, many previous studies had found that students with anxiety or stress had a higher risk of having poor sleep…”
Result
Buffering Effect of Perseverance and Meditation on Depression among Medical Students Experiencing Negative Family Climate
Pongpitpitak, N., Wongpakaran, N., Wongpakaran, T., & Nuansri, W. (2022) · Healthcare · doi:10.3390/healthcare10101895 · Cited by 12
“The prevalence of depression among medical students was found to be higher than that of the general population and age−matched peers [6].”
Background
How do stressful life events affect medical students’ academic adjustment? Parallel mediating mechanisms of anxiety and depression
Guo, H., & Qiu, C. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05601-0 · Cited by 13
“It is a consensus that the mental disorders among medical students are higher than those among non-medical students and the general population in different countries world-wide [11].”
Background
Mental health status among university students during the transition period from high school to university in Lebanon: a cross-sectional study
Affan, R., Darwich, K., Jarrouge, G., Hannouch, T., & Assaad, S. (2025) · BMC Public Health · doi:10.1186/s12889-025-23087-3 · Cited by 9
Breathwork for Chronic Stress and Mental Health: Does Choosing a Specific Technique Matter?
Siebieszuk, A., Płoński, A. F., & Baranowski, M. (2025) · Medical Sciences · doi:10.3390/medsci13030127 · Cited by 12
Stigma and Help-Seeking Attitudes in Relation to Psychological Distress Among Medical Students in Saudi Arabia
Al‐Johani, W. M., Almansour, A., Albakr, D. M., Alghirash, D. Y., Alfadhli, A. N., Almutairi, R., Mobarki, O. A., Alqasim, S., AlShammari, M. A., & Wahab, M. M. A. (2025) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/0117450179414477250905100917 · Cited by 10
Exploring wellbeing in first year medical students amidst a curriculum change
Merrick, D., Mbaki, Y., Pratten, M. K., & Simpson, T. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02678-9 · Cited by 11
“can be classified as academic or non-academic [7].”
BackgroundInfluential
SAÚDE MENTAL NO ENSINO SUPERIOR: REVISÃO DE LITERATURA
de Lima, V. D., Costa, A. G. M., de Vasconcelos, M. L. I., & Lourenço, L. M. (2023) · Interação em Psicologia · doi:10.5380/riep.v26i3.76204 · Cited by 9
Subscribers’ Perspectives and Satisfaction with the MoreGoodDays Supportive Text Messaging Program and the Impact of the Program on Self-Rated Clinical Measures
Agyapong, B., Shalaby, R., Eboreime, E., Hay, K., Pattison, R., Korthuis, M., Wei, Y., & Agyapong, V. I. O. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13020580 · Cited by 9
“Research prior to the COVID-19 pandemic indicates that this group experienced high levels of stress, anxiety and depression [1,2], which were further exacerbated by the pandemic [3].”
Background
Depression Among Medical Students of Karachi A Cross Sectional Study
Kumari, U., Dawani, N., Devnani, J., Qureshi, M. F. H., Soleja, F. K., Mohammad, D., Abubaker, Z. J., Haroon, A., & Sadiq, S. (2019) · MedEdPublish · doi:10.15694/mep.2019.000181.1 · Cited by 9
Lifestyle and Social Factors Exacerbated on the Prevalence of Mood Disorders and Functional Dyspepsia Among Neonatal Nurses in China
Huang, Z., Huang, F., Wang, M., Tang, C.-Z., Huang, J., Ling, J., Li, S.-E., Wei, S.-Q., Lei, H.-H., Li, J., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.905401 · Cited by 9
Prevalence of internet addiction and its relationship with insomnia, depression, anxiety, and stress among medical students of a tertiary care medical institute of Eastern India
Rani, S., Sinha, N., & Kumar, R. (2024) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_134_23 · Cited by 13
“[28] It was found that 17.7% had mild stress and moderate stress, which is higher than the findings from an Indian and Romanian study [16,26] but was almost equal and lower than the findings of the Lebanese study.”
