Prevalence and correlates of depression, anxiety, stress and suicidal ideation among allied health students in the College of Medicine, University of Lagos: a cross sectional study

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Ogunlewe, Olumide A. Noah, Adekemi O. Sekoni This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7802908/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Depression, anxiety, stress, and suicidal ideation are increasingly recognized as major public health concerns among university students, particularly those in health-related fields. Psychological distress and suicidal ideation are increasingly prevalent, particularly among young adults. These concerns are more pressing in low- and middle-income countries, where mental health resources are limited. This study assessed the prevalence of depression, anxiety, stress and suicidal ideation and their associations with sociodemographic factors among allied health students at the College of Medicine, University of Lagos. Methods A cross-sectional, institution-based study was conducted among 200 randomly selected allied health students. Data were collected using a structured online questionnaire comprising the Undergraduate Sources of Stress (USOS) tool, the 21-item Depression, Anxiety, and Stress Scale (DASS-21), and an adapted suicidal ideation item from the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics were used to estimate prevalence, while Pearson’s Chi-square test and correlation analyses assessed associations between variables. Results The prevalence of depression, anxiety, and stress (mild to extremely severe forms) was 51.5%, 60.5%, and 37.5%, respectively. Suicidal ideation was reported by 28.5% of respondents. Depression, anxiety, and stress were strongly and positively correlated (p < 0.001), while suicidal ideation demonstrated a moderate but significant correlation with depression (r = 0.579, p < 0.001). Off-campus residence was significantly associated with higher depression and anxiety, nursing students reported greater stress, and students uncertain about their sexual orientation were more likely to experience suicidal ideation, while no significant associations were observed for age, gender, or religion. Conclusion The high prevalence of mental health issues among allied health students, particularly anxiety, underscores a critical public health concern. Significant associations with residence, program of study, and sexual orientation point to the necessity for context-specific and inclusive mental health interventions within Nigerian universities to enhance student wellbeing and optimize academic outcomes. Mental health Stress Anxiety Depression Suicidal ideation Allied health students Figures Figure 1 INTRODUCTION According to the World Health Organisation (WHO), stress is defined as “a state of worry or mental tension caused by a difficult situation” [ 1 ]. Several studies have reported an association between elevated stress levels and the onset of various mental health disorders, including anxiety, depression, and suicidal ideation [ 2 , 3 , 4 ]. The American Psychological Association (APA) defines anxiety as an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure [ 5 ]. The WHO describes depression as involving a depressed mood or loss of pleasure or interest in activities for long periods of time [ 6 ]. Suicidal ideation is a broad term used to describe a range of contemplations, wishes, and preoccupations with death and suicide [ 7 ]. Stressors may arise from major life transitions or daily hassles such as academic demands, financial burdens, or interpersonal conflicts [ 8 , 9 ]. Moreover, factors like social isolation, insufficient sleep, maladaptive coping, and personality traits such as neuroticism and perfectionism can intensify an individual's stress response [ 10 , 11 , 12 , 13 ]. Chronic stress, marked by prolonged physiological and psychological activation, has been linked to cognitive impairments, decreased academic and work performance, and long-term mental and physical health consequences [ 14 , 15 ]. The WHO categorizes youth as individuals aged 15–24, a group especially vulnerable to stress-related disorders due to ongoing biological, psychological, and social transitions [ 16 , 17 ]. Globally, research has consistently documented the high prevalence of stress, anxiety, and depression among university students, particularly those in healthcare fields such as medicine and allied health. [ 18 , 19 , 20 , 21 ]. These students frequently face pressures from academic workloads, clinical responsibilities, and personal