Screening Medical Students for Depression Risk: The Effects of Disability Status

Although elevated depression rates have been reported among medical students and individuals with disabilities independently, no study has simultaneously assessed depression risk in medical students with disabilities (SWD) using a validated screening tool. This study aimed to compare depression risk in SWDs to peers without disabilities using the Patient Health Questionnaire-2 (PHQ-2).

A multi-institutional, cross-sectional survey was conducted in fall 2020 across seven allopathic medical schools in the U.S. and Canada. An anonymous Qualtrics survey asked medical students to complete the PHQ-2 and information about their disability status, both self-identified and registered with their institution's disabilities office (IDO). Depression risk was categorized using a PHQ-2 score cutoff of ≥ 3. Chi-square tests and independent-sample t-tests were used to assess associations between disability status and PHQ-2 scores.

Of 4,661 students invited, 1,800 (38.6%) responded. SWDs had significantly higher PHQ-2 mean scores (1.59; n = 195) than non-disabled peers (1.00, n = 1416; p < 0.01). A significant association was found between self-identified disability and PHQ-2 score (χ2 = 17.85, p < 0.01), and between IDO registration and PHQ-2 scores (χ2 = 8.21, p < 0.01). Among SWDs, there was no significant difference in mean depression risk between those registered (1.57, n = 93) and unregistered (1.67; n = 76) with their IDO (p = 0.70).

This is the first study to provide quantitative evidence that SWDs were associated with increased risk of depression, regardless of IDO registration. Results suggest institutions should enhance mental health support systems for SWDs. Further research is warranted to understand the impact of disability type and accommodations on the mental health of SWD.