EDITORIAL

REVISTA DE LA FACULTAD DE MEDICINA HUMANA 2019 - Universidad Ricardo Palma DOI 10.25176/RFMH.v19.n1.1801

ALCOHOL CONSUMPTION AS A FACTOR ASSOCIATED WITH DEPRESSION IN MALE STUDENTS OF HUMAN MEDICINE AT RICARDO PALMA UNIVERSITY IN 2018

CONSUMO DE ALCOHOL COMO FACTOR ASOCIADO A LA DEPRESIÓN EN ESTUDIANTES VARONES DE MEDICINA HUMANA DE LA UNIVERSIDAD RICARDO PALMA DEL AÑO 2018

Pedro Estrada-Durand^1,a, Cecilia Salinas-Salas²

¹ Ricardo Palma University, Lima - Peru.
² Human Medicine Student, Ricardo Palma University, Lima - Peru.
^a Institute of Research in Biomedical Sciences, Faculty of Human Medicine, Ricardo Palma University, Lima, Peru.

ABSTRACT:
Objective: To determine whether alcohol consumption is a factor associated with depression in male medicine students at the Ricardo Palma del Ciclo II Private University (August-December) in 2018. Methods: Non-experimental, analytical, transversal, descriptive, correlational in the Faculty of Human Medicine of the Ricardo Palma University, during the academic year 2018. A survey and a validated test carried out 200 male students after their informed consent: The validated test of self-evaluation of depressive features of Zung. which consists of 20 questions that help us determine the depressive state according to the diagnostic criteria ICD-10 and DSM IV. Results: 200 male students were surveyed. 67.5% of students are between 18 and 22 years old. 70% of students rarely consume alcohol, and 9% of students consume alcohol 2 to 6 times a week, 48.5% of students have mild depression and 3% of students have severe depression, in the group of students who have severe depression, 50% consume alcohol twice a week, in the Chi-square test the p-value (p = 0.000), which allows establishing that there is a significant relationship between alcohol consumption and depression in students Finally, it was found that the Odd Ratio (OR = 9.4) for Alcohol Consumption establishes that male students who consume alcohol more than once a week have 9,444 higher risk of developing depression than male students who consume alcohol 1 time a the week or less. Conclusion: Alcohol consumption is a risk factor associated with depression in male students of the Faculty of Medicine of the Ricardo Palma University.

Key words: Alcohol Consumption; Depression; Students; University; Lifestyle Medicine. (source: MeSH NLM)

RESUMEN:
Objetivo: Determinar si el consumo de alcohol es un factor asociado a la depresión en estudiantes de medicina varones de la Universidad Privada Ricardo Palma del Ciclo II (agosto-diciembre) del año 2018.Métodos: Estudio de tipo no experimental, analítico, transversal, descriptivo, correlacional en la Facultad de Medicina Humana de la Universidad Ricardo Palma, durante el año académico 2018. Una encuesta y un Test validado realizaron a 200 estudiantes varones luego de su consentimiento informado: El Test validado de auto-evaluación de rasgos depresivos de Zung. que consta de 20 preguntas que nos ayudan a determinar el estado depresivo según los criterios diagnósticos CIE-10 y DSM IV. Resultados: Se encuestaron a 200 estudiantes varones. El 67.5% de los estudiantes tienen entre 18 a 22 años. El 70% de los estudiantes rara vez consume alcohol, y el 9% de los estudiantes consume alcohol 2 a 6 veces por semana, el 48.5% de los estudiantes presenta depresión leve y el 3% de los estudiantes presenta depresión grave , en el grupo de estudiantes que tienen depresión grave el 50% consume alcohol 2 veces a la semana, en la prueba de Chi Cuadrado el valor p (p= 0.000), que permiten establecer que existe relación significativa entre el consumo de alcohol y la depresión en los estudiantes varones, Finalmente se encontró que el Odd Ratio (OR=9.4) para el Consumo de Alcohol establece que los estudiantes varones que consumen más de 1 vez por semana alcohol tienen 9.444 mayor riesgo de presentar Depresión que los estudiantes varones que consumen alcohol 1 vez a la semana o menos. Conclusión: El consumo de alcohol es un factor de riesgo asociado a la depresión en los estudiantes varones de la Facultad de Medicina de la Universidad Ricardo Palma.

