Self-reported physician-diagnosed depression among medical students: associations with sex, age, physical activity, and religious affiliation in a cross-sectional study

Abstract

Background: Depression is highly prevalent among medical students and may compromise well-being, academic performance, and future professional functioning. Demographic, behavioral, and psychosocial factors such as sex, age, physical activity, and religiosity have been implicated, but their combined role is not fully understood. Objective: This study aimed to estimate the prevalence of self-reported physician-diagnosed depression among medical students and evaluate its association with sex, age, course period, physical activity frequency, and religious affiliation using bivariate analyses and multivariable logistic regression. Methods: Coss-sectional, survey-type study, was conducted between 1st August and 31st October 2025, using a questionnaire completed voluntarily and anonymously. The study sample may include undergraduate medical programs in Brazil, from the first to the twelfth semester, invited by e mail or social media. The primary outcome was self-reported medical diagnosis of depression. Associated factors included sex, age category, course period, frequency of physical activity, and religious affiliation. Bivariate analyses and multivariable logistic regression were performed to evaluate independent associations. Results: Overall, 26.7% (342/1,283) of students reported a physician diagnosis of depression. The sample was predominantly female (68.0%) and most participants were aged 18–24 years (62.3%). More than half of participants reported engaging in physical activity ≥2 times/week (55.2%, 708/1,283). Religious practice data were available for 1,055 respondents; within this subgroup, 68.0% (717/1,055) reported being practitioners. In multivariable analysis, male sex was associated with higher odds of self-reported physician-diagnosed depression (adjusted odds ratio [aOR] = 2.708, 95% CI 1.976–3.711, p < 0.001). Age category was inversely associated (aOR = 0.715, 95% CI 0.635–0.806, p < 0.001), and religious affiliation remained independently associated with lower odds of self-reported physician-diagnosed depression (aOR = 0.455, 95% CI 0.334–0.620, p < 0.001). Physical activity, students exercising once per week had higher odds compared with those exercising two or more times per week (aOR=1.65; 95% CI 1.20–2.27), whereas physical inactivity was not independently significant. Course period was not associated with self-reported physician-diagnosed depression in either analysis. Conclusion: One in four medical students reported having received a physician-diagnosed depression. Male sex, younger age, absence of religious affiliation, and lower physical activity frequency were independently associated with higher risk. These findings highlight the multifactorial nature of depression in medical training and support targeted institutional strategies addressing psychosocial, behavioral, and spiritual dimensions of student well-being.