challenges. The global prevalence of stress has been estimated by multiple studies at approximately 25.18%, though higher rates have been documented in specific regions [ 22 , 23 , 24 ]. Depression affects about 4% of the global population and disproportionately impacts women, with prevalence rates in Africa (including Nigeria) ranging between 3.9% and 9% [ 6 , 25 , 26 ]. Anxiety disorders affect over 301 million people worldwide, with prevalence and disability burden varying by region; Nigeria reports rates of 2.7% nationally and 3.5% in Lagos [ 26 , 27 , 28 ]. Suicide remains the fourth leading cause of death among youth aged 15–29, with over 700,000 global deaths annually, 77% of which occur in low- and middle-income countries [ 29 ]. In Nigeria, the suicide rate is estimated at 17.3 per 100,000 [ 30 ]. Despite growing awareness of mental health issues among medical students, research focusing on allied health students remains limited. Yet, these students are critical to the healthcare workforce and experience significant academic, emotional, and clinical stressors [ 31 ]. The limited literature available suggests a high prevalence of mental health challenges within this group [ 21 ]. This study aims to assess the prevalence of stress, anxiety, depression, and suicidal ideation, and their association with socio-demographic factors among allied health students at the College of Medicine, University of Lagos. METHODS STUDY AREA, DESIGN AND PERIOD A cross-sectional, institution-based study was conducted between August and September 2024 to assess the mental health status of allied health students at the College of Medicine, University of Lagos (CMUL). It is located in Idi-Araba within the Ikeja division of Lagos State, CMUL shares its premises with the Lagos University Teaching Hospital (LUTH). The college comprises three faculties (clinical sciences, basic medical sciences, and dental sciences) and offers nine undergraduate programmes. Of these, seven are allied health courses: physiology, medical laboratory science, pharmacy, pharmacology, radiography, nursing science, and physiotherapy [ 32 ]. STUDY POPULATION This study was conducted among allied health students at the College of Medicine, University of Lagos (CMUL) in the 2023/2024 academic session. INCLUSION CRITERIA All full-time undergraduate students who had completed at least one semester at the CMUL were included in the study. EXCLUSION CRITERIA Participants who did not provide electronic informed consent, were ill, or unable to communicate during data collection were excluded. Participants who did not confirm their studentship via their student ID were excluded. SAMPLE SIZE ESTIMATION The minimum sample size was estimated using Cochran’s formula for the calculation of sample size for a cross-sectional study. $$\:n\:=\:\frac{{Z}^{2}pq}{{d}^{2}}$$ where n = minimum sample size Z = the Z-score based on a 95% confidence level: 1.96 p = 85.6% (0.856), The prevalence of anxiety as adapted from a study on the prevalence of psychological symptoms and their correlates carried out among physiotherapy students in Nigeria [ 21 ]. q = 1 - p = 1–0.856 = 0.144 d = acceptable margin of error, (5%) = 0.05 $$\:n\:=\:\frac{{1.96}^{2}\:\times\:0.856\:\times\:0.144}{{0.05}^{2}}$$ n = 189.4 Then, to correct for a total target population below 10,000 in this study and calculate the final sample size (n f ), the formula used will be: n f = \(\:\frac{n}{1\:+\:\frac{n\:-\:1}{N}}\) where, n = sample size when N is greater than 10,000 = 189.4 N = total target population size: 282 (MLS) + 142 (Nursing science) + 237 (Physiotherapy) + 187 (Radiography) = 848 n f = \(\:\frac{189.4}{1\:+\left(\frac{189.4\:-1}{894}\right)}\) n f = 156 Therefore, the minimum sample size is 156. A final sample size of 200 allied health students was employed, based on considerations of the expected variability in stress, anxiety, depression, and suicidal ideation scores, as well as the need to ensure sufficient statistical power to detect meaningful associations. SAMPLING TECHNIQUE The study employed a multistage sampling technique to select participants from allied health programs at the College of Medicine, University of Lagos. The process involved three stages. In the first stage, four out of seven allied health departments (Medical Laboratory Science, Nursing Science, Physiotherapy, and Radiography) were selected through simple random sampling via balloting. Each selected department was treated as a distinct stratum for the second stage, where two years of study within each department were randomly chosen, again by balloting. This approach was