Palabras clave: Consumo de Alcohol; Depresión; Estudiantes; Universitario; Medicina de Estilo de Vida. (fuente: DeCS BIREME)

INTRODUCTION
Psychiatric diseases are considered the cause of losing years of healthy life, due to disability or premature death in the world, which makes this group of diseases a new public health problem. According to 2014 World Health Organization (WHO, for its initials) report, it is estimated that every 40 seconds¹, a person commits suicide in the world, and depression is one of the main causes of this statistic. WHO estimated that this disease affects 350 million people around the world². In Peru, care for depression problems in the specialty of mental health has doubled in number between 1997 and 2000³ The prevalence of depression has varied over time. In Lima and Callao⁴, a quarter of the adult population has had a mental disorder at some time, the most frequent being depressive disorder. A depressive disorder is not the same as a passing state of sadness, it does not indicate personal weakness, nor is it a condition from which everyone can free oneself at will. On the contrary, depression is a disease, a pathological alteration of the mood, which becomes a serious health problem. It has the characteristic of being mild, moderate to severe intensity, producing great suffering, altering activities of daily life. It even leads those who suffer it to suicide. Therefore, early detection and management by psychiatrists constitutes a step for the timely control and management of this disease.

Depressive symptomatology is one the five main factors which limit academic development among the students, with rates that can be above 50%^8–10. Likewise, it has been associated with risky behaviors which contribute to the presence of unintentional injuries, violence, use of tobacco, alcohol and other types of drugs¹¹. This, in relation to male sex, we are talking about a masked depression, expressing emotional and psychological distress in the form of “depressive equivalents”⁵, because sadness and vulnerability in this gender, is seen as socially unacceptable in the macho society that still prevails. The above mentioned point increases the relevance of the study of this pathology in men, since the mere presence of the disease can be complicated by male ideals of: stoicism, resistance to asking for help and risky self-management measures (alcohol and drug consumption) that in a significant percentage of cases end up generating an addictive pathology and ignoring these behaviors can complicate the diagnosis of depression. Three different archetypes are presented: the risk-dependent man, the mad-man and the lonely man, of which the most frequent is the first one, since they are those who frequently consult for substance use, predominantly for alcohol; and accidents. There are no studies at the local level that relate the consumption variables of alcoholic beverages and depression, drug use or social violence. The situation raised leads us to ask ourselves: Is alcohol consumption a factor associated with depression in male medical students of the Ricardo Palma University of second cycle (August-December) of the year 2018?

METHODS
The present study is a non experimental, transversal and analytical, performed at Faculty of Human Medicine of Ricardo Palma University.

Population is made up of male human medicine students, between 18 and 28 years old, who consume alcohol associated or not associated with depression, who are studying in the 2018 second cycle of Ricardo Palma University, department of Lima. The sample size was 200 male students. The unit of analysis was made up of each male human medicine student between the ages of 18 and 28 who consume alcohol associated or not associated with depression, who are studying in the 2018 second cycle period of Ricardo Palma University. The data collection sheet (the “Survey”) was used and simple random sampling was used as a sampling method. The inclusion criteria to form part of the research were male students of the Faculty of Human Medicine of Ricardo Palma University and who are consumers of alcoholic beverages. As exclusion criteria, students from other colleges or universities, students with depression due to medical diseases or other causes not related to the consumption of alcoholic beverages, under 18 and over 28 years old and female students.

