The prevalence of depression, anxiety, and sleep disturbances among medical students and resident physicians in Iran: A systematic review and meta-analysis

by Arman Shafiee, Mohammad Mobin Teymouri Athar, Niloofar Seighali, Mohammad Javad Amini, Hamed Hajishah, Razman Arabazadeh Bahri, Amirhossein Akhoundi, Maryam Beiky, Nastaran Sarvipour, Saba Maleki, Atefeh Zandifar, Mahmood Bakhtiyari

Background

We sought to conduct this comprehensive systematic review and meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbance in Iranian medical students and resident physicians.

Methods

A systematic search was conducted on 23 December 2023 in PubMed/MEDLINE, Web of Science, Scopus, and Iranian national databases. We pooled the prevalence of individual studies using the random effect model.

Results

Our systematic search showed 36 articles that meet the eligibility criteria. Most included studies were cross-sectional. The most used questionnaire to assess depression, anxiety, and sleep disturbance were Beck Depression Inventory (BDI), The Depression, Anxiety and Stress Scale—21 Items (DASS-21), and The Pittsburgh Sleep Quality Index (PSQI), respectively. The overall prevalence of depression, anxiety, and sleep disturbance among Iranian medical students were 43% (95%CI: 33%–53%%, I2 = 98%), 44% (95%CI: 31%–58%%, I2 = 99%), 48% (95%CI: 39%–56%%, I2 = 97%), respectively. The results of subgroup and meta-regression analyses showed questionnaires used and the place of the medical school were significantly associated with the prevalence of aforementioned outcomes. Funnel plot and Begg’s regression test did not show a significant source of funnel plot asymmetry for depression, anxiety, and sleep disturbance.

Conclusion

In conclusion, our study showed that nearly half of the medical students had some type of depression, anxiety, and sleep disturbance problems. To address this serious national public health issue, efficient preventive measures, routine screenings, and prompt interventions are required.