adopted for its efficiency and to account for the relatively homogeneous nature of students within each department. In the third stage, the number of respondents from each selected year group was determined using proportional sampling, based on the population size of each program. Sample weights were calculated by dividing the number of students in each department by the total allied health student population, then multiplying the result by the target sample size of 200. Each department’s sample was split evenly between its two selected year groups. Students within each designated group were selected via simple random sampling using computer-generated random numbers. Comprehensive class lists were obtained in collaboration with the Medical Student Associations and departmental student body presidents. Each student was assigned a unique number, and selected individuals were contacted privately and provided a link to the anonymous online questionnaire. To preserve the integrity of the sampling, once selected, students were removed from the pool to avoid duplication. If a student declined to participate, a replacement was randomly selected from the same stratum, maintaining the intended sample size and representativeness. DATA COLLECTION TOOLS AND TECHNIQUES This study employed a structured, self-administered questionnaire delivered electronically via an online survey platform (Google Forms). The questionnaire was developed based on validated instruments used in prior research [ 33 , 34 , 35 ]. A pilot test (n = 30) confirmed the reliability of the study instrument, with Cronbach’s α values of 0.84 for the stress scale, 0.87 for the anxiety scale, 0.85 for the depression scale, and 0.81 for the suicidal ideation scale. The questionnaire had 4 parts, section A to D. Section A collected basic demographic information, including age, gender identity, year of study, and program of study, to understand the characteristics of the respondents. Section B explored perceived sources of stress using an adapted version of the Undergraduate Sources of Stress (USOS) questionnaire, which has been validated among allied health students in Ghana. It contained 13 self-reported items evaluating perceived sources of stress over the past semester. Responses were rated on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("a great deal"). To identify the most significant stressors, the mean score for each item was calculated across all participants. [ 33 ]. Section C measured the prevalence of stress, anxiety, and depression using the Depression, Anxiety, and Stress Scale (DASS-21), a validated 21-item instrument comprising three subscales, each assessing symptoms related to depression, anxiety, and stress. Participants rated how often they experienced each symptom in the past week using a 4-point Likert scale (0 = "did not apply to me at all" to 3 = "applied to me very much or most of the time"). Subscale scores ranged from 0 to 21, which were then doubled (following the tool developers' guidance) to yield final scores ranging from 0 to 42 for each emotional state [ 34 ]. Section D assessed suicidal ideation using an adapted item from the Patient Health Questionnaire-9 (PHQ-9). Respondents indicated how often they had thoughts of self-harm or that they would be better off dead over the past two weeks, using a scale from 0 ("not at all") to 3 ("nearly every day"). Any response greater than zero was classified as indicative of suicidal ideation [ 35 ]. Data collection was conducted anonymously via a Google Forms link shared individually with selected participants. DATA MANAGEMENT AND ANALYSIS After collecting all the data, it was exported from Google Forms to Microsoft Excel and then imported into the Statistical Package for the Social Sciences (SPSS) version 22 for Windows. Descriptive statistics was employed to summarise the collected data. This involved calculating frequencies, percentages, and measures of central tendency (median) and dispersion (interquartile ranges) for continuous variables. Additionally, categorical variables were presented using frequencies and tables. The Pearson’s Chi-squared test was employed to evaluate potential associations between categorical variables and levels of stress or mental health. A significance threshold of alpha (α) = 0.05 was adopted, whereby a p-value less than 0.05 was deemed statistically significant. RESULTS Socio-demographic Characteristics A total of 450 respondents completed the questionnaire of which 149 (74.5%) identified as cis female and 51 (25.5%) identified as cis male, with a mean age of 21.4 ± 2.4 years. The sample was