ORIGINAL RESEARCH
Public Health
doi: 10.25005/2074-0581-2026-28-3-649-663
PREVALENCE OF DEPRESSION, ANXIETY, STRESS AND COPING MECHANISM AMONG UNDERGRADUATE STUDENTS

D.P. NGADAN1, P.P. PAULINUS1, W.M.H. WAN ABDUL RAHIM1, S. DURASAMY1, M.M. NUR AMIRYA1, M. KAPITONOVA1,2

1Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia
2Volgograd State Medical University, Volgograd, Russian Federation

Objective: This study aimed to determine the prevalence of depression, anxiety and stress among undergraduate students at Universiti Malaysia Sarawak (UNIMAS) and to identify coping mechanisms associated with psychological distress.

Methods: A cross-sectional study was conducted among 395 undergraduate students from seven faculties at Universiti Malaysia Sarawak. Data were collected using a structured online questionnaire comprising sociodemographic characteristics, the Depression Anxiety Stress Scale-21 (DASS-21), and the Brief COPE Inventory. Data were analysed using descriptive statistics, independent sample t-tests and Pearson correlation analysis. Statistical significance was set at p<0.05.

Results: Among 395 respondents, anxiety was the most prevalent condition (73.2%), followed by depression (55.7%) and stress (44.6%). Extremely severe anxiety was reported by 30.9% of students. Emotion-focused coping was the most commonly utilised coping strategy (M=32.0, SD=8.0), followed by avoidant coping and problem-focused coping. Significant positive correlations were observed between avoidant coping and depression (r=0.623), anxiety (r=0.625), and stress (r=0.633) (p<0.01). Students aged 23-27 years demonstrated significantly higher depression (p=0.007) and stress scores (p=0.003) than younger students.

Conclusion: Psychological distress is highly prevalent among undergraduate students, with anxiety representing the dominant mental health concern. Although adaptive coping strategies were commonly reported, avoidant coping showed a strong association with depression, anxiety and stress. Universitybased interventions focusing on early detection, resilience-building and adaptive coping skills are necessary to reduce the burden of psychological distress among students.

Keywords: Depression, anxiety, stress, coping mechanisms, undergraduate students, DASS-21, Brief COPE.

Download file:

