Prevalence and associated factors of depression, anxiety, and stress among pharmacy students in a northern Thailand university: a cross-sectional study.

Abstract

Objective: To determine the prevalence and associated factors of depression, anxiety, and stress among pharmacy students at the University of Phayao, Thailand.

Methods: Undergraduate students aged ≥18 years majoring in pharmaceutical care at the University of Phayao in northern Thailand during the 2024 academic year were invited to participate in an online survey. Demographic and academic data were collected using a self-administered questionnaire. Mental health was assessed using the Thai version of the Depression, Anxiety and Stress Scale. Outcomes were dichotomised as present (at least moderate severity) or absent (normal/mild) for regression analyses.

Results: Of 470 undergraduate pharmacy students, 296 completed the questionnaire, yielding a response rate of 58.0%. Overall, 41.9%, 53.7%, and 34.1% of participants reported having depressive symptoms, anxiety, and stress, respectively; 64.2% experienced at least one mental health problem, and 23.3% reported comorbid depression, anxiety, and stress. The three mental problems were positively correlated (r = 0.48-0.52, all p < 0.001). Independent factors for depression were parental separation (adjusted odds ratio [aOR] = 10.80), high self-imposed pressure (aOR = 7.71), untreated mental health problems (aOR = 53.81), sleep deprivation (aOR = 2.92), lecture-based class (aOR = 4.08), and academic workload (≥4 assignments) [aOR = 3.22]. Independent factors for anxiety were commuting by private car (aOR = 2.07), compulsory participation in student clubs (aOR = 9.26), many problems with peers or partner (aOR = 3.48), sleep deprivation (aOR = 2.28), and lecture-based class (aOR = 2.52). Independent factors for stress were living with a partner (aOR = 13.20), living with family (aOR = 3.26), low support from peers or partner (aOR = 10.63), moderate problems with lecturers (aOR = 88.75), high self-imposed pressure (aOR = 18.61), self-study (aOR = 7.12), project-based learning (aOR = 3.13), and examinations (aOR = 3.60). Notably, sleep deprivation was inversely associated with stress (aOR = 0.19), suggesting potential confounding effects or adaptive coping mechanisms.

Conclusion: Depression, anxiety, and stress are prevalent among pharmacy students, particularly during preclinical years. These psychological disorders are associated with a combination of individual vulnerability, interpersonal dynamics, health behaviours, and excessive academic workload. Proactive mental health screening, integrated care, and reforms to foster supportive learning environments that promote sustained well-being and resilience among students are recommended.