الفهرس 
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Abstract
University students are a special group of people enduring a critical transitory period in which they are going from adolescence to adulthood and can be one of the most stressful times in a person’s life. Trying to fit in, maintain good grades, plan for the future careers, and be away from home often causes stress for a lot of students and predispose to depression. Medical students are at high risk of developing depressive symptoms rather than their age- matched group as medical education is stressful and medical students have psychological and academic stressors during their revolution from insecure students to young knowledgeable physicians Medical education characterized by being stressful, long study and working hours, extensive course content, examinations, peer competition, sleep deprivation and loneliness including other factors interfering in everyday personal, social and family. Aims of the study: To estimate prevalence of depressive symptoms among medical students, to investigate factors associated with depressive symptoms and to study association between sense of control and depressive symptoms among medical students. Methodology: The present study was a cross-sectional study conducted among Assiut University medical students at the academic year 2019-2020 with total calculated sample size of 809 students from which 766 students responded and completed the questionnaire. Data were collected by: Structured self-administered questionnaire that included socio-demographic characteristics, family affluence scale (III), patient health questionnaire-9, sense of control scale, medical student stressor questionnaire and satisfaction with life scale. Weight and height of students were measured. Results: characteristics of the sample and socio-demographics: The mean age of sampled students was 21.27 years old. About 56 % were female and almost all students (99.6%) were single. Regarding distribution of students according to their academic year, 18.9%, 14.8%, 16.7%, 16.2%, 17.6% and 15.8% were in the first, second, third, fourth, fifth and 6th year respectively. About two-third (29.4% and 28.7%) had excellent/ very good grade in the last year. Nearly 44% of students live with their families during their university study while 31.6% in University dormitory. Students who residing in apartment inside Assiut city either alone or with their colleagues or in students’ hostel were 24.5%.The study also investigated the socio-demographics of students’ families. As regards parents’ education and work, about 69% of students’ fathers were university graduates compared to nearly 57 % among the mothers while fathers who completed secondary or technical education were about 24% compared to about nearly 30% of mothers. As regards parents’ work, 49% of the fathers’ jobs of students were professional and about 24% were employee. About mothers who work in professional work and as employee represent nearly 43% and 14% respectively and about 43% 0f them were housewife. 56.4% of sampled students live in urban areas compared to 43.6% live rural areas. Mean socio-economic status of the family was 5.96. About 3% of the studied students were smokers and about 1% were drug addict. About family history of mental illness and depression 12.7% and nearly 10% of students have family history of mental illness and depression respectively. Mean life satisfaction of students was 20.57 and nearly 54% of students were satisfied with life. About 55% of students were in normal weight, 33% were overweight and about 9.5% were obese. Prevalence of depressive symptoms and distribution of severity of depressive symptoms and suicidal thoughts: The study revealed that 55.5% of students have depressive symptoms. About 34% of students had mild depressive symptoms and nearly 27% had moderate depressive symptoms while moderate to severe and severe depressive symptoms represent about 17% and 12% respectively. Mean severity of depressive symptoms total score was 11.58. Regarding suicidal thoughts among medical students, 59% of students had ever any suicidal thoughts; nearly 10% reported suicidal thoughts nearly every day, about 7% more than half the days and 24% had suicidal thoughts several days. Stress among medical students About stress caused by ARS: 54.6%, 25% and 3% of students had moderate, high and severe stress respectively. As regard IRS about 40% of students had moderate stress and nearly 31% and 10% had high and severe stress. As regard TLRS, nearly 32%, 26% and 18% of students had moderate, high and severe stress respectively. While SRS about 40% of students had moderate stress, nearly 30 % had high stress and 14.4% had severe stress. Regarding DRS, nearly 26% of students had moderate stress and 31.6% and 23.5% of students had high and severe stress respectively. Moreover, degree of stress by GARS represented as about 37%, 25.5% and 12% for moderate, high and severe stress respectively. Regarding total score of stress, nearly 44%, 41% and 6% of students had moderate, high and severe stress respectively. Sense of control Mean score of sense of control was 2.61. Correlates of depressive symptoms: Female students had significantly higher rates of depressive symptoms compared to males 58.9% compared to 51.2%, p = 0.033). There was statistically significant lower socio-economic score among students having depressive symptoms compared to students with no depressive symptoms and mean was (5.73±2.46 and 6.22±2.5, p=0.002). There was a statistically significant difference between students having depressive symptoms compared to others regarding: chronic illness, family history of depression and mental illness, life satisfaction, medical student stressors and sense of control. Therefore, the current study concluded that: The prevalence of depressive symptoms among medical students is 55.5% and the prevalence of suicidal thoughts is 41%. About stress among medical students, 40.6% have high stress and 6.3% have severe stress. Regarding correlates of depressive symptoms among Assiut University Medical Students are being a female, low socio-economic status, having chronic disease, presence of family history of either mental or depressive illness, low satisfaction with life, higher total medical stressors and low sense of control. In highlight of these results, the study recommends: For Policy makersThere is a need for health promotion programs at medical schools that prevent and control modifiable stressors and identify students with moderate to severe stress, and hence enable them to cope better with stress. Appropriate mental health services including early detection and management of the risk factors associated with depressive symptoms using clinical interviews may limit the possible negative consequences. A pre-admission and periodic screening program for psychiatric disorders especially depressive symptoms for medical students should be launched and maintained. For researchers: A large scale, well-designed study aimed to develop effective preventive and counseling services for the students should be implemented. Future research will need to include students from other health related faculties such as faculty of pharmacy; dentistry and nursing to assess the extent of the problem in students affiliated to different health related faculties.