The Survey is carried out as part of a research project, with the purpose of analyzing the reality of the male student of Human Medicine of Ricardo Palma University in the face of risk factors, such as alcohol consumption, which can lead to depression, putting in risk their professional future. In it, the respondent is asked: What cycle is he in, age, how often does he consume alcohol per week, and if there is a history of depression with or without medical treatment in the last six months. Zung’s validated depressive traits self-evaluation test is applied, which has a Cronbach’s alpha index between 0.79 and 0.92, this text consists of 20 questions that help us to determine the depressive state 33.

Techniques for information processing: Methods and data analysis models according to type of variables, inferential statistical analysis was used for each variable (odds ratio tables). The results are presented in tables and graphs, expressing the data obtained in nominal and percentage terms. For data analysis, inferential statistics were used; Odds Ratio, Frequency Tables, Percentages represented in tables and graphs and Programs to be used for data analysis. The data will be recorded in Office Word, Excel and SPPS Statistics Base. Ethical aspects: In this work, the data collection was done thanks to the permission granted by the Institute of Research in Biomedical Sciences of Ricardo Palma University. The confidentiality of the data collected was respected at all times and that the results obtained from this research are used for purely academic purposes.


RESULTS

DESCRIPTIVE ANALYSIS

From Table 1 and Figure 1, we can see that 67.5% of the students are between 18 and 22 years old and 32.5% of the students are between 23 and 28 years old, in the Faculty of Human Medicine of Ricardo Palma Private University (August-December) of year 2018.

From Figure 2, we can see that 87% of the students are studying between the 1st to the 7th cycle and 13% of the students are studying between the 8th to 14th cycle, at the Faculty of Human Medicine of the Ricardo Palma Private University (August-December) of year 2018.

From Figure 3, we can see that 70% of the students rarely consume alcohol, 21% of the students consume alcohol once a week, 7% of the students consume alcohol twice a week and 2% of the students consume alcohol 3 to 6 times a week in the Faculty of Human Medicine of Ricardo Palma University (August-December) in 2018.

From Table 2, we can see that 32.5% of the students do not present depression, 48.5% of the students present mild depression, 16% of the students present moderate depression and 3% of the students present severe depression at the Faculty of Human Medicine of the Ricardo Palma Private University (August-December) of year 2018.

From Table 3 and Figure 4, we can see that in the group of students who do not present depression, 90.8% rarely consume alcohol; in the group of students who have mild depression, 60.8% rarely consume alcohol; in the group of students who have moderate depression, 59.4% rarely consume alcohol and in the group of students who have severe depression, 50% consume alcohol twice a week.

The results of Chi-squared test (p<0.05), allow to establish that there is a significant relationship between alcohol consumption and depression in students of the Faculty of Human Medicine of Ricardo Palma Private University (August-December) in 2018.

It is established that Alcohol Consumption is a risk factor associated with depression, since it has an OR greater than 1 and the lower limit of the confidence interval is greater than 1. It is also established that students who consume alcohol more than once a week have a 9,444 greater risk of developing depression than students who consume alcohol once a week or less.

It is established that Alcohol Consumption is a risk factor associated with Depression in students aged 18 to 22, since there is a RR greater than 1 and the lower limit of the confidence interval is greater than 1. It is also established that students who consume alcohol more than once a week are 9,444 more likely to develop Depression.

It is established that Alcohol Consumption is not a risk factor associated with Depression in students aged 23 to 28 years, since the lower limit of the confidence interval is less than 1.

It is established that Alcohol Consumption is a risk factor associated with Depression in students from 1st to 7th Cycle, since there is a RR greater than 1 and the lower limit of the confidence interval is greater than 1. It is also established that students who consume alcohol more than once a week have a 1,590 greater relative risk of developing Depression.

It is established that Alcohol Consumption is not a risk factor associated with Depression in students from 8th to 14th Cycle, since RR and lower limit of confidence interval are less than 1.

