Psychiatric Morbidity among Fresher Medical Students in a Nigerian Tertiary Institution: A Mixed-Methods Study

Vollständiger Abstract

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Background: The transition into medical school represents a major developmental, academic, and psychosocial challenge for young adults. These challenges may be particularly significant among freshers. The study aimed to determine the prevalence and predictors of psychiatric morbidity among freshers in the medical school of a public university in Nigeria. Methods: A convergent mixed-methods design was used for the study. The quantitative component involved a cross-sectional survey of first-year medical students using a sociodemographic questionnaire and the 12-item General Health Questionnaire (GHQ-12). The qualitative component comprised three focus group discussions and two in-depth interviews. Data were analysed using descriptive statistics, chi-square tests, and multivariable logistic regression. Results: Based on the GHQ-12, 27.5% of participants screened positive for psychiatric morbidity, with religion associated with psychiatric morbidity (p = 0.011). The majority were in the 15–25-year age bracket, 32 (80.0%). Most participants, 34 (85.0%), belonged to the middle socioeconomic class, and 37 (92.5%) came from an urban centre. Only 2 (5%) consumed alcohol, and only 1 (2.5%) used a psychoactive substance. Qualitative analysis generated six themes: the shock of transition; academic overload; fear of failure and family expectations; homesickness and loneliness; coping and resilience; and barriers to mental-health help-seeking. Conclusion: This mixed-methods study observed psychiatric morbidity among freshers in a Nigerian public medical school. Socioeconomic and psychological factors are important predisposing factors for psychiatric morbidity. Further corroborative research involving larger populations and multicentre, multiregional approaches is required to strengthen the generalisability of these findings.