Psychiatric Morbidity among Final-year Medical Students in A Public University in Nigeria: A Mixed-methods Study

Abstract

Background: Medical education is associated with substantial academic, psychological and social demands. Medical                students may experience depression, anxiety, psychological distress, sleep disturbances and burnout at rates that are concerning for both student welfare and the future quality of healthcare delivery. Although studies have documented mental-health problems among Nigerian medical students, relatively limited evidence has combined quantitative estimates with students’ lived experiences. Objective: To determine the prevalence of psychiatric morbidity among final-year medical students in a public university in Nigeria and to explore the stressors, coping strategies and barriers to mental-health help-seeking associated with their experiences. Methods: A convergent mixed-methods design was used. The quantitative component consisted of a cross-sectional survey of final-year medical students using a sociodemographic questionnaire and the 12-item General Health Questionnaire (GHQ-12). Qualitative data were obtained through focus group discussions and individual interviews. Quantitative data were analysed using descriptive statistics, chi-square tests and multivariable logistic regression. Qualitative data were analysed thematically. Results: Probable psychiatric morbidity on the GHQ-12 was identified in 14 participants, corresponding to 29.2%. None of the sociodemographic factors was independently associated with psychiatric morbidity. Qualitative analysis generated five themes, including relentless academic pressure, the culture of expected resilience, informal rather than professional help-seeking and the need for confidential institutional support. Conclusion: The findings suggest that probable psychiatric morbidity was present among the final-year medical students studied. Medical schools should integrate confidential mental-health screening, counselling, mentorship, peer support and curriculum-level interventions into student welfare programmes.