Prevalence and Determinants of Depression, Anxiety, and Stress Among Secondary School Students

Background: Adolescence represents a critical period characterized by extensive changes across various domains. While some of the changes and behaviors that emerge during this period can have detrimental effects on adolescents' present and future health, mental health disorders continue to constitute a leading cause of morbidity among young individuals. Objective: Assess the prevalence and determinants of depression, anxiety, and stress among secondary school students in Saudi Arabia. Methods: This analytical cross-sectional study utilized an online questionnaire to collect responses from secondary school students in Saudi Arabia. The Arabic version of the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) was used to measure depression, anxiety, and stress levels. Data were analyzed using IBM Statistical Package for the Social Sciences software (SPSS, version 29.0, IBM Corp., Armonk, NY, USA). The study included 702 participants. Results: The prevalence of anxiety was 35.2%, followed by depression (30.8%) and stress (14.7%). Females had significantly higher anxiety and stress scores than males (P=0.004, and P=0.011, respectively). Students who were bullied in the last 30 days had significantly higher depression, anxiety, and stress scores than those who were not bullied (P<0.001 for all). Participants who experienced physical assault in the last 12 months had significantly higher depression, anxiety, and stress scores than those who did not (P<0.001 for all). Participants who had had fights in the last 12 months had significantly higher depression (P=0.004) and anxiety (P<0.001) scores than those who did not. Participants who felt unsafe on the way to school had significantly higher depression, anxiety, and stress scores than those who did not (P<0.001 for all). Conclusion: The study revealed prevalence rates of depression (30.8%), anxiety (35.2%), and stress (14.7%) among secondary school students in Saudi Arabia. The study highlights the importance of addressing social stressors such as bullying and physical assault and promoting a safe and supportive school environment to prevent mental health disorders in this population.