Prevalence and Associated Factors of Symptoms of Depression, Anxiety, Stress and Coping Strategies among Adults in a Rural Community in Southern Province, Sri Lanka

Background and objective: Negative emotional status due to various life challenges have been reported very often among adult population. These problems increase the risk of developing mental health problems and accelerate their progression in communities. The objective of the study was to determine the prevalence and associated factors of symptoms of depression, anxiety, stress, self-reported reasons for psychological distress and coping strategies among adults in Nagoda Divisional Secretariat area, Galle, Sri Lanka.Method: A descriptive cross-sectional study was conducted with the participation of 280 adults aged 20-64 years, selected using cluster sampling from randomly selected five Grama Niladari divisions in Nagoda Divisional Secretariat area. Previously validated Depression, Anxiety, Stress Scale-21(DASS-21) was administered to assess the symptoms of depression, anxiety and stress. Descriptive analysis and chi-square test were performed using SPSS software (Version 23).Results: Of the participants, 59.3% were females. Around 40% were aged 35-50 years. The prevalence of symptoms of depression, anxiety and stress were identified as 33.2%, 18.6% and 59.6% respectively. Prevalence of symptoms of depression (37.9%) and anxiety (21.7%) were higher among females. Stress was more prevalent (52.6%) in males. Gender (p=0.042) and living arrangement (p=0.025) showed a significant association with depression. Presence of a comorbidity (p=0.040) showed a significant association with stress. The reasons for psychological distress perceived by participants were; health issues of family members (53.6%), own health problems (52.1%), relationship issues (44.3%) and dietary pattern associated issues (44%). A few participants reported meditation (15.4%), engaging in exercises (14.6%), seeking counselling support (13.9%) and recreational activities (14.3%) as their healthy coping strategies.Conclusions: This study showed a high prevalence of symptoms of stress compared to depression and anxiety among adults and major determinants of emotional symptoms were personal and family health issues. Only few individuals were practicing healthy coping strategies. The results emphasize the importance of improving adult health at community level that may contribute to positive mental health.