Prevalence and associated factors of depression, anxiety and stress among Malaysian adults: An analysis from One Health perspective

Abstract

Objective: To determine the prevalence of, and identify the factors associated with, depression, anxiety, and stress (DAS), separately among Malaysian adults.
Methods: An online based cross-sectional study was conducted among Malaysian adults from January to March 2021 comprising 499 participants. The SPSS software was utilized in data analysis. Chi-squared test of association and multiple logistic regression with a backward deletion strategy were performed to identify the factors associated with DAS, separately.
Results: The prevalence (95%CI) of DAS were 49.7% (45.2%, 54.2%), 49.3% (44.8%, 53.8%), and 24.5% (20.7%, 28.5%), respectively. Based on the results of multiple logistic regression analysis, there was significant interrelationship of DAS among respondents. Depression was significantly associated with anxiety [OR_adj (95%CI):13.8 (8.3, 23.0)] and stress [OR_adj (95%CI): 15.3 (5.8, 40.7)]. Anxiety was significantly associated with depression [OR_adj (95%CI): 12.3 (7.6, 20.1)] and stress [OR_adj (95%CI): 8.6 (3.6, 20.2)]. Stress was significantly associated with depression [OR_adj (95%CI): 12.7 (5.2, 31.4)] and anxiety [OR_adj (95%CI): 7.8 (3.4, 17.9)]. Additionally, age group of the respondents was significantly associated with anxiety. However, residence and marital status of the respondents were found to have significant association with stress.
Conclusions: DAS are highly prevalent among Malaysian adults. Appropriate community-based interventions should be undertaken in order to improve the mental health status, especially among youths, urban dwellers, and singles (or) unmarried persons. Further prospective studies should also be conducted to assess the directions of such disorders.

Keywords

Anxiety / Depression / Stress / Malaysian adults / Malaysia

Conflict of interest statement

The authors claim there is no conflict of interest.

Acknowledgements

The authors are very grateful to the respondents for their voluntary participation and the members of institutional ethical committee, AIMST University, Malaysia for their ethical approval.

Funding

The study receives no extramural funding.

Data availability statement

The data supporting the findings of this study are available from the corresponding author upon request.

Authors’ contributions

Maung TM, and Oo WM conceptualized and developed the study design, reviewed the literatures, analysed and interpreted the results of data analysis and writing the manuscript. Swa K and Win PTN took part in proposal development, led the data collection and data entry, took part in data analysis and interpretation, manuscript preparation and review. All read and approved the final version of manuscript.

References

[1] World Health Organization. World mental health report: Transforming mental health for all. [Online] Available from: https://www.who.int/publications/i/item/9789240049338. [Accessed on 30 March 2023].

[2] World Health Organization. Comprehensive mental health action plan 2013-2030. [Online] Available from: https://iris.who.int/bitstream/handle/10665/345301/9789240031029-eng.pdf. [Accessed on 30 March 2023].

[3] World Health Organization. Mental health: Strengthening our responses. [Online] Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response. [Accessed on 26 December 2022].

[4] United Nations: Department of Economic and Social Affairs. Mental health and development. [Online] Available from: https://www.un.org/development/desa/disabilities/issues/mental-health-and-development.html. [Accessed on 18 December 2022].

[5] Raaj S, Navanathan S, Tharmaselan M, Lally J. Mental disorders in Malaysia: An increase in lifetime prevalence. BJPsych International 2021; 18(4): 97-99.

[6] Young KS. Internet addiction: The emergence of a new clinical disorder. Cyber Psychol Behav 1998; 1(3): 237-244.

[7] Johansson A, Götestam KG. Internet addiction: Characteristics of a questionnaire and prevalence in Norwegian youth (12-18 years). Scand J Psychol 2004; 45: 223-229.

[8] Psychology Tools. Binge Eating Scale (BES). [Online] Available from: https://psychology-tools.com/test/binge-eating-scale. [Accessed on 28 December 2022].

[9] Escrivá-Martínez T, Galiana L, Rodríguez-Arias M, Baños RM. The Binge Eating Scale: Structural equation competitive models, invariance measurement between sexes, and relationships with food addiction, impulsivity, binge drinking, and body mass index. Front Psychol 2019; 10: 530.

[10] Musa R. Malaysian DASS21 Questionnaire. [Online] Available from: http://www2.psy.unsw.edu.au/dass/Malaysian/DASS21_BahasaMalaysia_Musa.doc. [Accessed on 18 December 2022].

[11] Motor Accident Insurance Commission. DASS21 questionnaire. [Online] Available from: https://maic.qld.gov.au/wp-content/uploads/2016/07/DASS-21.pdf. [Accessed on 19 December 2022].

[12] Musa R, Fadzil MA, Zain Z. Translation, validation and psychometric properties of Bahasa Malaysia version of the Depression Anxiety and Stress Scales (DASS). ASEAN J Psychiatry 2007; 8(2): 82-89.

[13] Mohd Tamrin SB, Yokoyama K, Jalaludin J, Aziz NA, Jemoin N, Nordin R. et al. The association between risk factors and low back pain among commercial vehicle drivers in Peninsular Malaysia: A preliminary result. Ind Health 2007; 45(5): 268-278.

[14] Lugova H, Andoy-Galvan JA, Patil SS, Wong YH, Baloch GM, Suleiman A. et al. Prevalence and associated factors of the severity of Depression, Anxiety and Stress among low-income community-dwelling adults in Kuala Lumpur, Malaysia. Community Ment Health J 2021; 57(2): 1489-1498.

[15] Amu H, Osei E, Kofie P, Owusu R, Bosoka SA, Konlan KD. et al. Prevalence and predictors of depression, anxiety, and stress among adults in Ghana: A community-based cross-sectional study. PLoS ONE 2021; 16(10): e0258105.

[16] Marzo RR, Vinay V, Bahari R, Chauhan S, Ming DAF, Fernandez S. et al. Depression and anxiety in Malaysian population during third wave of the COVID-19 pandemic. Clin Epidemiol Glob Health 2021; 12: 100868.

[17] World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. [Online] Available from: https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide. [Accessed on 24 December 2022].

[18] Singh M, Goel NK, Sharma MK, Bakshi RK. Prevalence of depression, anxiety and stress among students of Punjab University, Chandigarh. Natl J Community Med 2017; 8(11): 666-671.

[19] ScienceDaily. Biological link between stress, anxiety and depression identified. [Online] Available from: https://www.sciencedaily.com/releases/2010/04/100411143348.htm. [Accessed on 10 January 2023].

[20] Mirzaei M, Ardekani SMY, Mirzaei M, Dehghani A. Prevalence of Depression, Anxiety and Stress among Adult Population: Results of Yazd Health Study. Iran J Psychiatry 2019; 14(2): 137-146.

[21] Zin Aris AZ, Othman SZ. Mental health issues and help-seeking behaviour among Malaysian academics: A preliminary study. Jurnal Pembangunan Sosial 2022; 25(7): 101-119.

[22] Ismail F, Owaida NI. Depression at workplaces: The factors that influencing and how to overcome the issues. JTS (Journal Techno-Social) 2023; 15(2): 1-17.

[23] Mud ShukriID MI, Minhat HS, Ahmad N, Ismail F, Kanthavelu C, Nurfarahin D. et al. Prevalence and factors associated with depression, anxiety and stress in Malaysia during COVID-19 pandemic: A systematic review. PLoS ONE 2023; 18(7): e0288618.

[24] Wong LP, Alias H, Md Fuzi AA, Omar IS, Mohamad Nor A, Tan MP. et al. Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey. PLoS ONE 2021; 16(3): e0248916.