fairly distributed across the four allied health programmes. Radiography had the highest representation (30.5%), followed by Medical Laboratory Science (28.0%). Nearly half of the respondents (44.5%) were in their 500 level (fifth year). Almost all respondents were single (99.5%). Living arrangements were mainly on-campus (81.0%). Sociodemographic characteristics of the respondents are shown in Table 1 . Table 1 Sociodemographic characteristics of the respondents Socio-demographics variables Frequency (n = 200) Percentage (%) Age Category (Years) 21–23 95 47.5 18–20 74 37.0 24–25 31 15.5 Mean age ± SD: 21.4 ± 2.4 Gender Identity Cis woman (assigned female at birth, currently identifies as female) 149 74.5 Cis man (assigned male at birth, currently identifies as male) 51 25.5 Sexual Orientation Heterosexual/Straight 188 94.0 Questioning (not sure of sexual orientation) 8 4.0 Bisexual female 4 2.0 Programme of Study Radiography 61 30.5 MLS 56 28.0 Physiotherapy 47 23.5 Nursing sciences 36 18.0 Level of Study 500L 89 44.5 400L 58 29.0 300L 27 13.5 200L 26 13.0 Ethnicity Yoruba 156 78.0 Others a 23 11.5 Others a : Edo, Efik, Egun, Hausa, Ibibio, Idoma, Ijaw, Tarok, Urhobo Igbo 21 10.5 Religion Christianity 149 74.5 Islam 46 23.0 Others 5 2.5 Others b : Atheism, Traditional Marital Status Single 199 99.5 Married 1 0.5 Living Arrangement On-campus 162 81.0 Off-campus alone 15 7.5 Off-campus with family 15 7.5 Off-campus with friends 7 3.5 Off-campus with spouse/partner 1 0.5 Sources of Stress Figure 1 illustrates the sources of stress among the study participants. The subscale scores are listed in descending order from the participants. "Amount of material to be learnt in the course" recorded the highest mean score (2.83), followed by "Personal Finances" (2.67). The lowest-ranked sources of stress include "Relationship with family members" (1.18) and "Relationship with partner" (0.77). Prevalence of depression, anxiety, and stress among participants. The overall prevalence of depression, anxiety, and stress showed that 48.5%, 39.5%, and 62.5% of the respondents had normal levels, respectively. Collectively, the prevalence rate ranging from mild to extremely severe forms for depression, anxiety, and stress among the students was 51.5%, 60.5%, and 37.5%, respectively. Prevalence of depression, anxiety, and stress are shown in Table 2 . Table 2 Prevalence of depression, anxiety and stress Variables Categories Number (%) Depression Normal 97 (48.5) Mild 42 (21.0) Moderate 34 (17.0) Severe 20 (10.0) Extremely severe 7 (3.5) Anxiety Normal 79 (39.5) Mild 55 (27.5) Moderate 38 (19.0) Severe 24 (12.0) Extremely severe 4 (2.0) Stress Normal 125 (62.5) Mild 47 (23.5) Moderate 15 (7.5) Severe 10 (5.0) Extremely severe 3 (1.5) Prevalence of Suicidal Ideation symptoms among participants The prevalence of suicidal ideation among participants was 28.5%, with 20.0% reporting such thoughts on several days, 5.0% on more than half the days, and 3.5% nearly every day. In contrast, 71.5% reported no suicidal ideation ( Table 3 ). Table 3 Suicidal Ideation Among Participants Variable (n = 200) Frequency Percentages (%) Thoughts that you would be better off dead or hurting dead of hurting yourself in someway Not at all 143 71.5 Several days 40 20.0 More than half the days 10 5.0 Nearly everyday 7 3.5 Associations between Stress, Anxiety, Depression and Suicidal Ideation Table 4 presents the correlation matrix, which demonstrates strong positive relationships among depression, anxiety, and stress, with all associations reaching statistical significance (p < 0.001). Depression was strongly correlated with both anxiety and stress, while anxiety also showed a strong positive correlation with stress. In addition, suicidal ideation exhibited a moderate but significant correlation with depression. Table 4 Correlation Analysis of Depression, Anxiety, Stress, and Suicidal Ideation Depression, r(p 1 ) Anxiety, r(p 1 ) Stress, r(p 1 ) Suicidal Ideation, r(p 1 ) Depression 1 0.760 ( < 0.001 ) 0.850 ( < 0.001 ) 0.579 ( < 0.001 ) Anxiety 0.760 ( < 0.001 ) 1 0.862 ( < 0.001 ) 0.477 ( < 0.001 ) Stress 0.850 ( < 0.001 ) 0.862 (< 0.001) 1 0.485 ( < 0.001 ) Suicidal Ideation 0.579 ( < 0.001 ) 0.477 ( < 0.001 ) 0.485 ( < 0.001 ) 1 r = Correlation coefficient; p = p-value; 1 T-test Associations Between Selected Sociodemographic Factors and Mental Health Outcomes Off-campus residence was significantly associated with higher rates of depression (χ² = 8.148, p = 0.047) and anxiety (χ² = 9.239, p = 0.016). Students of Nursing Sciences exhibited greater levels of stress compared with their peers (χ² = 