Influential
Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand
Vadhanavikkit, P., Srifuengfung, M., Wiwattarangkul, T., Wiwattanaworaset, P., Oon‐arom, A., Chiddaycha, M., Piyavhatkul, N., & Wainipitapong, S. (2024) · Journal of Homosexuality · doi:10.1080/00918369.2024.2389905 · Cited by 8
“…to new living environments, and separation from family; and sociodemographic stressors, including female gender, family socioeconomic background, substance abuse, and deep-seated religious beliefs (Ayinde et al., 2021; Carrard et al., 2022; Fawzy & Hamed, 2017; Moutinho et al., 2017; Seo, 2021).”
Sleep hygiene practices and sleep quality among medical students in Egypt: a cross-sectional study
Talaia, A. M., Sowidan, A., Fahim, A., Elzohery, A., Hammoda, A. B. F., & Kabbash, I. (2025) · Sleep Science and Practice · doi:10.1186/s41606-025-00125-y · Cited by 13
“Previous studies conducted in Egypt reported prevalence rates of 58.5% and 55.7% (Ahmed Salama and University 2017; Fawzy and Hamed 2017).”
Influential
The journey of medical field students: uncovering medical student syndrome, personality traits, and their interactions
Abdellatif, M. A., Salam, H. A. A., Ali, H. T., Hussein, S. A. M., Abdalla, A. A., Khorkhash, M. K., Alsabbagh, F. A., Elsayed, N. K., Ibrahim, F., & Amer, S. A. (2025) · BMC Psychology · doi:10.1186/s40359-025-02788-9 · Cited by 8
“Specifically, Backović et al. (2012) [25] Faravelli et al., (2013) [26]; Karger, (2014) [27], Moskalewicz et al., (2015) [28]; and Fawzy & Hamed (2017) [21] found that women are more likely than men to display morbid fear for their health among the 606 students from the Silesian region [29].”
Academic stress and online learning engagement in medical students: the parallel mediating roles of sleep quality and positive academic emotions
Li, H., Li, W., Zhang, Y., Wang, J., Ye, Y., Li, S., Liu, B., & Tian, J. (2025) · BMC Medical Education · doi:10.1186/s12909-025-08369-z · Cited by 11
“Medical students undergo proportionately undue stress relative to other students [13], an issue which is similarly well-documented among nursing students in a range of learning environments, including clinical practice [14].”
Assessing psychological distress among medical students: a systematic review and meta-analysis of tools available
L’hote, D., Potiron, L., & Levaillant, M. (2026) · BMC Medical Education · doi:10.1186/s12909-025-08386-y · Cited by 8
The effect of stress and depression on quality of life of pharmacy students in Malaysia
Blebil, A. Q., Dujaili, J. A., Mohammed, A. H., Cheong, C. M., & Hoo, Y. (2021) · Pharmacy Education · doi:10.46542/pe.2021.211.323333 · Cited by 8
“…faculties in different universities across the world have suggested that depression is a fairly common issue existing among health professions students (Basudan, Binanzan, & Alhassan, 2017; Fawzy & Hamed, 2017; Hunt & Gable, 2013; Ibrahim & Abdelreheem, 2015; Nahar et al., 2019; Xu et al., 2014).”
Background
Stress Factors and Depression Levels of International Medical Students in Bulgaria and Turkish Medical Students
Vatansever, M., Georgieva, E., & Velkova, A. S. (2021) · Education in Medicine Journal · doi:10.21315/eimj2021.13.3.6 · Cited by 8
Emotional intelligence associated with levels of anxiety and depression in medical students of a public University
Ayala-Servín, N., Martínez, M. A. D., González, C. A. U., Alviso, A. I., Castaldelli-Maia, J. M., Ventriglio, A., Almirón‐Santacruz, J., García, O. E., & Torales, J. C. (2021) · Anales de la Facultad de Ciencias Médicas (Asunción) · doi:10.18004/anales/2021.054.02.51 · Cited by 8
Correlates of orthorexia nervosa in a sample of Lebanese adolescents: the co-moderating effect of body dissatisfaction and self-esteem between mental health issues and orthorexia nervosa
Mhanna, M., Azzi, R., Hallit, S. R., Obeïd, S., & Soufia, M. (2023) · Vulnerable Children and Youth Studies · doi:10.1080/17450128.2022.2163732 · Cited by 8
“In fact, unlike ON, it appears that the high comorbidity between anxiety and other eating disorders seems to arise from the urge to control the quantity of food rather than its quality (Fawzy & Hamed, 2017).”
