Prevalence and Factors Related to Stress and Depression Among Students at Nakhon Si Thammarat Rajabhat University

Abstract

Depression and stress are prevalent mental health challenges among university students worldwide, particularly during the critical transition from adolescence to adulthood. This cross-sectional descriptive study aimed to examine stress levels, the prevalence of depression, associated factors, and predictors of depression among undergraduates at Nakhon Si Thammarat Rajabhat University (NSTRU). A proportional stratified random sample of 367 students in Years 1–4 (Semester 1, Academic Year 2024) was recruited. Data were collected using a 107-item, six-part questionnaire encompassing demographic characteristics, a multidimensional Stress Perception Scale, the SPS-T (20-item), the 2-Question Depression Screener (2Q), the 9-Question Depression Inventory (9Q), and the 8-Question Suicidality Assessment (8Q). Content validity (IOC > 0.5) and reliability (Cronbach’s α ≥ 0.78) were confirmed. Data were analyzed using descriptive statistics, Pearson’s correlation, and multiple regression. Most students reported low stress (55.59%) and screened negative for depression (71.37%); however, 28.63% were at risk of depression. Among the 105 screen-positive students subsequently assessed with the 9Q, 30.48% were classified as mild and 10.47% as moderate depression (equivalent to 8.7% and 3.0% of the full sample, respectively). Among students with mild-to-moderate depression (n = 43), 23.25% showed suicidal tendency. Religion was the only personal factor significantly related to stress. GPA, religion, and parental marital status were significantly associated with depression. All seven external factor domains (family, interpersonal relationships, academic, personality, health, financial, and environment) correlated significantly with both stress and depression. Multiple regression revealed that environmental, personality, family, GPA, and parental marital status collectively predicted 14.60% of depression variance (Adjusted R² = 0.117). Compared with middle-aged rural Thai populations in which occupational, health, and family stressors predominate, university students exhibited distinctly different stress source profiles, underscoring the need for age-group-specific mental health interventions. These findings highlight the importance of systematic, multi-component mental health programs within higher education institutions.