The Prevalence of Depression, Anxiety, and Stress Among Medical Residents: A Cross-Sectional Study in Iran

  • Pourya Farhangi Tehran University of Medical Sciences
  • Farahnaz Khajehnasiri Mail Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences
Anxiety, Depression, Hospitals, Education, Medical, Graduate, Stress, Psychological


Medicine is a stressful job. It is shown in several studies that decreased clinical function, disturbance in decision making, and the doctor-patient relationship, anxiety, depression, alcohol and substance abuse, and suicide are associated with stress. So, it is important to investigate the prevalence of depression, anxiety, and stress among medical staff. This is a cross-sectional study on the Tehran University of Medical Sciences residents, and 152 residents were surveyed by the DASS-21 questionnaire, which measures the depression, anxiety, and stress level. One hundred fifty-two residents (24.5% male, 75.5% female) with a mean age of 29.6 (SD=2.96) were surveyed. According to this study results, 23% of residents had severe to extremely severe depression, 24.9% had severe to extremely severe anxiety, and 33.8% had severe to extremely severe stress. Prevalence of depression, anxiety, and stress among Tehran University of Medical Sciences residents are higher than some other countries and universities, and it could be due to more working pressure in our educational hospitals. However, similar studies in different countries have not similar results, especially about the associated factors; so, more studies should be done, especially with the interventional and socioeconomic considerations, to address these issues.


1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.
2. Sen S, Kranzler HR, Krystal JH, Speller H, Chan G, Gelernter J, et al. A prospective cohort study investigating factors associated with depression during medical internship. Archives of general psychiatry. 2010;67(6):557-65.
3. Khajehnasiri F, Akhondzadeh S, Mortazavi SB, Allameh A, Khavanin A, Zamanian Z. Oxidative Stress and Depression among Male Shift Workers in Shahid Tondgouyan Refinery. Iran J Psychiatry. 2014;9(2):76-82.
4. Levey RE. Sources of stress for residents and recommendations for programs to assist them. Academic medicine : journal of the Association of American Medical Colleges. 2001;76(2):142-50.
5. Shapiro SL, Shapiro DE, Schwartz GE. Stress management in medical education: a review of the literature. Academic medicine : journal of the Association of American Medical Colleges. 2000;75(7):748-59.
6. Newbury-Birch D, White M, Kamali F. Factors influencing alcohol and illicit drug use amongst medical students. Drug and alcohol dependence. 2000;59(2):125-30.
7. Clark EJ, Rieker PP. Gender differences in relationships and stress of medical and law students. Journal of medical education. 1986;61(1):32-40.
8. Linn BS, Zeppa R. Stress in junior medical students: relationship to personality and performance. Journal of medical education. 1984;59(1):7-12.
9. Hays LR, Cheever T, Patel P. Medical student suicide, 1989-1994. The American journal of psychiatry. 1996;153(4):553-5.
10. Flaherty JA, Richman JA. Substance use and addiction among medical students, residents, and physicians. The Psychiatric clinics of North America. 1993;16(1):189-97.
11. Lue BH, Chen HJ, Wang CW, Cheng Y, Chen MC. Stress, personal characteristics and burnout among first postgraduate year residents: a nationwide study in Taiwan. Medical teacher. 2010;32(5):400-7.
12. 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 (Clinical research ed). 2008;336(7642):488-91.
13. Saini NK, Agrawal S, Bhasin SK, Bhatia MS, Sharma AK. Prevalence of stress among resident doctors working in Medical Colleges of Delhi. Indian journal of public health. 2010;54(4):219-23.
14. Sameer ur R, Kumar R, Siddiqui N, Shahid Z, Syed S, Kadir M. Stress, job satisfaction and work hours in medical and surgical residency programmes in private sector teaching hospitals of Karachi, Pakistan. JPMA The Journal of the Pakistan Medical Association. 2012;62(10):1109-12.
15. Yousuf A, Ishaque S, Qidwai W. Depression and its associated risk factors in medical and surgical post graduate trainees at a teaching hospital: a cross sectional survey from a developing country. JPMA The Journal of the Pakistan Medical Association. 2011;61(10):968-73.
16. Demir F, Ay P, Erbas M, Ozdil M, Yasar E. [The prevalence of depression and its associated factors among resident doctors working in a training hospital in Istanbul]. Turk psikiyatri dergisi = Turkish journal of psychiatry. 2007;18(1):31-7.
17. Sadiq MS, Morshed NM, Rahman W, Chowdhury NF, Arafat S, Mullick MSI. Depression, Anxiety, Stress among Postgraduate Medical Residents: A Cross Sectional Observation in Bangladesh. Iran J Psychiatry. 2019;14(3):192-7.
18. 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. Behaviour research and therapy. 1995;33(3):335-43.
19. Sahebi A, Asghari MJ, Salari R. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. 2005.
20. Al Atassi H, Shapiro MC, Rao SR, Dean J, Salama A. Oral and Maxillofacial Surgery Resident Perception of Personal Achievement and Anxiety: A Cross-Sectional Analysis. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 2018;76(12):2532-9.
How to Cite
Farhangi P, Khajehnasiri F. The Prevalence of Depression, Anxiety, and Stress Among Medical Residents: A Cross-Sectional Study in Iran. Acta Med Iran. 58(9):445-451.