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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 2  |  Page : 57-60

A study of association between depression and self-esteem among dental students of Udaipur


1 Department of Oral and Maxillofacial Surgery, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
2 Department of Public Health Dentistry, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
3 Department of Public Health, Western Kentucky University, Bowling Green, Kentucky, USA
4 Department of Public Health Dentistry, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
5 Department of Oral and Maxillofacial Pathology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India

Date of Web Publication1-Feb-2018

Correspondence Address:
Ramandeep Singh Gambhir
Department of Public Health Dentistry, Gian Sagar Dental College and Hospital, Rajpura - 140 401, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijofr.ijofr_15_17

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  Abstract 

Background: Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer and tends to have negative and self-critical thoughts. The purpose of the present study was to explain the correlation between depression and self-esteem among dental students of Udaipur. Materials and Methods: Three hundred and fourteen students participated in the study. Self-esteem was estimated using Rosenberg method using 4-point Likert scale format ranging from strongly agree to strongly disagree. Beck depression inventory is a 21-question multiple-choice self-report inventory and was used for measuring the severity of depression with a 4-point scale ranging on severity. Descriptive statistics were used to calculate means. T-test and Pearson's correlation were used for statistical analysis. Results: The mean scores of depression and self-esteem were found to be 9.11 ± 10.11and 20.11 ± 5.17, respectively, and a negative correlation was found between depression and self-esteem (r = −0.38). The mean score of self-esteem of male participants was higher, i.e., 22.24 ± 5.16 and the mean depression score was lesser, i.e., 10.12 ± 7.82 and the findings were statistically significant. Conclusion: The present research suggests that low self-esteem and depression have strong negative correlation. Improving self-esteem reduces risk of depression regardless of whether the individual is enduring stressful or nonstressful life experiences.

Keywords: Beck depression inventory, correlation, personality, Rosenberg method, vulnerability


How to cite this article:
Bhanawat N, Maheshwari V, Joshi G, Dhaduk P, Singh A, Gambhir RS, Kahlon H. A study of association between depression and self-esteem among dental students of Udaipur. Int J Orofac Res 2017;2:57-60

How to cite this URL:
Bhanawat N, Maheshwari V, Joshi G, Dhaduk P, Singh A, Gambhir RS, Kahlon H. A study of association between depression and self-esteem among dental students of Udaipur. Int J Orofac Res [serial online] 2017 [cited 2019 Jul 21];2:57-60. Available from: http://www.ijofr.org/text.asp?2017/2/2/57/224497


  Introduction Top


Depression is a significant contributor to the global burden of disease and affects people in all communities worldwide. Today, depression is estimated to affect 350 million people.[1] It often starts at young age; it reduces people's functioning and is often recurring. Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration (WHO).[1] It is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being.[2]

The idea of self-esteem is omnipresent in contemporary life. In classrooms and working environments, sports activities, and music presentations, individuals by and large accept that high self-esteem is necessary for achievement in that area. Without a doubt, the advancement of self-regard, and the avoidance of low self-regard, is broadly seen as a vital societal objective that benefits boundless intercessions to help self-esteem levels in the populace.[3]

The depressive state disturbs the way people evaluate and see themselves. It changes the perception that they have of others and the world and affects their personal esteem. Self-esteem levels are personality constructs that result from intra- and inter-personal relationships. They affect people's attitudes in their school activities, at work, and in every other daily activity.[4] Depression, the silent killer, has become one of the alarming crises in today's fast paced society. Even without the presence of any actual illness, major depression robs off all self-worth, self-esteem, self-confidence, and self-image.[5] Numerous speculations of depression hypothesize that low self-esteem is a characterizing highlight of depression. Self-esteem in youngsters has been related to various risk factors and defensive parameters in the past studies, but lesser studies have been done in dental students and that too involving Indian population.[6],[7] Hence, this study was carried out to analyze the association between self-esteem and depression among dental students of Udaipur.


