Aim: prevalence of depression among Undergraduate female students
Basic Concept
Mood disorders involve much more severe alterations in mood for much longer
periods of time. In such cases, the disturbances of mood are intense and persistent enough to
lead to serious problems in relationships and work performance. Mood disorders are diverse.
Nevertheless, in all mood disorders (formerly called affective disorders), extremes of emotion
or affect—soaring elation or deep depression—dominate the clinical picture. Other symptoms
are also present, but abnormal mood is the defining feature.
Types of Mood Disorders:
Mood
Disorders
Unipolar Bipolar &
Depressive Related
Disorders Disorders
Major Persistant
Cyclothymic
Depressive Depressive Bipolar I & II
Disorder
Disorders Disorders
DSM-5 Criteria for…
Major Depressive Disorder
A. Five (or more) of the following symptoms have been B. The symptoms cause clinically significant distress or
present during the same 2-week period and represent a impairment in social, occupational, or other important
change from previous functioning; at least one of the areas of functioning.
symptoms is either (1) depressed mood or (2) loss of C. The episode is not attributable to the physiological
interest or pleasure. effects of a substance or another medical condition.
Note: Do not include symptoms that are clearly attributable Note: Criteria A–C constitutes a major depressive
to another medical condition. episode. Major depressive episodes are common in
1. Depressed mood most of the day, nearly every day, as bipolar I disorder but are not required for the diagnosis
indicated by either subjective report (e.g., feels sad, of bipolar I disorder.
empty, or hopeless) or observations made by others (e.g., Note: Responses to a significant loss (e.g.,
appears tearful). (Note: In children and adolescents, can bereavement, financial ruin, losses from a natural
be irritable mood.) disaster, a serious medical illness or disability) may
2. Markedly diminished interest or pleasure in all, or include feelings of intense sadness, rumination about
almost all, activities most of the day, nearly every day (as the loss, insomnia, poor appetite, and weight loss noted
indicated by either subjective account or observation). in Criterion A, which may resemble a depressive
3. Significant weight loss when not dieting or weight gain episode. Although such symptoms may be
(e.g., a change of more than 5% of body weight in a understandable or considered appropriate to the loss,
month) or decrease or increase in appetite nearly every day. the presence of a major depressive episode in addition
(Note: In children, consider failure to make expected to the normal response to a significant loss should also
weight gain.) be carefully considered. This decision inevitably
4. Insomnia or hypersomnia nearly every day. requires the exercise of clinical judgment based on the
5. Psychomotor agitation or retardation nearly every day individual’s history and the cultural norms for the
(Observable by others; not merely subjective feelings of expression of distress in the context of loss.
restlessness or being slowed down). D. The occurrence of a major depressive episode is not
6. Fatigue or loss of energy nearly every day. better explained by schizoaffective disorder,
7. Feelings of worthlessness or excessive or inappropriate schizophrenia, schizophreniform disorder, delusional
guilt (which may be delusional) nearly every day (not disorder, or other specified and unspecified
merely self-reproach or guilt about being sick). schizophrenia spectrum and other psychotic disorders.
8. Diminished ability to think or concentrate, or E. There has never been a manic episode or a
indecisiveness, nearly every day (either by subjective hypomanic episode
account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying),
recurrent suicidal ideation without a specific plan, or a
suicide attempt or a specific plan for committing suicide
Depression is a disorder of major public health importance, in terms of its prevalence
and the suffering, dysfunction, morbidity, and economic burden. Depression is more common
in women than men. The report on the Global Burden of Disease (2017) estimates the point
prevalence of unipolar depressive episodes to be 1.9% for men and 3.2% for women, and the
one-year prevalence has been estimated to be 5.8% for men and 9.5% for women. It is
estimated that by the year 2020 if current trends for demographic and epidemiological
transition continue, the burden of depression will increase to 5.7% of the total burden of
disease and it will be the second leading cause of disability-adjusted life years (DALYs),
second only to ischemic heart disease. In view of the morbidity, depression as a disorder has
always been a focus of attention of researchers in India. Various authors have tried to study
its prevalence, nosological issues, psychosocial risk factors including life events,
symptomatology in the cultural context, comorbidity, psychoneurobiology, treatment,
outcome, prevention, disability, and burden. Some of the studies have also tried to address
various issues in children and the elderly.
