Associations among stress, anxiety, and depression in postgraduate dental students: a cross-sectional study

Postgraduate dental education is a demanding process characterized by increased clinical responsibility and academic expectations. While psychological distress among undergraduate dental students has been widely studied, evidence regarding postgraduate populations remains limited. This study aimed to assess levels of stress, anxiety, and depression among postgraduate dental students and to examine their associations with sociodemographic factors.

A cross-sectional observational study was conducted among 192 postgraduate dental students. Data were collected using a demographic questionnaire and the Depression Anxiety Stress Scale-21 (DASS-21). Subscale scores were multiplied by two for comparability with standard severity classifications. Statistical analyses included Cronbach's alpha, Pearson correlation, and linear regression. Multiple regression models were used to assess associations between psychological variables and sociodemographic factors. Group comparisons were performed using t-tests and one-way ANOVA with Scheffé post hoc tests.

Significant positive associations were observed among stress, anxiety, and depression (p < .001). In multiple regression analysis, stress (β = 0.543, p < .001) and anxiety (β = 0.317, p < .001) were significantly associated with depression, accounting for a substantial proportion of the observed variance (R² = 0.696). Participants with "normal" perceived financial status tended to show higher distress levels than those with "good" status, although this association did not reach statistical significance in multivariable analysis. No significant differences were found for training year, specialty, residence, or smoking status. The majority of participants were classified within the normal range across all DASS-21 subscales.

Stress, anxiety, and depression are closely interrelated among postgraduate dental trainees. Psychological distress appears to be associated with individual and perceived contextual factors; however, these associations were not consistently supported in the multivariable model and should therefore be interpreted with caution.