  Materials and Methods Top


Ethical consideration

Authority to conduct the research was sought from the Ethical Committee of Pacific Dental College and Hospital, Udaipur. Informed consent was sought from the study participants where they obtained a written and signed consent after an explanation was given to them by the principal investigator. All information collected were treated with utmost confidentiality.

Study design and study population

This was a descriptive questionnaire survey as it included collection of data from the students then followed by data analysis. The study was carried out among dental students in Udaipur, Rajasthan, India.

Sample size

Sample size was computed using the Raosoft sample size calculator. Margin of error was kept at 5% and confidence level of 95%. A total of 620 students were initially enrolled in the study. The response rate was 50%. The final sample size was calculated as 314 using systematic probability sampling.

Inclusion and exclusion criteria

Dental students of Udaipur who gave their consent to participate in the study and who were present in the dental college on the day of the study were included in the present study. Students with a history of substance dependence, psychotic disorders, any comorbid chronic medical illness, and who did not give their consent to participate in the study were excluded from the study.

Data collection and questionnaire

Data were collected through a self-administered questionnaire. The questionnaire was filled by students who meet the inclusion criteria. A brief introduction about the objectives of the study was given to students. Confidentiality was assured. A total number of 314 students participated in the study. All data were collected by the researcher between January and February 2016. Self-esteem scale was used to measure participants' self-esteem.[8] A 10-item scale that measures global self-worth by measuring both positive and negative feeling about self. All items are answered using a 4-point Likert scale format ranging from strongly agree to strongly disagree.[9],[10],[11] Beck depression inventory (BDI) is a 21-question multiple-choice self-report inventory, one of the most widely used instruments for measuring the severity of depression. All items are rated on 4-point scale ranging on severity of each item. The BDI was originally developed to provide a quantitative assessment of the intensity of depression.[9],[11]

Statistical analysis

The data for all two research instruments were numerically scored and quantified using SPSS version 22 (Statistical Package for Social Sciences, Chicago, IL, USA). Descriptive statistics were used to calculate means. T-test was utilized to compare male and female's scores on main variables of the study. Pearson's correlation was used to determine the direction of relationship between depression and self-esteem.


  Results Top


[Table 1] shows the demographic detail of the participants, it shows that there were 79.9% undergraduate students and 20.1% were the postgraduate students. Female students were more (71.7%) as compared to male students.
Table 1: Demographic details of the students

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The means and standard deviations for depression and self-esteem are presented in [Table 2]. The mean score for depression was below the cutoff point for the identification of depressive symptoms in normal population, i.e., 9.11 ± 10.11. Kovacs [12] set a score of 20 as the midpoint to categorize depressed and nondepressed respondents. The mean score of the participants with depression was 27.48 ± 7.72.
Table 2: Depression and self-esteem of the participants

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The mean self-esteem (20.11 ± 5.17) score was on the higher end of the self-esteem scale score [Table 2]. It shows that there was a significant relationship (P < 0.0001) between self-esteem on participant's state of depression, whether present or not. When the correlation was sorted out between depression and self-esteem of the participants as a whole, it was found highly significant (P < 0.0005). The r value of the test was calculated as −0.38 meaning that self-esteem had an inverse significant relationship with depression. Those with high self-esteem tend to have lower depressive symptoms.

[Table 3] shows gender-wise comparison of depression and self-esteem of the participants. The mean score of self-esteem of male participants was higher, i.e., 22.24 ± 5.16 and the mean depression score was lesser, i.e., 10.12 ± 7.82, the difference was highly significant (P < 0.0001).
Table 3: Gender-wise comparison of depression and self-esteem of the participants

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  Discussion Top


Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. Depression is the leading cause of disability for both male and female, the burden of depression is 50% higher for female than male (WHO, 2008).[1] Studies have shown that negative cognitions during depression are prevalent and are reflected in low self-appraisals, dysfunctional attitudes, and pessimistic outlook.[9]