DSM-5 Criteria for…
Persistent Depressive Disorder
A. Depressed mood for most of the day, for more days F. The disturbance is not better explained by a persistent
than not, as indicated by either subjective account or schizoaffective disorder, schizophrenia, delusional
observation by others, for at least 2 years. disorder, or other specified or unspecified schizophrenia
Note: In children and adolescents, mood can be irritable, spectrum and other psychotic disorders.
and duration must be at least 1 year. G. The symptoms are not attributable to the
B. Presence, while depressed, of two (or more) of the physiological effects of a substance (e.g., a drug of
following: abuse, a medication) or another medical condition (e.g.,
1. Poor appetite or overeating. hypothyroidism).
2. Insomnia or hypersomnia. H. The symptoms cause clinically significant distress or
3. Low energy or fatigue. impairment in social, occupational, or other important
4. Low self-esteem. areas of functioning.
5. Poor concentration or difficulty making decisions. Note: Because the criteria for a major depressive
6. Feelings of hopelessness. episode include four symptoms that are absent from the
C. During the 2-year period (1 year for children or symptom list for persistent depressive disorder
adolescents) of the disturbance, the individual has never (dysthymia), a very limited number of individuals will
been without the symptoms in Criteria A and B for more have depressive symptoms that have persisted longer
than 2 months at a time. than 2 years but will not meet the criteria for persistent
D. Criteria for a major depressive disorder may be depressive disorder. If full criteria for a major depressive
continuously present for 2 years. episode have been met at some point during the current
E. There has never been a manic episode or a hypomanic episode of illness, they should be given a
episode, and criteria have never been met for diagnosis of major depressive disorder. Otherwise, a
cyclothymic disorder. diagnosis of other specified depressive disorder or
unspecified depressive disorder is warranted.
The National Mental Health Survey of India 2015-2016 highlighted the prevalence of
depression, including Major Depressive Disorder (MDD), at approximately 5.25%. This
variance in prevalence rates across the country is attributed to India's diverse population and
differences in research methodologies. The typical onset age for MDD in India is in the early
to mid-20s, although urban settings may see earlier onset and higher rates, likely due to urban
stressors. Comorbidity, particularly with anxiety, substance abuse, and chronic physical
illnesses, significantly complicates MDD management, necessitating integrated care
strategies. The challenges of limited resources, societal stigma, and low awareness further
contribute to the underdiagnosis and undertreatment of MDD. Addressing these issues
requires a comprehensive public health approach that includes enhancing mental health
services, raising awareness, and integrating mental health care with primary health systems,
focusing on both mental and physical well-being to improve outcomes for those with MDD.
Causal Factors of Unipolar Depressive Disorders
1. Biological Perspective:
• Genetic Influences
Studies have established that individuals with depression and bipolar disorder
often find a history of these disorders in immediate family members.6,13
Evidence suggests that many different genes may act together and with other
factors to cause a mood disorder. According to family research, blood relatives of
people with mood disorders have a two- to three-fold increased prevalence of
mood disorders. Compared to the general population, there is a higher prevalence
of clinically diagnosed unipolar depression (Levinson, 2006, 2009; Wallace et al.,
2002). Twin studies also point to a moderate genetic impact to MDD, and twin
studies can offer far more definitive evidence of genetic influences on an illness.
According to Sullivan, Neale, and Kendler (2000), monozygotic co-twins of an
MDD twin had a roughly twofold increased risk of developing the illness
compared to dizygotic co-twins, with genetic effects accounting for between 31
and 42 per cent of the variance in liability.