References
  1. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858. https://doi.org:10.1016/S0140-6736(18)32279-7
  2. Roy S, Biswas AK, Sharma M. Stress, anxiety, and depression as psychological distress among college and undergraduate students: A scoping review of reviews guided by the socio-ecological model. Healthcare (Basel). 2025;13(16):1948. https://doi.org:10.3390/healthcare13161948
  3. Barbayannis G, Bandari M, Zheng X, Baquerizo H, Pecor KW, Ming X. Academic stress and mental well-being in college students: Correlations, affected groups, and COVID-19. Front Psychol. 2022;13:886344. https://doi.org:10.3389/ fpsyg.2022.886344
  4. Chong LZ, Foo LK, Chua SL. Student burnout: A review on factors contributing to burnout across different student populations. Behav Sci (Basel). 2025;15(2):170. https://doi.org:10.3390/bs15020170
  5. Dessauvagie AS, Dang HM, Nguyen TAT, Groen G. Mental health of university students in Southeastern Asia: A systematic review. Asia Pac J Public Health. 2022;34(2-3):172-81. https://doi.org:10.1177/10105395211055545
  6. Arifin S. Depression, anxiety, and stress levels among Malaysian university students. Malays J Med Health Sci. 2023;19(Suppl 1):62-9.
  7. Mohd Azlan S, Mohamad F, Dahlan R, Ismail IZ, Shahar HK, Kamaruddin KN, et al. Self-system and mental health status among Malaysian youth attending higher educational institutions: A nationwide cross-sectional study. Malays Fam Physician. 2024;19:12. https://doi.org:10.51866/oa.341
  8. Asif S, Muddassar A, Shahzad TZ, Raouf M, Pervaiz T. Frequency of depression, anxiety and stress among university students. Pak J Med Sci. 2020;36(5):971-6. https://doi.org:10.12669/pjms.36.5.1873
  9. Fauzi MF, Anuar TS, Teh LK, Lim WF, James RJ, Ahmad R, et al. Stress, anxiety and depression among a cohort of health sciences undergraduate students: The prevalence and risk factors. Int J Environ Res Public Health. 2021;18(6):3269. https://doi.org:10.3390/ijerph18063269
  10. Carver CS. You want to measure coping but your protocol's too long: Consider the Brief COPE. Int J Behav Med. 1997;4(1):92-100. https://doi.org:10.1207/ s15327558ijbm0401_6
  11. Crego A, Carrillo-Diaz M, Armfield JM, Romero M. Stress and academic performance in dental students: The role of coping strategies and examinationrelated self-efficacy. J Dent Educ. 2016;80(2):165-72.
  12. Freire C, Ferradás MDM, Regueiro B, Rodríguez S, Valle A, Núñez JC. Coping strategies and self-efficacy in university students: A person-centered approach. Front Psychol. 2020;11:841. https://doi.org:10.3389/fpsyg.2020.00841
  13. Thiyagarajan A, James TG, Marzo RR. Psychometric properties of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) among Malaysians during COVID-19: A methodological study. Humanit Soc Sci Commun. 2022;9(1):220. https://doi.org:10.1057/s41599-022-01229-x
  14. Waterhouse P, Samra R. University students' coping strategies to manage stress: A scoping review. Educ Rev. 2025;77(2):1-41. https://doi.org:10.1080/00131911 .2024.2438888
  15. Wong SS, Wong CC, Ng KW, Bostanudin MF, Tan SF. Depression, anxiety, and stress among university students in Selangor, Malaysia during COVID-19 pandemics and their associated factors. PLoS One. 2023;18(1):280680. https:// doi.org:10.1371/journal.pone.0280680
  16. Das P, Krishnan PK. Cross sectional study: Stress, depression, anxiety and coping styles among Malaysian university students. J Health Transl Med. 2022;25(1):242- 50. https://doi.org:10.22452/jummec.vol25no1.25
  17. Arifin S, Abdullah SS, Omar NE. The prevalence of mental health among Malaysian university students. Int J Acad Res Bus Soc Sci. 2023;13(12):1-15. https://doi.org:10.6007/IJARBSS/v13-i12/19796
  18. Mohd Idrus IA, Robinson F. Factors associated with stress, anxiety, and depression among first-year undergraduate students at Universiti Malaysia Sabah. Malays J Public Health Med. 2024;24(3). https://doi.org:10.37268/mjphm/vol.24/no.3/ art.2596
  19. Mustafa SMS, Hamzah LM, Alias NF. Stress coping strategies among university students in Malaysia. Int J Acad Res Progress Educ Dev. 2023;12(3):3317-30. https://doi.org:10.6007/IJARPED/v12-i3/19176
  20. Abdul Halim B, Fuzi SF, Jama SR. Depression, anxiety, stress and its association with coping strategies among Malaysian university students. Inf Manag Bus Rev. 2024;16(4):1-15. https://doi.org:10.22610/imbr.v16i4(S)I.4308
  21. Deasy C, Coughlan B, Pironom J, Jourdan D, Mannix-McNamara P. Psychological distress and coping amongst higher education students: A mixed method enquiry. PLoS One. 2014;9(12):115193. https://doi.org:10.1371/journal.pone.0115193
  22. Ruiz-Camacho C, Gozalo M, Sánchez-Casado I. The mediating role of active coping strategies in the relationship between academic stressors and stress responses among university students. Healthcare (Basel). 2025;13(14):1674. https://doi.org:10.3390/healthcare13141674
  23. Auerbach RP, Alonso J, Axinn WG. Mental disorders among college students in the WHO World Mental Health Surveys. Psychol Med. 2016;46(14):2955-70. https://doi.org:10.1017/S0033291716001665
  24. Karyotaki E, Cuijpers P, Albor Y. Sources of stress and their associations with mental disorders among college students: Results of the World Health Organization World Mental Health International College Student Initiative. Front Psychol. 2020;11:1759. https://doi.org:10.3389/fpsyg.2020.01759

