Depression, anxiety, and stress among college students: a Kashmir-based epidemiological study

Abstract

Introduction: Depression and anxiety are major public health concerns, especially among young adults. However, limited regional data exist from Kashmir, Northern India, to guide targeted mental health strategies. Therefore, the present study aimed to assess the levels of depression and anxiety among college-going students in Kashmir and examine associated demographic factors.

Methods: A cross-sectional survey was conducted from January to April 2024, involving 1,471 college students aged 18 to 26 years from institutions across the Kashmir division. Data were collected using an online Google Form after obtaining informed consent. Depression and anxiety were measured using validated scales: PHQ-9 and GAD-7. Statistical analyses included t-tests, chi-square tests, logistic regression, and Pearson correlation to explore associations and trends.

Results: Among the participants, 12.5% exhibited severe depression, with a slightly higher prevalence in females (13.39%). Severe anxiety was reported by 24.26% of students, and 19.17% reported high perceived stress levels. Gender showed notable relevance with anxiety (OR ≈ 1.68, p = 0.0001) and stress (OR ≈ 1.65, p = 0.0007). Correlation analysis revealed positive relationships between depression and stress score (r = 0.6322), anxiety and stress score (r = 0.6824), and depression and anxiety (r = 0.8064), suggesting that higher stress levels correlate with increased depression and anxiety among surveyed individuals.

Discussion: The high prevalence of depression, anxiety, and stress among college students, especially among females, highlights an urgent need for gender-sensitive, campus-based mental health interventions. The strong interrelations among these psychological conditions suggest that comprehensive stress-reduction programs may effectively mitigate multiple mental health risks. Future research should focus on designing and evaluating such targeted strategies to enhance student well-being.

Keywords: anxiety; depression; epidemiological study; kashmiri population; prevalence.

Figure 1

Flowchart illustrates the stepwise selection process of study participants, including exclusions, consent status, and final sample distribution by gender.

Figure 2

The presented graphs illustrate the demographic characteristics of the surveyed population. (A) The bar graph shows the distribution of participants based on their residential location, indicating a higher proportion of rural residents compared to urban residents across total, male, and female groups. (B) The bar graph represents the marital status distribution, revealing a significantly higher percentage of unmarried individuals in all categories. (C) The line graph depicts the distribution of guardian income levels, showing a declining trend as income levels increase, followed by a slight rise in the highest income category.

Figure 3

The presented pie charts illustrate the frequency distribution of mental health conditions among the surveyed population. (A) The pie charts display the prevalence of depression across the overall, male, and female participants, showing varying proportions across different severity levels. (B) The pie charts highlight the distribution of anxiety levels in the total population, as well as by gender. (C) The pie charts depict the prevalence of perceived stress among the overall, male, and female groups, revealing distinct trends in stress severity.

Figure 4

The forest plot shows the association between demographic factors and the risk of depression, anxiety, and stress. Each square represents the Adjusted Odds Ratio (AOR) with confidence intervals for factors such as dwelling place, gender, marital status, and guardian’s income. The dotted line (AOR = 1) indicates no effect.