• Neurochemical Factors
The idea that disturbances in the delicate balance of neurotransmitter chemicals,
which regulate and control the activity of the brain's nerve cells, might be the
cause of sadness has drawn a lot of attention since the 1960s. Many biological
treatments, including electroconvulsive therapy and antidepressant drugs, which
are frequently used to treat severe mood disorders, have been linked to alterations
in the concentrations or activity of neurotransmitters at the synapse, according to a
substantial body of research. These first results fueled the growth of
neurochemical explanations for the cause of severe depression. According to
other, more recent studies, bipolar depression and depression with atypical
characteristics are among the kinds of depression that may be significantly
impacted by dopamine dysfunction, particularly diminished dopaminergic activity
(Krishnan & Nestler, 2010; Thase, 2009a). These findings are consistent with the
importance of anhedonia, the inability to experience pleasure, which is a key
symptom of depression, given the significant role dopamine plays in the sensation
of reward and pleasure.
• Abnormalities Of Hormonal Regulatory and Immune Systems
The focus of research has been on potential hormonal correlations or causation of
certain types of mood disorders (Southwick et al., 2005; Thase, 2009a). The
hypothalamic-pituitary-adrenal (HPA) axis has received the greatest attention,
with special emphasis paid to the hormone cortisol, which is secreted by the
outermost region of the adrenal glands and is controlled by an intricate feedback
loop. Elevated activity of the HPA axis, which is partially regulated by serotonin
and norepinephrine, is linked to the human stress response. When a person feels
stressed or threatened, their hypothalamus may become more active due to
norepinephrine release. This results in the production of corticotrophin-releasing
hormone (CRH), which in turn causes the pituitary to release adrenocorticotropic
hormone (ACTH). Additionally, studies have shown that individuals with
depression and increased cortisol also frequently exhibit memory deficits,
difficulties with abstract thought, and difficulties understanding complicated tasks
(Belanoff et al., 2001). Some of these cognitive issues could be connected to
recent research (e.g., Southwick et al., 2005; Thase, 2009a) that demonstrates that
extended cortisol spikes cause cell death in the hippocampus, a limbic system
region that is crucial to memory performance.
• Neurophysiological And Neuroanatomical Influences
Recent exciting neurophysiological research has confirmed earlier neurological
findings that depression is frequently caused by injury (e.g., from a stroke) to the
left anterior prefrontal cortex but not the right (Davidson et al., 2009; Robinson &
Downhill, 1995). This gave rise to the theory that reduced activity in the same
area of the brain may be associated with depression in individuals who do not
have brain injury. Numerous investigations have backed up this theory. Research
examining the electroencephalographic (EEG) activity of the two cerebral
hemispheres in individuals with depression reveals an imbalance or asymmetry in
the EEG activity of the two sides of the brain's prefrontal areas. In these areas, the
left hemisphere is less active in those with depression, whereas the right
hemisphere is more active (Davidson et al., 2009; Stewart et al., 2010, 2011).
Using positron emission tomography (PET) neuroimaging methods, similar results
have been reported (Davidson et al., 2009; Phillips et al., 2003).
• Sleep And Other Biological Rhythms
While there has long been evidence of sleep problems in depressed patients, it has
only been lately that some of these results have been connected to more
widespread disruptions in biological rhythms. People who are depressed often
show one or more of a variety of sleep problems, ranging from difficulty falling
asleep to periodic awakening during the night (poor sleep maintenance), to early
morning awakening. Such changes occur in about 80 per cent of hospitalized
patients with depression and about 50 per cent of outpatients with depression and
are particularly pronounced in patients with melancholic features.
2. Psychological Perspective:
• Stressful Life Events as Causal Factors
Stressors in the environment are known to have a part in the start of several
illnesses, from schizophrenia to various anxiety disorders, but no condition has
had their involvement in the development of more research than unipolar major
depression. Numerous studies have demonstrated that extremely stressful life
events frequently function as triggers for unipolar depression (e.g., Monroe et al.,
2009; Hammen, 2005). This is particularly true for young adult females, as they
are more likely than males to have a higher stress-depression association
following stressful life events (Harkness et al., 2010).