18.859, p = 0.026); and questioning one’s sexual orientation correlated with an increased prevalence of suicidal ideation (χ² = 5.780, p = 0.036). In contrast, age, gender, and religion were not significantly associated with any of the assessed mental health outcomes. DISCUSSION The prevalence of stress among students in this study was found to be 37.5%. This finding aligns closely with similar studies in India (38.6%) [ 37 ], Nigeria (42.6%) [ 38 ], and Ethiopia (44%) [ 39 ], suggesting that a significant proportion of university students globally experience stress due to shared academic and social pressures. Higher prevalence rates reported in studies from Pakistan (63.1%) [ 40 ], Iraq (77.5%) [ 41 ], South Africa (78%) [ 42 ], and Egypt (93%) [ 43 ], may reflect differences in academic demands, socio-political conditions, cultural expectations, and availability of mental health support. Particularly in medical students, stress levels tend to be elevated due to the rigorous nature of training and heightened performance expectations. The key sources of stress among allied health students in this study were identified to be "amount of material to be learnt in the course," "personal finances," "uncertainty about expectations in the course," "time demands of the course," "intellectual demands of the course," "physical demands of the course," and “university fees." This observation aligns with findings from other studies conducted in various regions of Nigeria, where academic workload and financial strain were also reported as major stressors [ 36 , 38 , 44 , 45 ]. Comparable trends have been noted in studies from other parts of Africa, including Ghana and South Africa, where academic pressure consistently emerged as the leading source of stress among health science students [ 46 , 47 ]. International studies in Canada, Jamaica, the Netherlands, and Saudi Arabia likewise highlight academic workload, clinical responsibilities, financial difficulties, and future uncertainty as major stress contributors [ 48 , 49 , 50 , 51 ]. While there is corroboration across these studies regarding the prominence of academic stress, differences in the reported stressors, such as financial or personal stress, may be attributed to variations in socio-economic conditions, access to resources, cultural norms, and the availability of institutional support across different regions and institutions. Differences in study designs, sample sizes, and specific stress measurement criteria could also account for the observed variations in stress prevalence and contributing factors. The prevalence of anxiety among students in this study was found to be 60.5%. This aligns with findings from Bayero University, Kano (66.1%) [ 52 ] and Fayoum University, Egypt (64.3%) [ 53 ], suggesting high anxiety levels are common among allied health and medical students, likely due to similar academic demands. In contrast, lower prevalence rates were observed in institutions such as Niger Delta University (29.5%) [ 54 ] and a multi-center Nigerian study (28.1%) [ 55 ], possibly reflecting methodological differences or institutional support variations. International studies report even lower rates (e.g., 20.2% in South India [ 56 ], 19% in Pakistan [ 57 ]), though some African studies report higher rates up to 85.6% [ 21 , 58 ]. These discrepancies may reflect contextual factors such as cultural attitudes, coping strategies, and socio-economic conditions. The prevalence of depression among students in this study was determined to be 51.5%. This finding align with a cross-sectional study in Pakistan among medical students, with a reported prevalence rate of 51.46% [ 59 ]. Similarly, a study among allied health students at Bayero University, Kano, found a prevalence rate of 58.86% [ 30 ]. These results suggest a significant burden of depressive symptoms among students in health-related fields, potentially exacerbated by academic pressures and limited access to mental health resources. However, lower rates were reported in other Nigerian institutions (21.3%–22.5%) [ 57 , 59 ] and international contexts like Chile (23%) [ 60 ], highlighting potential variations in population characteristics and assessment tools. The prevalence of suicidal ideation among students in this study was found to be 28.5%, which is higher than the rates reported Bayelsa (14.8%) [ 54 ], South India (12.5%) [ 56 ], and Tanzania (11.6%) [ 61 ]. This elevated prevalence may reflect institutional or regional disparities in mental health literacy, service availability, or stigma-related underreporting in other studies. This study identified