Academic Psychiatry

, Volume 40, Issue 1, pp 92–96 | Cite as

Medical Students’ Stress, Psychological Morbidity, and Coping Strategies: a Cross-Sectional Study from Pakistan

  • Nazish ImranEmail author
  • Khaula Fatima Tariq
  • Muhammad Ijaz Pervez
  • Masood Jawaid
  • Imran Ijaz Haider
In Brief Report



The authors studied the prevalence of psychological morbidity, sources and severity of stresses, as well as coping strategies in Pakistani medical students.


Medical students in Lahore, Pakistan, completed a cross-sectional, self-administered questionnaire in 2013 on the sources and severity of various stressors. The General Health Questionnaire-12 (GHQ-12) and Brief COPE assessed the psychological morbidity and coping strategies.


Out of 1500 students, 527 responded to the survey. The prevalence of psychological morbidity was 23.3 %; 52.3 % respondents showed evidence of distress. By logistic regression analysis, GHQ-12 caseness was associated with being male and occurrence of health-related stressors. The most common stressors were related to academic concerns. Coping strategies showed variation by GHQ-caseness.


The significant psychological morbidity and distress warrants establishing support systems to support students and bringing about evidence-based changes to teaching and evaluation systems. Adequate counseling facilities should be made available and students encouraged to seek help.


Medical students Depression Coping Psychological morbidity 


  1. 1.
    Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354–73.CrossRefPubMedGoogle Scholar
  2. 2.
    Supe AN. A study of stress in medical students at Seth G.S. Medical College. J Postgrad Med. 1998;44:1–6.PubMedGoogle Scholar
  3. 3.
    Saipanish R. Stress among medical students in a Thai medical school. Med Teach. 2003;25:502–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Sherina MS, Rampal L, Kaneson N. Psychological stress among undergraduate medical students. Med J Malays. 2004;59:207–11.Google Scholar
  5. 5.
    Stewart SM, Lam TH, Betson CL, Wong CM, Wong AM. A prospective analysis of stress and academic performance in the first two years of medical school. Med Educ. 1999;33:243–50.CrossRefPubMedGoogle Scholar
  6. 6.
    Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: from medical students to doctors. Drug Alcohol Depend. 2001;64:265–70.CrossRefPubMedGoogle Scholar
  7. 7.
    Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334–41.CrossRefPubMedGoogle Scholar
  8. 8.
    Rennie S, Rudland J. Differences in medical students’ attitudes to academic misconduct and reported behavior across the years—a questionnaire study. J Med Ethics. 2003;29:97–102.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ. 2004;38:522–34.CrossRefPubMedGoogle Scholar
  10. 10.
    Ashton CH, Kamali F. Personality, lifestyles, alcohol and drug consumption in a sample of British medical students. Med Educ. 1995;29:187–92.CrossRefPubMedGoogle Scholar
  11. 11.
    Shaikh BT, Kahloon A, Kazmi M, Khalid H, Nawaz K, Khan N, et al. Students, stress and coping strategies: a case of Pakistani medical school. Educ Health (Abingdon). 2004;17:346–53.CrossRefGoogle Scholar
  12. 12.
    Shah M, Hasan S, Malik S, Sreeramareddy CT. Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school. BMC Med Educ. 2010;10:2. doi: 10.1186/1472-6920-10-2.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Jadoon NA, Yaqoob R, Raza A, Shehzad MA, Zeshan SC. Anxiety and depression among medical students: a cross-sectional study. J Pak Med Assoc. 2010;60(8):699–702.PubMedGoogle Scholar
  14. 14.
    Hashmi AM, Aftab MA, Naqvi SH, Sajjad W, Mohsin M, Khawaja IS. Anxiety and depression in Pakistani medical students: a multicenter study. Health Med. 2014;8(7):813–20.Google Scholar
  15. 15.
    Goldberg D, Williams P. A users guide to the General Health Questionnaire. Slough: NFER-Nelson; 1988.Google Scholar
  16. 16.
    Carver CS. You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med. 1997;4(1):92–100.CrossRefPubMedGoogle Scholar
  17. 17.
    Minhas FA, Mubbashar MH. Validation of General Health Questionnaire in a primary care setting of Pakistan. J Coll Phys Surg Pak. 1996;6:133–6.Google Scholar
  18. 18.
    Sreeramareddy CT, Shankar PR, Binu VS, Chiranjoy M, Biswabina R, Ritesh G. Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Med Educ. 2007;7:26.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Grant BF, Stinson FS, Dawson DA, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61:807–16.CrossRefPubMedGoogle Scholar
  20. 20.
    Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a 5-year prospective longitudinal study. J R Soc Med. 1998;91(5):237–43.PubMedCentralPubMedGoogle Scholar
  21. 21.
    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;38:482–91.CrossRefPubMedGoogle Scholar
  22. 22.
    Redwood SK, Pollak MH. Student-led stress management program for first-year medical students. Teach Learn Med. 2007;19:42–6.PubMedGoogle Scholar
  23. 23.
    Finkelstein C, Brownstein A, Scott C, Lan YL. Anxiety and stress reduction in medical education: an intervention. Med Educ. 2007;41:258–64.CrossRefPubMedGoogle Scholar

Copyright information

© Academic Psychiatry 2015

Authors and Affiliations

  • Nazish Imran
    • 1
    Email author
  • Khaula Fatima Tariq
    • 1
  • Muhammad Ijaz Pervez
    • 1
  • Masood Jawaid
    • 2
  • Imran Ijaz Haider
    • 3
  1. 1.King Edward Medical University/Mayo HospitalLahorePakistan
  2. 2.Dow University of Health SciencesKarachiPakistan
  3. 3.Fatima Memorial College of Medicine and DentistryLahorePakistan

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