{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:46:50Z","timestamp":1792176410520,"version":"4.4.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depression is a leading cause of disability among university students. While medical students are often assumed to be at highest risk, cross-disciplinary comparisons in South Asia remain scarce. This study examined depressive symptom differences between medical and non-medical students in Pakistan and evaluated the concurrent psychometric performance of the PHQ-9 and DASS-21.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey of 602 undergraduate students (424 medical, 178 non-medical) was conducted at universities in Lahore, Pakistan. Measures included the PHQ-9 and DASS-21. Analyses comprised descriptive statistics, Wilcoxon rank-sum tests, multivariable linear regression (separate models for PHQ-9 and each DASS-21 domain), confirmatory factor analysis, item response theory using a graded response model, and symptom network analysis with stability testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Non-medical students had higher PHQ-9 scores than medical students (median 10.0 vs. 9.0). In adjusted models, non-medical students scored higher on PHQ-9 (\u03b2 = \u22121.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), DASS Depression (\u03b2 = \u22121.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and DASS Anxiety (\u03b2 = \u22122.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001); the DASS Stress difference was non-significant (\u03b2 = \u22120.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.089). Female gender predicted higher scores across all domains (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Each additional hour of sleep was associated with lower PHQ-9 scores (\u03b2 = \u22120.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010). Prior depression treatment was the strongest predictor (\u03b2\u2009=\u20094.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). DASS-21 confirmatory factor analysis showed adequate fit (CFI\u2009=\u20090.954, TLI\u2009=\u20090.948, RMSEA\u2009=\u20090.052), but latent factor correlations were very high (Depression\u2013Stress\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.939; Anxiety\u2013Stress\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.949). Cronbach\u2019s \u03b1 ranged 0.82\u20130.88 across scales. Item response theory indicated that self-worth, concentration, down, and appetite items showed the highest discrimination; interest (anhedonia) showed the lowest (\n                      <jats:italic>a<\/jats:italic>\n                      \u2009=\u20090.468). In network analysis, self-worth, concentration, and downheartedness were the most central nodes; stability coefficients ranged 0.31\u20130.44. Measurement invariance across discipline was supported. Model R\u00b2 values were low (0.029\u20130.041).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non-medical students reported higher depressive and anxiety symptoms than medical students in this Pakistani sample, although academic discipline explained only a small proportion of variance. Both instruments performed adequately, though the DASS-21\u2019s near-unity latent correlations may raise questions about subscale distinguishability in this population. Cognitive and self-worth symptoms emerged as the most informative for screening purposes. Campus mental health strategies should address the whole student population, with particular attention to female students and sleep health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40359-026-05332-5","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:13:38Z","timestamp":1786508018000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric properties and symptom profiles of the PHQ-9 and DASS-21 among medical and non-medical university students: a cross-sectional study in Pakistan"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5017-8523","authenticated-orcid":false,"given":"Taimoor","family":"Asghar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifrah","family":"Sahar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Tahir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Shahid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal","family":"Komal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"3","key":"5332_CR1","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.jpsychires.2012.11.015","volume":"47","author":"AK Ibrahim","year":"2013","unstructured":"Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. 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