• Different Types of Vulnerabilities for Unipolar Depression
Numerous biological and psychological diatheses for unipolar depression have
been investigated; diathesis–stress hypotheses have been developed from some of
these diatheses. Remember that these theories of vulnerability do not have to
conflict with one another; in fact, some of them could be merely expressing the
same diathesis at various levels of analysis or using different terminology. These
suggested hypotheses are partially connected since, for instance, neuroticism has a
reasonably strong hereditary base and is substantially correlated with pessimism
(Clark, Watson, & Mineka, 1994). Furthermore, several additional cognitive
diatheses are highly associated with emotional abuse, dysfunctional early
parenting, and parental loss (Alloy et al., 2004; Bowlby, 1980; Goodman &
Brand, 2009). As a result, the only difference between these two hypothesized
theories might be how closely (bad early parenting) or distantly (negative thought
patterns) they function to increase an individual's vulnerability to depression.
• Behavioral Theories
Several theorists in the behavioral tradition developed behavioral theories of
depression in the 1970s and 1980s. These theories postulated that people
experience an increase in negative experiences or a decrease in positive
reinforcement when responding to stimuli (Ferster, 1974; Lewinsohn & Gotlib,
1995). These hypotheses align with empirical evidence demonstrating that those
diagnosed with depression do receive fewer affirmative verbal and social cues
from their loved ones and friends than those without the illness, and they also
encounter a greater number of adverse occurrences. In addition, they appear to be
less active, and their emotions appear to be influenced by the proportion of
pleasant and bad experiences they have (Lewinsohn & Gotlib, 1995; Martell,
2009).
• Beck’s Cognitive Theory
Since 1967, one of the most significant theories of depression has been that of
psychiatrist Aaron Beck (b. 1921), who created his own cognitive theory of
depression after growing disillusioned with psychodynamic views of the condition
early in his career (Beck, 1967, 2005). Although affective or mood symptoms are
typically thought to be the most noticeable signs of depression, Beck proposed
that the cognitive symptoms of sadness frequently come on before and cause the
affective or mood symptoms, rather than the other way around. It wouldn't be
shocking if, for instance, you believed that you were unattractive or a failure, as
those ideas may contribute to depression.
• The Helplessness and Hopelessness Theories of Depression
To explain these effects, Seligman, and colleagues (Maier et al., 1969; Overmeier
& Seligman, 1967) established the notion of learned helplessness. It says that
when people or animals discover they have little control over traumatic situations
(like shock), they may come to believe they are powerless and get discouraged
about trying to react in the future. Rather, they display apathy and even signs of
depression. They also take a while to realize that the responses they do make are
successful, which might be like the depressive cognitive state in humans.
Persistent Depressive Disorder, also known as dysthymia, is characterized by a
chronic, low-grade depressed mood that persists for at least two years in adults and one year
in children and adolescents. In India, like in many other countries, mental health data can be
challenging to obtain comprehensively. The prevalence of depressive disorders in India has
been reported to be around 4.5% of the population, according to a World Health Organization
(WHO) estimate. However, specific data on persistent depressive disorders may vary. The
onset age for PDD is typically in late adolescence or early adulthood, with symptoms lasting
for a considerable duration. Comorbidity with other mental health conditions, such as anxiety
disorders, substance use disorders, and physical health issues, is common in individuals with
persistent depressive disorders. The interplay of various factors, including socio-cultural
aspects and access to mental health services, influences the manifestation and management of
PDD in the Indian context.
Hammen, C. L. (1980) Examined the diagnostic and clinical features of depression in
34 students who scored as moderately depressed on the Beck Depression Inventory. Clinical
interviews based on the Hamilton Rating Scale for Depression and the Research Diagnostic
Criteria for Affective Disorders indicate that although depression was transitory for half of
the Ss over 2–3 weeks, many of the others had diagnosable major or minor depressive
disorders.
McConnell et al., (2001) focused on the rate of self-assessed depression and suicide
among college students and examined contributing factors and help-seeking behavior. Results
of the study indicated that 53% of the sample stated that they experienced depression since
beginning college, with 9% reporting that they had considered committing suicide since
beginning college. Suggestions for college mental health practitioners related to
programming, prevention, and psychoeducation are described.