strong positive correlations between depression, anxiety, and stress, highlighting depression as an independent factor significantly associated with these conditions. Furthermore, individuals residing off-campus demonstrated a higher prevalence of depression. These findings are consistent with studies from the United States [ 62 ], Ethiopia [ 63 ], Saudi Arabia [ 64 ], and Ireland [ 65 ], which identified financial stress, extended commute times, and life events as key contributors to depressive symptoms. Suicidal ideation showed a significant correlation with depression, further validating depression as a major predictor of suicidal thoughts, as documented in prior studies [ 59 ]. Students questioning their sexual orientation reported higher rates of suicidal ideation, consistent with research highlighting the mental health vulnerabilities of sexual minorities [ 65 ]. These findings emphasize the need for inclusive and targeted mental health strategies within university settings. CONCLUSION This study highlights a substantial burden of mental health challenges among allied health students at the College of Medicine, University of Lagos, with high prevalence rates of anxiety, depression, stress, and suicidal ideation. Key stressors identified included academic pressures, financial constraints, and time management challenges, emphasizing the varied nature of stressors within this population. Strong correlations were identified among the conditions, with specific sociodemographic factors such as off-campus residence, program of study, and sexual orientation emerging as significant predictors of adverse outcomes. These findings highlight the urgent need for targeted mental health interventions, including readily accessible counseling services, comprehensive financial and academic support systems, and policies that address the distinct vulnerabilities of allied health students. Abbreviations APA - The American Psychological Association CMUL - College of Medicine, University of Lagos GBD - Global Burden of Disease LASUCOM - Lagos State University College of Medicine LUTH - Lagos University Teaching Hospital MLS - Medical Laboratory Science USOS - Undergraduate Sources of Stress WMH-ICS - World Mental Health - International College Student WHO - World Health Organization YLD - Years Lived with Disability Declarations Ethics approval and consent to participate This study was approved by the Health Research and Ethics Committee of Lagos University Teaching Hospital with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Health Research and Ethics Committee of Lagos University Teaching Hospital (ADM/DCST/HREC/APP/871). The survey was anonymous, and data confidentiality was maintained. Electronic informed consent was obtained before survey participation, and participants could withdraw from the study at any time. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding No funding. Clinical trial number Not applicable Authors’ contributions Conception of study: AOO. Data Collection: AOO, OAN. Data analysis: AOO, AOS. Writing of the first draft: AOO, OAN, AOS. Manuscript revisions: AOO, OAN, AOS. All authors read and approved the final manuscript. Acknowledgements Not applicable References World Health Organization (WHO). Stress. 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Nurs Open. 2017;5:70–6. https://doi.org/10.1002/nop2.113 Yakasai AM, Dermody G, Maharaj SS, Hassan AB, Abdullahi A, Usman JS, et al. Prevalence of psychological symptoms and their correlates among physiotherapy clinical students: A cross-sectional study. South Afr J Physiother. 2022;78:1795. https://doi.org/10.4102/sajp.v78i1.1795 Mahmud S, Mohsin M, Dewan MdN, Muyeed A. The Global Prevalence of Depression, Anxiety, Stress, and Insomnia Among General Population During COVID-19 Pandemic: A Systematic Review and Meta-analysis. Trends Psychol. 2023;31:143–70. https://doi.org/ 10.1007/s43076-021-00116-9 Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob Health. 2020;16:57. https://doi.org/10.1186/s12992-020-00589-w National Institutes of Health (NIH). 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Current prevalence, comorbidity and associated factors for symptoms of depression and generalized anxiety in the Lagos State Mental Health Survey (LSMHS), Nigeria. Compr Psychiatry. 2018;81:60–5. https://doi.org/10.1016/j.comppsych.2017.11.010 World Health Organization (WHO). