Depression, Anxiety, Stress among Postgraduate Medical Residents: A Cross sectional Observation in Bangladesh

A Cross-sectional Observation in Bangladesh

  • Mohammad Shibli Sadiq National Institute of Mental Health, Dhaka, Bangladesh.
  • Nahid Mahjabin Morshed Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
  • Wasima Rahman Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Nafia Farzana Chowdhury Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • S M Yasir Arafat Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Mohammad S.I. Mullick Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Anxiety, Bangladesh, Depression, Residents, Stress


Objective: Medical training has been reported as being stressful, and postgraduate medical training environment has always been regarded as highly stressful, which may lead to different psychiatric disorders. In this study, it was aimed to determine the extent of depression, anxiety, and stress among the postgraduate medical residents of Bangladesh.

Method: This cross sectional study was conducted at the Department of Psychiatry of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were collected from 200 residents through face to face interview which was conducted by a psychiatrist using research instruments. Initially, respondents were approached by cluster sampling. Then, they were selected from each cluster using simple random sampling method (lottery method). Sample size was calculated by considering the prevalence of 50%; however, 200 residents were interviewed due to time constraints. The questionnaire consisted of 3 parts: (1) demographic variable, (2) the structured clinical interview for DSM-IV Axis-I disorders, and (3) Bangla Depression Anxiety Stress Scale (DASS-21). Data were analyzed using software Statistical Package for Social Sciences version 16.0.

Results: Distribution of depression, anxiety, and stress revealed that 11.5% of the residents had depressive disorders, 11% anxiety disorders, and 10.5% stress disorders. Also, it was found that 14.5% of the respondents were found to have at least one of three disorders. The DASS-21 score revealed that 6% of the residents had severe to extremely severe depression, 3.5% severe to extremely severe anxiety, and 6.5% severe to extremely severe stress disorder.

Conclusion: The study revealed that one in every seven residents has been suffering from at least one disorder from depression, anxiety, and stress related disorders. A large-scale multicenter study is recommended to validate the findings of the present study.


1. Firoz AHM, Karim ME, Alam MF. Community based multi-centric service oriented research on mental illness with focus on awareness, prevalence, care, acceptance and follow up in Bangladesh. Manual on Mental Health for primary health care physicians 2nd edn. NIMH & WHO 2007.
2. Woloschuk W, Harasym P, Mandin H. Implementing a clinical presentation curriculum: impact on student stress and workload. Teach Learn Med 1998; 10(1): 44-50.
3. Levey RE. Sources of stress for residents and recommendations for programs to assist them. Acad Med 2001; 76(2): 142–50.
4. Arafat SMY, Kabir R. Burnout in Physicians: Global and Bangladesh Perspective. EC Psychol Psychiatry 2017; 2: 112–6.
5. Baldwin DC, Daugherty SR. Sleep deprivation and fatigue in residency training: results of a national survey of first- and second-year residents. Sleep. 2004;27(2):217-23.
6. Chung RS, Ahmed N. How surgical residents spend their training time: the effect of a goal-oriented work style on efficiency and work satisfaction. Arch Surg. 2007;142(3):249-52.
7. Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008; 336(7642): 488–91.
8. Sadeghi M, Navidi M, Sadeghi AE. Depression among Resident Doctors in Tehran, Iran. Iran J Psychiatry 2007; 2(2):50-52.
9. Moffat KJ, McConnachie A, Ross S, Morrison JM. First year medical student stress and coping in a problem-based learning medical curriculum. Med Educ 2004; 38: 482-491.
10. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
11. Alim SMAHM, Mahbub-E-Kibria S, Islam MJ, Uddin MZ, Nessa M, Wahab MA, et al. Translation of DASS 21 into Bangla and validation among medical students. Bang J Psychiatry 2014;28(2):67-70.
12. Yousuf A, Ishaque S, Qudwai W. Depression and Its Associated Risk Factors in Medical and Surgical Postgraduate Trainees at A Teaching Hospital: A Cross-sectional Survey From A Developing Country. J Pak Med Assoc. 2011;61(10):968-73.
13. Saini NK, Agrawal S, Bhasin SK, Bhatia MS, Sharma AK. Prevalence of Stress Among Resident Doctors Working in Medical Colleges of Delhi. Indian J Public Health. 2010;54(4):219-23.
14. Zaman S, Rahim M, Khan AH, Habib SH, Rahman MM, Ahsan MS, et al. Prevalence of Depression Among Post-Graduate Medical Trainees: A Multi-Centre Survey. Birdem Medical Journal 2014; 4(1): 18-21.
15. Figen DEMIR, Pınar AY, Melek ERBAŞ, Mine ÖZDİL, Esra YAŞAR. The Prevalence of Depression and its Associated Factors among Resident Doctors Working in a Training Hospital in Istanbul. Turkish J Psych 2007; 18(1): 31-37.
16. Yusoff MSB, Rahim AFA. Prevalence & sources of stress among postgraduate medical trainees: Initial findings. ASEAN J Psychiatry 2010; 11(2): 1-10.
17. Firth-Cozens J. Interventions to improve physicians’ well-being and patient care. Soc Sci Med. 2001;52(2):215-22.
18. Thommasen HV. Mental health, job satisfaction and intention to relocate, Opinions of physicians in rural British Columbia. Can Fam Physician 2001; 47: 737-44.
19. Khuwaja AK, Qureshi R, Azam SI. Prevalence and factors associated with anxiety and depression among family practitioners in Karachi, Pakistan. J Pak Med Assoc. 2004;54(2):45-9
20. Akvardar Y, Demiral Y, Ergör G. Substance use among medical students and physicians in a medical school in Turkey. Soc Psychiatry Psychiatr Epidemiol 2004;39(6): 502-6.
21. Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med 2002; 77(9): 918-21.
22. Graske J. Improving the mental health of doctors. BMJ. 2003;327(7428):s188.
23. Newbury-Birch D, White M, Kamali F. Factors influencing alcohol and illicit drug use amongst medical students. Drug Alcohol Depend. 2000 ;59(2):125-30.
24. Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, et al. Confronting depression and suicide in physicians, A consensus statement. JAMA. 2003;289(23):3161-6.
25. Tyssan R, Valgum P. Mental health problems among young doctors, An updated review of prospective study. Harv Rev Psychiatry. 2002;10(3):154-65.
How to Cite
Shibli Sadiq M, Mahjabin Morshed N, Rahman W, Farzana Chowdhury N, Arafat SM, Mullick MS. Depression, Anxiety, Stress among Postgraduate Medical Residents: A Cross sectional Observation in Bangladesh. Iran J Psychiatry. 14(3):192-197.
Original Article(s)