Lindsey, Billie J. (2000) examined depression among a random sample of students
(N=618) enrolled in a medium-sized university in the Pacific Northwest who responded to
the American College Health Association's National College Health Assessment. The results
indicated that one in four students experienced depression in the past year and men were as
likely as women to report feeling depressed. Depressed students were more likely than non-
depressed students to report academic impairment due to various physical conditions
including chronic pain and sinus infections, as well as psycho-social conditions such as
learning disabilities, relationship difficulties and stress. Depressed students were more likely
to report their health as fair or poor, smoke cigarettes, and be gay/lesbian, bisexual, or
transgendered. There were notable findings: several correlates of depression identified in
previous studies, including alcohol use, did not prove to be significant. Students who worked,
and volunteered more hours, were more likely to be depressed. These results provide
important information for student affairs professionals and faculty as they respond to the
growing concern of depression and its effect on student learning and well-being.
Lee, Jong-Bum et al., (1985), studied depression in 5,869 college students (male:
3,893, female: 1,976) using Zung's Self-Rating Depression Scale (SDS). The results are as
follows: 1) Female college students showed significantly higher total depression scores than
male college students. 2) The items of confusion, indecisiveness, and psychomotor
retardation were scored higher in both groups and the Items of suicidal rumination,
psychomotor agitation, constipation, and tachycardia were scored lower in both groups. 3)
18.2% of male college students showed a rather serious depression level of score 50 or
higher, while 33.1 % of female college students showed the same scores. 4) The psychosocial
factors relating to pessimistic views of past, present & future self-images showed
significantly high depression scores. 5) The depression items of fatigue, irritability,
palpitation, hopelessness & dissatisfaction and the anxiety Items of fatigue, anxiousness,
tachycardia, apprehension, fear, and body aches & pain were correlated significantly over
0.40 of the correlation coefficients.
A study by Anjana A., Asha T Chacko (2024), aims to investigate the prevalence of
depressive symptoms and its association with demographic socioeconomic and health factors
of the elderly in Kerala using data from the Longitudinal Aging Study in India (LASI). The
LASI is a nationally representative survey of the elderly population in India. This study used
data from the LASI Wave 1 survey conducted in 2017-18. The sample consisted of 671
elderly women aged 60 years and above from Kerala. Depressive symptoms were measured
using the Center for Epidemiological Studies Depression Scale (CES-D). In the study sample,
it is observed that about 30 per cent of women have depression symptoms. This study
suggests the need for gender-sensitive interventions to address the high prevalence of
depressive symptoms among the elderly population in Kerala. These interventions should
focus on reducing gender disparities in education, income, and access to healthcare.
Moreover, it is essential to create awareness about mental health issues among the elderly and
their families and provide adequate support and care to those suffering from depressive
symptoms.
Being away from home has a negative physical and psychological impact on many
people, especially students. In this study by Pillai, A. A. (2023), Kristu Jayanti College
students who were not with them were evaluated for the presence of depression, anxiety, and
stress as well as its indicators. This descriptive study used a purposive sampling
method. Information was gathered from a random sample of 50 students. The DASS-21 was
utilised to gather information from the participants using a web-based survey. The results
were shown that at different levels, there were 78.7%, 67.9%, and 58.7% prevalence rates for
depression, anxiety, and stress. Depression, anxiety, and stress had somewhat high mean
scores. Depression, stress, and anxiety were shown to be strongly correlated with
demographic, health-related, and lifestyle factors. Moreover, several factors predicted stress,
anxiety, and depression.
Relevance of the Study
Conducting a study on depression in psychology is crucial for multifaceted reasons.
Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six
people (16.6%) will experience depression at some time in their life. Firstly, depression is a
pervasive mental health concern, impacting individuals globally and significantly affecting
their daily functioning and overall well-being. Understanding the psychological mechanisms
underlying depression is essential for accurate diagnosis, effective treatment, and prevention
strategies. Secondly, such research contributes to unravelling the complex interplay of
genetic, environmental, and cognitive factors that contribute to the onset and maintenance of
depression. This knowledge is fundamental for developing targeted therapeutic interventions,
including psychotherapies and medications, tailored to address specific aspects of the
condition. Moreover, studying depression in psychology aids in reducing the societal stigma
surrounding mental health issues. Increased awareness and understanding foster empathy,
support, and a more inclusive environment for individuals grappling with depression.