Background
Fear Related to COVID-19, Mental Health Issues, and Predictors of Insomnia among Female Nursing College Students during the Pandemic
Albikawi, Z. F. (2023) · Healthcare · doi:10.3390/healthcare11020174 · Cited by 8
Mental health, job satisfaction, and quality of life among psychiatric nurses in China during the COVID-19 pandemic: A cross-sectional study
Li, M., Yang, Y., Zhang, L., Xia, L., Zhang, S., Kaslow, N. J., Liu, T., Liu, Y., Jiang, F., Tang, Y., et al. (2024) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2024.101540 · Cited by 9
Gender Disparities in Symptoms of Depression After Medical School Exams and Student Coping Strategies for Postexam Depression Symptoms
Arabatzis, T. J., Marsidi, J. L., Ashraf, M. J., Supino, C., & Smith, R. (2022) · Journal of Medical Education and Curricular Development · doi:10.1177/23821205211055391 · Cited by 12
Sociodemographic, lifestyle, and psychological factors as controllable predictors of academic self-efficacy after reforming a medical education system; the Egyptian Nationwide experience
Samir, A. A., Elamir, A. H., Helal, M. B., Goudy, Y. M., Elbarbary, K., El‐mezayen, M. Y., Elenien, W. I. A., Abdelazim, E. H., Mabrouk, M. A., the ASE-Egypt Group, et al. (2025) · BMC Medical Education · doi:10.1186/s12909-025-06805-8 · Cited by 7
The evaluation of depression, anxiety, and stress among undergraduate dental students in graduation year in Mainland China: a cross-sectional study
Fang, Y., Yang, M. S., Huang, W., Zhang, Y., Gao, X., Chen, Y., Meng, S., & Zeng, S. (2025) · BMC Medical Education · doi:10.1186/s12909-025-07141-7 · Cited by 7
“This may be related to the fact that female students have a higher sensitivity in dealing with interpersonal relationships, which is important throughout dental education, as a high level of interpersonal skills is often required in this field [28].”
A Qualitative Research on the Occupational Anxieties Final Year Medical Students in Medical Faculty, Aydın
YASİN, Y. K., Öztürk, S., Dereboy, Ç., & Okyay, P. (2018) · Tıp Eğitimi Dünyası · doi:10.25282/ted.377160 · Cited by 7
Effect of ergonomics awareness in controlling work-related musculoskeletal-pain among dental students: A cross-sectional study
Sabbagh, H. J., Shagagi, A. M., Basheer, H. M., Mahmoud, R. A., & Arafah, A. M. (2023) · Work · doi:10.3233/wor-220601 · Cited by 7
“Regarding psychological factors, undergraduate students have shown high levels of depression, anxiety, and stress [30].”
Exploring Sociodemographic Characteristics, Adverse Childhood Experience, and Mental Health History as Predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada
Agyapong, B., Shalaby, R., Hay, K., Pattison, R., Eboreime, E., Korthuis, M., Wei, Y., & Agyapong, V. I. O. (2023) · Behavioral Sciences · doi:10.3390/bs13090749 · Cited by 33
“%) for depression [45].”
A study of comparing two cognitive-behavioral workshop for college students
Ehrampoush, M. H., Tabei, S. Z., Mahmoodabad, S. S. M., Fallahzadeh, H., Nami, M., Khayer, E., Ghaemi, S. Z., Matin, M., & Forouhari, S. (2019) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_130_19 · Cited by 7
“[14] It agrees also with results of a recent study, 2017, from Egypt;[18] as students enrolled in the preclinical years obtained higher score of PSQI compared to others.”