DISCUSSION

According to a certain amount of research done, male population is more likely to develop abuse or alcohol and drug dependence in the course of his life than women. That is where it arises the concern and debate of researchers and professionals in mental health, regarding whether the use of toxic substances as alcohol or drugs, are a symptom of depression that underlies on male population or conversely is a disorder that occurs at the same time or as a consequence of these substances consumption. The situation raised leads us to ask ourselves: Is alcohol consumption a factor associated with depression in male human medicine students of Ricardo Palma University of Cycle II (August-December) of year 2018?

In our population of male medicine students of Ricardo Palma Private University, 67.5% of the students are between 18 to 22 years old and it was established that Alcohol Consumption is a risk factor associated to Depression in students at this age range, where students who consume alcohol more than once a week have 9,444 more relative risk to present Depression. It was also demonstrated that Alcohol Consumption is a risk factor associated to Depression in students from 1st to 7th Cycle, where it is established that students who consume alcohol more than once a week have 1,590 more relative risks to present Depression. These results are in accordance with research performed by Valle R. and collaborators, who studied depressive symptomatology and problems related to alcohol consumption during academic training of medicine students. As a result, they obtained that the frequency of depressive symptomatology and problems related to alcohol consumption is greater in students of the first years of study, and that the symptomatology prevalence is bigger in students that are studying the first years of study. This is explained by the adaptation of students to the different stressors of the university, which also adds to their own individual problems. This would explain the manifestation of depressive symptoms.

In our population of male medical students from the Ricardo Palma Private University, in the Chi-square test, the p-value obtained (p = 0,000), allows us to establish that there is a significant relationship between alcohol consumption and depression in male students. Finally, it was found that the Odd Ration (OR = 9,4) for Alcohol Consumption establishes that male students who consume alcohol more than once a week have a 9,444 greater risk of presenting Depression than male students who consume alcohol once a week or less. This goes in accordance with studies such as that of Ato, B., that was carried out in a similar population of university students in order to investigate the association of alcoholic beverage consumption and depression, which obtained as a result that it is higher in men (52.96%) than in women (47.04%) and that the risk level that prevails in this study according to the Odds Ratio is 3,968, which means that these young are four times more exposed than others. It concluded that there is a relationship between the consumption of alcoholic beverages and depression, with a greater tendency for males with regard to alcohol consumption.

CONCLUSION

From the analysis of the research on alcohol consumption as a factor associated with depression in male human medicine students at Ricardo Palma University (August-December) in 2018, the following conclusions have been established that:

70% of the students rarely consume alcohol and 21% of the students consume alcohol once a week. Having said that, we are able to conclude that there exists a low level of alcohol consumption of male students of Faculty of Human Medicine of Ricardo Palma University

There is a mild depression prevalence of 48.5% and 16% of moderate depression of male students of the Faculty of Human Medicine of Ricardo Palma University.

67.5% of students are between the ages of 18 and 22 years old. It was concluded that students in this age range have Alcohol Consumption as a risk factor associated with depression, where students who consume alcohol more than once a week have a 9,444 greater relative risk to present Depression.

It was also demonstrated that Alcohol Consumption is a risk factor associated to Depression in students between 1st and 7th Cycle, where it was established that students who consume alcohol more than once a week have a 1,590 greater relative risk of present Depression.

It was concluded that alcohol consumption is a risk factor associated with Depression in male students of the Faculty of Human Medicine of Ricardo Palma University, where it is stated that the students who consume alcohol more than once a week have a 9,444 greater risk to present depression .

RECOMMENDATIONS

It is recommended to continue to perform this type of research, that evaluates the consumption of alcoholic beverages and depression in university students of our environment.

It is proposed the possibility to follow up the students of the first cycles from their entry to the university in order to see the continuity of presenting adherence to alcohol consumption on a regular basis and if it correlates with the presence of depressive symptoms.

Future studies with a larger sample size, greater statistical power and with students from multiple faculties, representative of the universities of Peru, must be carried out.

Data on alcoholic beverages consumption, depression and prevalence in university students should be confirmed and institutional programs should be developed for the early identification of adherence to alcoholic beverage consumption and depression, and evaluate how these affect the academic performance and social life of university students.

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