Depressive symptoms in Italian medical students: a repeated cross-sectional study

Background

Medical students are a high-risk population for developing depressive symptoms. However, existing data are mostly derived from single-cohort studies, limiting the ability to identify consistent determinants across timepoints. This study aimed to assess the prevalence of depressive symptoms and to identify associated factors across three waves of Italian medical students.

Methods

We conducted a repeated cross-sectional survey combining data collected at three different timepoints within an Italian medical student sample (2018, 2021, 2024). The primary outcome was the presence of depressive symptoms, assessed through the Beck Depression Inventory-II (BDI-II) (cut-off score ≥14). Main analyses included multivariable logistic regressions to identify factors associated with depressive symptoms.

Results

The study included 1,038 students (68.21% females; median age 23 years, IQR=22-24). Overall, 40.88% reported depressive symptoms, with a peak in 2021 (46.56%, p = 0.008). Also in multivariable analysis, depressive symptoms were higher in 2021 (p < 0.001). Depressive symptoms were positively associated with sexual minority status (adjOR 1.50, p = 0.024), family history of psychiatric disorders (adjOR 1.44, p = 0.025), poor economic status (adjOR 1.98, p = 0.021), negative or uncertain judgment about medical school choice (adjOR 4.12, p < 0.001), and unsatisfying friendships with classmates (adjOR 2.47, p < 0.001).

Conclusions

A substantial proportion of medical students experience depression across different timepoints, highlighting a persistent and significant public health burden exacerbated during the pandemic. Consistent associations across timepoints underlined the relevance of modifiable academic and social determinants. Public health actions should prioritize improving peer support, reducing stigma, and strengthening accessible psychological support services within medical schools to mitigate long-term impacts on both student wellbeing and the healthcare system.

Key messages

• Italian medical students showed a high burden of depressive symptoms, exacerbated during the pandemic.

• Addressing modifiable academic and social factors is key to improve wellbeing and foster a healthier learning environment.