Skip to main content Skip to main navigation menu Skip to site footer
Original Research Articles
Published: 2026-02-21

PREVALENCE OF STRESS AND ITS CORRELATION WITH COGNITION AMONG MEDICAL STUDENTS

Department of Physiology, Tagore Medical college and hospital, Chennai, India
Department of Physiology, Sri Venkateshwara Medical College Hospital and Research Centre, Pondicherry, India
Department of Psychiatry, Indira Gandhi Medical College and research Institute, Pondicherry, India
Department of Dermatology, Panimalar Medical College, Chennai, India
Department of Physiology, All India Institute of Medical sciences, Madurai, India.
Stress; MSSQ-40; Medical students; P300; Cognition; Event-related potentials

Abstract

Stress is highly prevalent among medical students due to academic demands, clinical responsibilities, and psychosocial factors. Persistent stress has been linked to impaired cognitive performance and long-term neuropsychological consequences. However, objective assessment of cognition in relation to stress among medical undergraduates remains limited. Stress was assessed using MSSQ-40 which evaluates six stressor domains, and categorized as mild, moderate, high, and severe. For correlation analysis, 125 students were recruited and subjected to cognitive assessment using auditory P300 event-related potentials recorded at the Cz electrode placement. The overall prevalence of stress (high + severe categories) was 53.37%. Academic-related stressors (72.8%) and teaching-learning related stressors (69.0%) were the most predominant domains. Statically significant differences in mean stress scores across phases  were observed for academic related, teaching learning, Social related and group activities related stressor (p <0.05). P300 latency showed a significant positive correlation with academic related (r=0.28, p=0.04), teaching learning (r=0.31, p=0.02), Drive related (r=0.527, p<0.001), and group activities related stressor (r=0.39, p<0.001). More than half of the medical students experienced significant stress, predominantly academic related factors. Higher stress levels were associated with prolonged P300 latency, suggesting stress-related cognitive slowing. Early identification and targeted interventions may help improve both mental well-being and cognitive performance among medical undergraduates.

References

  1. Melaku L, Mossie A, Negash A. Stress among medical students and its association with substance use and academic performance. J Biomed Educ. 2015;2015:149509.
  2. Panchu P, Bahuleyan B, Vijayan V. An analysis of the factors leading to stress in Indian medical students. Int J Clin Exp Physiol. 2017;4:48–50.
  3. Esch T, Stefano GB, Fricchione GL, Benson H. The role of stress in neurodegenerative diseases and mental disorders. Neuro Endocrinol Lett. 2002;23(3):199–208.
  4. Gupta S, Choudhury S, Das M, Mondol A, Pradhan R. Factors causing stress among students of a medical college in Kolkata, India. Educ Health (Abingdon). 2015;28:92–95.
  5. Sarkar S, Gupta R, Menon V. A systematic review of depression, anxiety, and stress among medical students in India. J Ment Health Hum Behav. 2017;22:88–96.
  6. Kumar SG, Kattimani S, Sarkar S, Kar S. Prevalence of depression and its relation to stress level among medical students in Puducherry, India. Ind Psychiatry J. 2017;26(1):86.
  7. Nandi M, Sarkar S, Mondal R, Ghosal M, Hazra A. Stress and its risk factors in medical students: An observational study from a medical college in India. Indian J Med Sci. 2012;66(1):1.
  8. Johansson L, Guo X, Waern M, Ostling S, Gustafson D, Bengtsson C, et al. Midlife psychological stress and risk of dementia: A 35-year longitudinal population study. Brain. 2010;133(Pt 8):2217–2224.
  9. Pradhan G, Mendinca NL, Kar M. Evaluation of examination stress and its effect on cognitive function among first-year medical students. J Clin Diagn Res. 2014;8(8):BC05–BC07.
  10. Nabe-Nielsen K, Rod NH, Hansen ÅM, Prescott E, Grynderup MB, Islamoska S, et al. Perceived stress and dementia: Results from the Copenhagen City Heart Study. Aging Ment Health. 2020;24(11):1828–1836.
  11. Pickering TG. Mental stress as a causal factor in the development of hypertension and cardiovascular disease. Curr Hypertens Rep. 2001;3(3):249–254.
  12. Yuen EY, Wei J, Liu W, Zhong P, Li X, Yan Z. Repeated stress causes cognitive impairment by suppressing glutamate receptor expression and function in prefrontal cortex. Neuron. 2012;73(5):962–977.
  13. Anderer P, Saletu B, Gruber D, Linzmayer L, Semlitsch HV, Saletu-Zyhlarz G, et al. Age-related cognitive decline in the menopause: Effects of hormone replacement therapy on cognitive event-related potentials. Maturitas. 2005;51(3):254–269.
  14. Himani A, Tandon OP, Bhatia MS. A study of P300 event-related evoked potential in patients with major depression. Indian J Physiol Pharmacol. 1999;43(3):367–372.
  15. Shah SMA, Mohammad D, Qureshi MFH, Abbas MZ, Aleem S. Prevalence, psychological responses and associated correlates of depression, anxiety and stress in a global population during the COVID-19 pandemic. Community Ment Health J. 2021;57(1):101–110.
  16. von Keyserlingk L, Yamaguchi-Pedroza K, Arum R, Eccles JS. Stress of university students before and after campus closure in response to COVID-19. J Community Psychol. 2022;50(1):285–301.
  17. Halliburton AE, Hill MB, Dawson BL, Hightower JM, Rueden H. Increased stress, declining mental health: Emerging adults’ experiences in college during COVID-19. Emerg Adulthood. 2021;9(5):433–448.
  18. Punita P, Saranya K, Kumar SS. Effect of gender on six domains of stress in medical students. Int J Curr Res. 2016;8.
  19. Ghosal K, Behera A. Study on prevalence of stress in medical students. J Res Med Dent Sci. 2018;6(5):182–186.
  20. Lupien SJ, Maheu F, Tu M, Fiocco A, Schramek TE. The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain Cogn. 2007;65(3):209–237.
  21. Pandey SK, Sharma V. Sudden and early death among medical professionals: How to reverse this trend? Indian J Ophthalmol. 2023;71(5):2286–2287.
  22. Chahal S, Nadda A, Govil N, Gupta N, Nadda D, Goel K, et al. Suicide deaths among medical students, residents and physicians in India spanning a decade (2010–2019): An exploratory study using online news portals and Google database. Int J Soc Psychiatry. 2022;68(4):718–728.

How to Cite

Subhashri Soundirarajan, Tamilselvan Kuppusamy, Mathan kaliaperumal, Perumal Manoharan, & Jothi Marie Feula. (2026). PREVALENCE OF STRESS AND ITS CORRELATION WITH COGNITION AMONG MEDICAL STUDENTS. International Journal of Clinical and Biomedical Research, 11(1), 23–27. Retrieved from https://www.ijcbr.com/index.php/ijcbr/article/view/422