BackgroundResultInfluential
Prevalence of Depression, Anxiety among International Students in the Health Professions at Southern Medical University, P. R. China
Mahihu, C. (2020) · Open Journal of Social Sciences · doi:10.4236/jss.2020.812014 · Cited by 8
Gender Differences on COVID-19 Related Anxiety Among Students
Thahır, A., Sulastri, S., Bulantika, S. Z., & Novita, T. (2021) · Pakistan Journal of Psychological Research · doi:10.33824/pjpr.2021.36.1.05 · Cited by 7
FAKTOR - FAKTOR YANG MEMPENGARUHI STRESS AKADEMIK MAHASISWA TINGKAT AKHIR
Djoar, R. K., & Anggarani, A. P. M. (2024) · Jambura Health and Sport Journal · doi:10.37311/jhsj.v6i1.24064 · Cited by 7
Prevalence of Depression and its Associated Factors among Medical Students in International Islamic University Malaysia (IIUM)
Said, A. H., Azmi, M. A. N. H., Hanapiah, H. M., Abdullah, A. W., & Shalihin, M. S. E. (2021) · IIUM Medical Journal Malaysia · doi:10.31436/imjm.v20i4.1854 · Cited by 7
Comparison of the Effectiveness of Mindfulness Training and Massage-Aromatherapy on Rising Psychological Health of Elderly Women with Chronic Pain
Alemi, S., Malihialzackerini, S., alhosseini, K. A., & Khabiri, M. (2019) · ranian Journal of Health Education and Health Promotion · doi:10.29252/ijhehp.7.4.359 · Cited by 7
STUDENT RESILIENCE IN FACING COVID-19 PANDEMIC VIEWED FROM SOCIAL SUPPORT
Asiyah, S. N., Kumalasari, M. L. F., & Kusumawati, E. (2020) · Humanities & Social Sciences Reviews · doi:10.18510/hssr.2020.8513 · Cited by 7
“…an individual is in a state of distress, then that individual would prefer to return to their closest people, relatives, or friends rather than consult with experts or professionals but do not have social closeness or emotional bonding with themselves (Fawzy & Hamed, 2017; Smolkowski et al., 2017).”
Background
Investigating Saudi university medical students’ English language difficulties: a needs analysis study
Alrashed, M., & Latif, M. M. M. A. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2024.1492031 · Cited by 6
Factors Associated With Sleeping Quality and Behaviors Among University Students in Malaysia
Ong, S. C., Azman, N., & Ho, H. T. (2023) · Sleep Medicine Research · doi:10.17241/smr.2022.01536 · Cited by 6
Basic Psychological Needs Predicting Physical Activity Participation among Young Adults
Adelusi, J. O., Oguntuase, S. B., & Jaiyeoba, O. M. (2023) · Athens Journal of Sports · doi:10.30958/ajspo.10-4-4 · Cited by 8
“…and difficulties, a lack of time due to cumbersome lesson schedules and assignments, financial burdens, change in residence, and other school environment-related factors (Glascoe 2023, Ting 2009, Hiester et al. 2009, Oluyinka and Endozo 2019, Jaiyeoba 2018, Fawzy and Hamed 2017, Arnett 2000).”
Correlates of perceived stress with anxiety symptoms sleep quality and academic performance among Moroccan students
Madani, H. E., Aarab, C., Tachfouti, N., Fakir, S. E., Aalouane, R., & Berraho, M. (2024) · Educación Médica · doi:10.1016/j.edumed.2024.100953 · Cited by 6
“3 The impacts of chronic stress on medical students are preponderant; the decrease of academic achievement, 4 and poor sleep quality.”
Background

Authors: Fawzy, M., & Hamed, S. A.
Affiliations: Assiut University Hospitals (EG)
Corresponding author: Hamed, Sherifa A.
ORCID: Hamed, Sherifa A.
Venue: Psychiatry Research
Publisher: Elsevier BV
Published: 2017-09
Volume: 255
Pages: 186-194
ISSN: 0165-1781 (ISSN-L)
DOI: 10.1016/j.psychres.2017.05.027
OpenAlex: W2615784653
Cited by: 455
References: 83
Citations by year: 2026: 30 · 2025: 52 · 2024: 60 · 2023: 74 · 2022: 68 · 2021: 81 · 2020: 46 · 2019: 28 · 2018: 13 · 2017: 2
FWCI: 39.29
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Psychiatry Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords: psychological stress, depression, anxiety, medical students, sleep quality, prevalence, sociodemographic factors, sex differences, academic performance, Assiut University
MeSH terms: Adolescent, Adult, Anxiety, Cross-Sectional Studies, Depression, Egypt, Female, Humans, Male, Mental Health, Surveys and Questionnaires, Stress, Psychological, Students, Medical, Prevalence, Young Adult

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Prevalence of psychological stress, depression and anxiety among medical students in Egypt

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