Two dominant models exist in the literature to explain the relationship between depression and self-esteem. The vulnerability model hypothesizes that low self-esteem serves as a risk factor for depression, especially in the face of major life stressors.[13],[14],[15] For instance, as indicated by Beck's (1967) intellectual hypothesis of sadness, negative convictions about the self –one of three focal parts of depressive issue – are not simply symptomatic of sadness but assume a basic causal part in its etiology.[10] Interestingly, the scar model postulates that low self-esteem is a result of melancholy as opposed to a cause. In particular, discouragement is accepted to relentlessly crumble individual assets, for example, self-esteem, even after settlement of a depressive scene, that is, episodes of depression may leave scars in the individual's self-idea that continuously wear down self-esteem after some time.[11],[16],[17]

The present study found that female students experience more negative affective states compared to male students. Female students tended to have higher depressive symptoms and lower self-esteem than male students. These findings of gender differences in depression and self-esteem are consistent with findings of the past studies. A conducted study among Malaysian adolescents found significant differences in scores of depression and self-esteem among males and females.[18] Similar studies were conducted by some other authors who also arrived at similar conclusions.[19],[20],[21],[22]

The results of Pearson's correlation analysis suggested a significant negative relationship between self-esteem and depression in the present study. This explains that students with higher self-esteem had lower tendency to be depressed. The bivariate correlations' findings support other researchers, who examined adolescent depression and self-esteem. Our findings were in concordance with a similar study which also found that self-esteem had an inverse significant relationship with depression.[18] Those with high self-esteem tend to have lower depressive symptoms. Our findings were in partial concordance with another study which was conducted to examine correlation between self-esteem and depression in high school children.[23] Their correlational analysis suggested a significant negative relationship between self-esteem and vulnerability to depression. Some other authors also asserted that self-esteem showed a significant strong inverse association with depressive symptoms.[24] Jayanthi and Rajkumar [25] performed the odds ratio analysis and revealed that adolescents who had low self-esteem have 3.7 times (95% confidence interval = 1.9–6.9 and P = 0.001) more risk of developing depression than the adolescents who had high self-esteem. Findings of present work, with a strong negative correlation between self-esteem and depression, were in partial agreement a study conducted by Halit [26] whose test results showed that there was a significant relationship between self-esteem and depression levels, but the relationship is weak.

These observations connoted that low self-esteem is a strong risk factor for depression among dental students. Deficient emotional self-regulation may be regarded as a personal vulnerability factor leading to depression and hence can encroach on the well-being of students. Therefore, more noteworthy significance ought to be given to the nearness of low self-esteem amid students which can assist them to develop and work enthusiastically throughout their lives.


  Conclusion and Limitations Top


Considering the results of the present study, certain limitations should be kept in mind. Future studies could render better results from a larger sample size, selecting participants from other parts of the country. Another limitation of the study comes from the fact that other variables also affect the development of depressions such as stress, loneliness, students' academic background, and peer influence. The observations of this intervention indicate that females are more vulnerable to psychological problems than males during the study period. It also suggested a strong negative correlation between self-esteem and depression. Thus, research results contribute to the development of an empirical database for better understanding of approached relationships and to the development of counseling programs aiming to nurture the students' self-esteem and hence prevention of depression.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Marcus M, Yasamy MT, van Ommeren M, Chisholm D, Saxena S. Depression: A Global Public Health Concern. Available from: http://www.who.intmental_healthmanagementdepressionwho_paper_depression_wfmh_2012.pdf. [Last accessed on 2016 Jan 15].  Back to cited text no. 1
    
2.
Meenu KS. A comparative study of depression among rural and urban secondary school students in relation to their achievement motivation. Indian J Appl Res 2014;4:209-12.  Back to cited text no. 2
    
3.
Orth U, Robins RW. The development of self-esteem. Curr Dir Psychol Sci 2014;23:381-7.  Back to cited text no. 3
    
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Furegato AR, Santos JL, Silva EC. Depression among nursing students associated to their self-esteem, health perception and interest in mental health. Rev Lat Am Enfermagem 2008;16:198-204.  Back to cited text no. 4
    
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Deb S, Bhattacharjee A. Self-esteem of depressive patients. J Indian Acad Appl Psychol 2009;35:239-44.  Back to cited text no. 5
    