Authors' information:

Deburra Peak Ngadan,
MD, MPH, DrPH, Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS)
Researcher ID: IYS-1112-2023
Scopus ID: 56111985600
ORCID ID: 0009-0001-4270-6090
E-mail: pndeburra@unimas.my

Priska Petrus Paulinus,
Graduate Student, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS)
ORCID ID: 0009-0009-7523-8527
E-mail: 106063@siswa.unimas.my

Wan Mohamad Hafizuddin Bin Wan Abd Rahim,
Graduate Student, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS)
ORCID ID: 0009-0006-5054-7559
E-mail: 103016@siswa.unimas.my

Shranya Durasamy,
Graduate Student, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS)
ORCID ID: 0009-0009-3925-3447
E-mail: 106328@siswa.unimas.my Nur Amirya Binti Marc Masdzlan,
Graduate Student, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS)
ORCID ID: 0009-0001-0319-2648
E-mail: 102823@siswa.unimas.my

Marina Kapitonova,
MD, PhD, Full Professor, Professor of Anatomy, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS); Professor of the Department of Histology, Embryology, Cytology, Volgograd State Medical University
Researcher ID: 8854275100
ORCID ID: 0000-0001-6055-3123
E-mail: kmarina@unimas.my

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Marina Kapitonova,
MD, PhD Full Professor, Professor of Anatomy, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS); Professor of the Department of Histology, Embryology, Cytology, Volgograd State Medical University

94300, Malaysia, Sarawak, Kota Samarahan, Faculty of Medicine and Health

Sciences, Universiti Malaysia Sarawak, UNIMAS campus

Tel.: +60 (176) 243699

E-mail: kmarina@unimas.my


This work is licensed under a Creative Commons Attribution 4.0 International License.

Materials on the topic:
  1. ANALYTICAL ASSESSMENT OF HEALTHCARE SERVICE DELIVERY INDICATORS IN THE REPUBLIC OF TAJIKISTAN
  2. FACTORS INFLUENCING DECISION-MAKING IN NURSING PRACTICE IN THE REPUBLIC OF KAZAKHSTAN
  3. PREVALENCE OF SOCIAL MEDIA ADDICTION AND ITS ASSOCIATED FACTORS AMONG UNDERGRADUATE STUDENTS AT UNIVERSITI MALAYSIA SARAWAK (UNIMAS), SARAWAK
  4. PSYCHOLOGICAL IMPACTS ON EMERGENCY MEDICAL SERVICES PERSONNEL PERFORMANCE AND PRODUCTIVITY
  5. SURVEY ON MEDICAL, DEMOGRAPHIC, AND SOCIOECONOMIC INDICATORS IN TAJIKISTAN
  6. THE EFFECTIVENESS OF DECENTRALIZED MEDICAL CARE AND INTEGRATION OF HIV SERVICES IN PRIMARY HEALTHCARE FOR PEOPLE LIVING WITH HIV IN DUSHANBE, REPUBLIC OF TAJIKISTAN
  7. INTRODUCING A QUALITY MANAGEMENT SYSTEM IN A MEDICAL ORGANIZATION: SWOT ANALYSIS
  8. INTRODUCTION OF HIV SERVICES IN THE TAJIKISTAN'S PRIMARY HEALTH CARE INSTITUTIONS: DUSHANBE EXPERIENCE, CURRENT RESULTS, AND PROSPECTS FOR FURTHER DEVELOPMENT
  9. MEDICAL AND SOCIAL APPROACHES TO ENSURE EARLY DIAGNOSIS AND PREVENTION OF ALLERGIC RHINITIS AT THE REGIONAL LEVEL
  10. QUALITY MANAGEMENT SYSTEM IN A HEALTHCARE ORGANISATION: FROM BASICS TO OPERATING MODEL

◄ Back to the list