Prevalence and associated factors of depression, anxiety, and stress among high school students in, Northwest Ethiopia, 2021

Background: Many studies have revealed that students' performance in school, is affected by symptoms of depression, anxiety, and stress, which may impair their academic achievement, and lead to school dropout. However, to date, no studies have evaluated these three disorders among high school students in Africa. Therefore, in this study, we aimed to assess the prevalence of depression, anxiety, stress, and their associated factors among high school students in Northwest Ethiopia.

Methods: An institution-based cross-sectional study was conducted. A simple random sampling technique was used to select 849 participants from six high schools in Northwest Ethiopia. A self-administered Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was used to collect the data. Data were analyzed using SPSS Version 25.0 software to identify factors associated with DAS, and bi-variable and multi-variable analyses were performed.

Results: The prevalence of depression, anxiety, and stress was 41.4, 66.7, and 52.2% respectively. Being female (AOR = 1.304, 95% CI = 1.006-1.849), higher risky khat chewers (AOR = 5.595, 95% CI = 2.357-11.132), having social phobia (AOR = 1.416, 95% CI = 1.045-1.919) were associated with depression. Being higher risky cigarette smokers (AOR = 4.777, 95% CI = 1.407-7304), having a history of chronic medical illness (AOR = 2.099, 95% CI = 1.045-4.218), and having a family history of mental illness (AOR = 1.777, 95% CI = 1.028-3.073) associated with anxiety. Stress was associated with high-risk alcohol drinkers (AOR = 1.828, 95% CI = 1.012-3.303), rural residency (AOR = 1.395, 95%CI = 1.010-1.925), and low social support (AOR 1.7391, 95% CI = 1.203-2.515).

Conclusion: The burden of DAS among high school students was found to be high. Female sex, chewing khat, and having social phobia are associated with depression. Conversely, smoking cigarettes, having a chronic medical illness, and having a family history of mental illness are all linked to anxiety. Being a highly risky alcoholic drinker, having poor social support, and being a rural resident are positively associated with stress. Therefore, extending mental health services to all high schools, and strengthening the existing counseling services, are recommended.