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Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation – Psychological factors and coping strategies in dental and medical students. GMS Z Med Ausbild 2012;29:Doc10.  Back to cited text no. 6
    
7.
Newbury-Birch D, Lowry RJ, Kamali F. The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: A longitudinal study. Br Dent J 2002;192:646-9.  Back to cited text no. 7
    
8.
Rosenberg M, editor. Determinants of self-esteem. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965. p. 326.  Back to cited text no. 8
    
9.
Luxton DD, Ingram RE, Wenzlaff RM. Uncertain self-esteem and future thinking in depression vulnerability. J Soc Clin Psychol 2006;25:840-54.  Back to cited text no. 9
    
10.
Beck AT, Steer RA, Garbin MG. Psychometric properties of the beck depression inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988;8:77-100.  Back to cited text no. 10
    
11.
Orth U, Robins RW, Roberts BW. Low self-esteem prospectively predicts depression in adolescence and young adulthood. J Pers Soc Psychol 2008;95:695-708.  Back to cited text no. 11
    
12.
Kovacs M. The children's depression, inventory (CDI). Psychopharmacol Bull 1985;21:995-8.  Back to cited text no. 12
    
13.
Butler AC, Hokanson JE, Flynn HA. A comparison of self-esteem lability and low trait self-esteem as vulnerability factors for depression. J Pers Soc Psychol 1994;66:166-77.  Back to cited text no. 13
    
14.
Metalsky GI, Joiner TE Jr, Hardin TS, Abramson LY. Depressive reactions to failure in a naturalistic setting: A test of the hopelessness and self-esteem theories of depression. J Abnorm Psychol 1993;102:101-9.  Back to cited text no. 14
    
15.
Beck AT. Depression: Clinical, Experimental, and Theoretical Aspects. New York: Harper & Row; 1967.  Back to cited text no. 15
    
16.
Coyne JC, Gallo SM, Klinkman MS, Calarco MM. Effects of recent and past major depression and distress on self-concept and coping. J Abnorm Psychol 1998;107:86-96.  Back to cited text no. 16
    
17.
Coyne JC, Whiffen VE. Issues in personality as diathesis for depression: The case of sociotropy-dependency and autonomy-self-criticism. Psychol Bull 1995;118:358-78.  Back to cited text no. 17
    
18.
Yaacob SN, Juhari R, Talib MA, Uba I. Loneliness, stress, self-esteem and depression among Malaysian adolescents. J Kemanusiaan Bil 2009;14:86-95.  Back to cited text no. 18
    
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Rayle AD. Adolescent gender differences in mattering and wellness. J Adolesc 2005;28:753-63.  Back to cited text no. 19
    
20.
Petersen AC, Sarigiani PA, Kennedy RE. Adolescent depression: Why more girls? J Youth Adolesc 1991;20:247-71.  Back to cited text no. 20
    
21.
Twenge JM, Nolen-Hoeksema S. Age, gender, race, socioeconomic status, and birth cohort differences on the children's depression inventory: A meta-analysis. J Abnorm Psychol 2002;111:578-88.  Back to cited text no. 21
    
22.
Windle M. A longitudinal study of stress buffering for adolescent problem behaviors. Dev Psychol 1992;28:522-30.  Back to cited text no. 22
    
23.
Negovan V, Bagana E. A comparison of relationship between self-esteem and vulnerability to depression among high school and freshmen university students. Procedia Soc Behav Sci 2011;30:1324-30.  Back to cited text no. 23
    
24.
Moksnes U, Mary-Eilertsen EB, Lazarewicz M. The association between stress, self-esteem and depressive symptoms in adolescents. Scand J Psychol 2016;57:22-9.  Back to cited text no. 24
    
25.
Jayanthi P, Rajkumar R. Is low self-esteem a risk factor for depression among adolescents? An Analytical study with interventional component. Int J Med Res Health Sci 2014;3:627-33.  Back to cited text no. 25
    
26.
Halit AH. Self-esteem and its relation to depression among the elderly. Int J Bus Soc Sci 2014;5:266-73.  Back to cited text no. 26
    



 
 
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