Anxiety and depression and its correlates among undergraduate medical students in Nepal: A cross-sectional study

Mental health problems like anxiety and depression among medical students are increasing. The academic stress, hectic duty, lack of personal and social life, financial hardship, etc., make them more vulnerable to poor mental health outcomes. This study aimed to determine the prevalence of anxiety and depression and their correlates among undergraduate medical students in Nepal. A web-based cross-sectional study was conducted in 2023 among 579 undergraduate MBBS and BDS students (≥18 years) enrolled in medical colleges under Tribhuvan University, Kathmandu University, Patan Academy of Health Sciences, and BP Koirala Institute of Health Sciences, Nepal. Symptoms of anxiety and depression were assessed using the validated Nepali version of the Hospital Anxiety and Depression Scale (HADS). Univariate analysis was carried out using frequency, percentage, mean, and standard deviation. Associations were examined using the chi-square test, followed by multivariate binary logistic regression. Statistical significance was set at p < 0.05 with a 95% confidence interval. The mean age of the participants was 21.0 ± 2.2 years and 53.7% were male. The prevalence of anxiety and depressive symptoms was 46.3% and 43.7%, respectively. Anxiety was significantly associated with female sex (AOR = 0.69, 95% CI: 0.49-0.98), Brahmin/Chhetri ethnic group (AOR = 0.64, 95% CI: 0.45-0.91), and presence of any disease (AOR = 8.51, 95% CI: 1.88-38.48). Depression was significantly associated with younger age (AOR = 1.96, 95% CI: 1.10-3.49), Brahmin/Chhetri ethnic group (AOR = 0.54, 95% CI: 0.38-0.78), father's formal employment (AOR = 1.62, 95% CI: 1.13-2.33), being fourth year student (AOR = 3.25, 95% CI: 1.49-7.08) and daily consumption of green leafy vegetables (AOR = 0.66, 95% CI: 0.46-0.94). A high prevalence of anxiety and depressive symptoms was observed among undergraduate medical students in Nepal. These findings highlight the need for supportive academic environments and lifestyle-focused interventions to improve student well-being and strengthen the future healthcare workforce.