Additionally, psychological research on depression informs public health policies, resource
allocation, and community-based interventions. By exploring the psychological dimensions
of depression, psychologists can contribute to the development of evidence-based strategies
for prevention and early intervention, ultimately improving mental health outcomes on both
individual and societal levels. In essence, studying depression in psychology is indispensable
for advancing our comprehension of this complex disorder, enhancing treatment modalities,
and fostering a more empathetic and informed society.
Objective of the Study
• To estimate the prevalence of depression among Undergraduate students of 2nd Year
and 3rd Year.
• To find out the differences in the level of depression among Undergraduate students
of 2nd Year (NEP curriculum) and 3rd Year (LOCF curriculum).
Hypothesis
Method
Design:
A single cross-sectional research/survey method is used in the study which involves
collecting data from a single group of participants or subjects at a single point in time it
collects data from many subjects and compares differences between subjects.
Participants:
The sample for the study consisted of undergraduate college students the sample size
was ______ college students ____ 2nd Year students and _____ 3rd Year students aged
between 18 to 22 years. The sampling technique used is stratified random sampling.
Stratified random sampling is a method of sampling that involves the division of a population
into smaller subgroups known as strata. In stratified random sampling or stratification, the
strata are formed based on members’ shared attributes or characteristics, such as income or
educational attainment. Stratified random sampling has numerous applications and benefits,
such as studying population demographics and life expectancy.
In our study, we included the students from BA (program), and BA (Hons) of 2nd and
3rd Years. Also, only female students at the Delhi University colleges were taken into
consideration while taking the responses. While we excluded the students in 1st Year from BA
(Hons), no psychology student was involved while filling out the responses. We excluded all
the male students.
Tool Used:
The Tool used in the study is the Beck Depression Inventory (BDI) is a 21-item, self-
report rating inventory that measures characteristic attitudes and symptoms of depression
(Beck, et al., 1961). The BDI has been developed in different forms, including several
computerized forms, a card form (May, Urquhart, Tarran, 1969, cited in Groth-Marnat, 1990),
the 13-item short form and the more recent BDI-II by Beck, Steer & Brown, 1996. The BDI
takes approximately 10 minutes to complete, although clients require a fifth – sixth grade
reading level to adequately understand the questions (Groth-Marnat, 1990). It is a 4-point
scale from 0 (symptom absent) to 3 (severe symptoms). Scoring is achieved by adding the
highest ratings for all 21 items. The minimum score is 0 and the maximum score is 63.
Higher scores indicate greater symptom severity. In non-clinical populations, scores above 20
indicate depression. In those diagnosed with depression, scores of 0–13 indicate minimal
depression, 14–19 (mild depression), 20–28 (moderate depression) and 29–63 (severe
depression).
The BDI test has been tested for content, concurrent, and construct validity. High
concurrent validity ratings are given between the BDI and other depression instruments as the
Minnesota Multiphasic Personality Inventory and the Hamilton Depression Scale; 0.77
correlation rating was calculated when compared with inventory and psychiatric ratings. The
BDI has also shown high construct validity with the medical symptoms it measures. Beck’s
study reported a coefficient alpha rating of 0.92 for outpatients and 0.93 for college student
samples. The BDI-II positively correlated with the Hamilton Depression Rating Scale, r =
0.71, had a one-week test–retest reliability of r = 0.93 and internal consistency of α=0.91.
Procedure
The aim of the study was prevalence of depression among Undergraduate female
students. For the study participants from the age range 18-22 were taken. Each student
researcher took the data from 2nd and 3rd year students pursuing undergraduate from different
colleges of the University of Delhi. The rapport was formed with the participants, and they
were ensured full confidentiality and told that this research would be silently used for
educational purposes. After that, they were provided with clear instructions that the test
would cover a list of common symptoms of depression. The instructions were as follows: ----
Please carefully read each symptom i.e., now at all, mildly, moderately, severely. After each
researcher collected data from 4 participants, they sat down together and assembled the data
in an excel sheet. The total number of participants taken was _____. After the data was
obtained, it was calculated and analyzed on the individual and group level and was converted
into the form of graphs and tables.
Result
