ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
This article is part of the Research TopicPromoting Mental Health among Healthcare ProfessionalsView all 11 articles
Health-Promoting Behaviors are Associated with Lower Depression and Anxiety in Ecuadorian Medical Residents: A Cross-Sectional Study
Provisionally accepted
Xavier Sánchez1*
Andrés Cruz2María Daniela Cortez2
Ruth Jimbo-Sotomayor3*Santiago Escalnte2Diego Mera2- 1Community and Primary Care Research Group – Ecuador (CPCRG-E), Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- 2Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
- 3Community and Primary Care Research Group – Ecuador (CPCRG-E), Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
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Introduction: Mental health problems, hazardous drinking, and unhealthy behaviors are global concerns among medical residents, particularly in resource-limited regions such as Latin America. Long hours, heavy workloads, and stigma increase the risk of depression, anxiety, and substance misuse. This study assessed the prevalence of mental health symptoms, alcohol use, and health behaviors among residents in Ecuador. Methods: A cross-sectional online survey was conducted among 307 residents at the Pontificia Universidad Católica del Ecuador, after inviting all 1,122 enrolled residents to participate. Validated instruments assessed depression (PHQ-9), anxiety (GAD-7), hazardous drinking (AUDIT), and health behaviors (Health Behavior Inventory, HBI), alongside sociodemographic and training factors. Prevalence rates were estimated, and associations were analyzed using correlations and mixed-effects logistic regression. Results: The prevalence of depression, anxiety, and hazardous drinking was 38.8%, 33.9%, and 12.1%, respectively. Depression and anxiety were strongly correlated and inversely associated with health-promoting behaviors. Higher HBI scores significantly reduced the odds of depression (OR = 0.34, 95% CI 0.24–0.47, p < 0.001) and anxiety (OR = 0.52, 95% CI 0.39–0.69, p < 0.001). Hazardous drinking was independently associated with surgical programs and tobacco use. Conclusions: Ecuadorian residents face substantial burdens of depression, anxiety, and hazardous drinking. Health-promoting behaviors were associated with better mental health, underscoring the importance of targeted interventions, workload reforms, and stigma reduction. From a public health perspective, supporting residents' well-being is critical not only for individual outcomes but also for patient safety and the sustainability of healthcare systems.
Keywords: Anxiety, Depression, Ecuador, Health Behavior, Mental Health
Received: 29 Sep 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Sánchez, Cruz, Cortez, Jimbo-Sotomayor, Escalnte and Mera. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xavier Sánchez
Ruth Jimbo-Sotomayor
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