Burnout as a correlate of depression among medical students in Cameroon: a cross-sectional study

Tsi Njim; Clarence Mvalo Mbanga; Maxime Tindong; Steve Fonkou; Haman Makebe; Louise Toukam; Johnson Fondungallah; Azingala Fondong; Isabelle Mulango; Belmond Kika

doi:10.1136/bmjopen-2018-027709

Burnout as a correlate of depression among medical students in Cameroon: a cross-sectional study

BMJ Open. 2019 May 5;9(5):e027709. doi: 10.1136/bmjopen-2018-027709.

Authors

Tsi Njim^{1

2}, Clarence Mvalo Mbanga³, Maxime Tindong⁴, Steve Fonkou⁵, Haman Makebe⁵, Louise Toukam⁶, Johnson Fondungallah⁷, Azingala Fondong⁵, Isabelle Mulango⁸, Belmond Kika⁹

Affiliations

¹ Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
² Research Group, Health and Human Development (2HD), Douala, Cameroon.
³ Surgical Unit, Mankon Sub-divisional Hospital, Bamenda, Cameroon.
⁴ Research Group, Clinical Research Education Networking and Consultancy, Douala, Cameroon.
⁵ Faculty of Health Sciences, University of Buea, Buea, Cameroon.
⁶ Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon.
⁷ Surgical Unit, Buea Town Medical Centre, Buea, Cameroon.
⁸ Internal Medicine Department, District Hospital Kumba, Kumba, Cameroon.
⁹ Internal Medicine Department, District Hospital Ekondo-Titi, Ekondo-Titi, Cameroon.

Abstract

Objective: Burnout syndrome has been shown to mediate the pathway between job stress and depression. This study aims to assess the relationship between the various components of burnout syndrome and depression; and to determine the contribution of other sociodemographic variables to depression among medical students in Cameroon.

Design: A cross-sectional study.

Setting: Three of the five medical schools in Cameroon with students in both preclinical and clinical levels of studies.

Participants: The study included 413 consenting medical students.

Primary outcome measure: Data were collected via a printed self-administered questionnaire. The primary outcome-depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Burnout was assessed using the Oldenburg Burnout Inventory. Multivariable linear regression was used to identify independent correlates of depression.

Results: The overall prevalence of depression (PHQ-9 >4) and major depressive disorder (PHQ-9 >9) in these students was 66.34% and 23.00%, respectively. After multivariable linear regression analysis, four variables-total OLBI (beta=0.32; 95% CI 0.22 to 0.42; p<0.001); number of children (beta=-2.26; 95% CI -3.70 to -0.81; p=0.002); occurrence of a life-changing crises (beta=1.29; 95% CI 0.13 to 2.45; p=0.029) and presence of a chronic illness (beta=3.19; 95% CI 0.96 to 5.42; p=0.005) significantly predicted depression in these students and explained 32.4% of the variance (R²=32.4, F[14, 204]=6.98, p<0.001). The emotional exhaustion component (R²=17.4, F[1, 411]=86.39, p<0.001) explained more of the variance in depression than the disengagement component (R²=6.1, F[1, 411]=26.76, p<0.001) of burnout syndrome.

Conclusion: The prevalence of depression among medical students in Cameroon is high. It is important that correlates of depression are identified early in medical students to limit progress to depression.

Keywords: burnout syndrome; cameroon; medical students; oldenburg burnout inventory; patient health questionnaire - 9.

MeSH terms

Burnout, Professional / complications*
Cameroon
Correlation of Data
Cross-Sectional Studies
Depression / epidemiology
Depression / etiology*
Depressive Disorder, Major / epidemiology
Depressive Disorder, Major / etiology
Female
Humans
Male
Prevalence
Students, Medical / psychology*
Young Adult