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide. Accessed on May 29, 2024. World Health Organization (WHO). Suicide worldwide in 2019. Available from: https://www.who.int/publications-detail-redirect/9789240026643. Accessed on June 8, 2024. James BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:382–8. https://doi.org/10.5116/ijme.59c6.3075 University of Lagos [Internet]. Wikipedia; [cited 2025 Sep 22]. Available from: https://en.wikipedia.org/wiki/University_of_Lagos Nyante G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. J Prev Rehabil Med. 2020;2:40–6. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335–43. Adewuya AO, Ola BA, Coker OA, Atilola O, Zachariah MP, Olugbile O, et al. Prevalence and associated factors for suicidal ideation in the Lagos State Mental Health Survey, Nigeria. BJPsych Open. 2016;2:385–9. https://doi.org/10.1192/bjpo.bp.116.004333 Lunn MR, Cui W, Zack MM, Thompson WW, Blank MB, Yehia BR. Sociodemographic Characteristics and Health Outcomes Among Lesbian, Gay, and Bisexual U.S. Adults Using Healthy People 2020 Leading Health Indicators. LGBT Health. 2017;4:83–94. https://doi.org/10.1089/lgbt.2016.0087 Verma S, Nambiar V. Prevalence of Stress among Undergraduate Physiotherapy Students. Indian J Physiother Occup Ther - Int J. 2014;8:2-95. Muhammad DG, Ahmad A, Usman J. Assessment of Level and Sources of Stress Among Allied Health Sciences Students of Bayero University Kano: A Comparison Between Clinical and Pre-Clinical Students. Educ Med J. 2019;11:11–19. Asfaw H, Fekadu G, Tariku M, Oljira A. Anxiety and Stress Among Undergraduate Medical Students of Haramaya University, Eastern Ethiopia. Neuropsychiatr Dis Treat. 2021;17:13–46. https://doi.org/10.2147/ndt.s290879 Haider Z, Khan MU, Yasin A, Abbas T, Ahsan M, Rehman IU, et al. Evaluation of stress and its clinical correlation among the students of Allied Health Sciences. Adv Life Sci. 2023;9:3-14. Shawi AF, Abdullateef AN, Khedher MA, Rejab MS, Khaleel RN. Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study. Pan Afr Med J. 2018;31:96. https://doi.org/10.11604/pamj.2018.31.96.16737 Naidoo S, Van Wyk J, Higgins-Opitz S, Moodley K. An evaluation of stress in medical students at a South African university. South Afr Fam Pract. 2014;56:58–62. Ebrahim OS, Sayed HA, Rabei S, Hegazy N. Perceived stress and anxiety among medical students at Helwan University: A cross-sectional study. J Public Health Res. 2024;13:22-79. https://doi.org/10.1177/22799036241227891 Francis-Edoziuno C, Abiona M, Odetola T. Stressors and coping measures among undergraduate nursing students in western nigeria. PAN Afr Sci J. 2024;4. Okoye OC. Perceived Stress and Stressors among Undergraduate Medical Students of a Nigerian Institution. Malawi Med J. 2022;34:24–51. https://doi.org/10.4314/mmj.v34i4.4 Nyanteh G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. 2020;1:1-15 Henderson RM, Chetty O, Gurayah T. Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review. South Afr J Occup Ther. 2021;51:29–38. Lavoie-Tremblay M, Sanzone L, Aubé T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:26–71. https://doi.org/10.1177/08445621211028076 Leslie K, Brown K, Aiken J. Perceived academic-related sources of stress among graduate nursing students in a Jamaican University. Nurse Educ Pract. 2021;53:10-88. https://doi.org/10.1016/j.nepr.2021.103088 Slimmen S, Timmermans O, Mikolajczak-Degrauwe K, Oenema A. How stress-related factors affect mental wellbeing of university students A cross-sectional study to explore the associations between stressors, perceived stress, and mental wellbeing. PLOS ONE. 2022;17:27-59. https://doi.org/10.1371/journal.pone.0275925 Gazzaz ZJ, Baig M, Al Alhendi BSM, Al Suliman MMO, Al Alhendi AS, Al-Grad MSH, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ. 2018;18:1–9. https://doi.org/10.1186/s12909-018-1133-2 Awotidebe AW, Adamu GN, Ali TM, Mohammed J, Lawal IU, Lawan A. Prevalence and factors associated with symptoms of psychological distress among students of Allied Health Sciences in a Nigerian University. Philipp J Allied Health Sci. 2022;15–22. Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alex J Med. 2017;53:77–84. Chikezie U, Okoro T. Prevalence of Depression and Associated Factors among Medical Students in a Southern Nigerian University. Glob J Health Sci. 2021;13:12. James BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:2–8. https://doi.org/10.5116/ijme.59c6.3075 Arun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment? Indian J Psychol Med. 2022;44:10–26. https://doi.org/10.1177/0253717620982326 Azad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety And Depression In Medical Students Of A Private Medical College. J Ayub Med Coll Abbottabad JAMC. 2017;29:12–73. Abed HA, Abd El-Raouf MS. Stress, Anxiety, Depression Among Medical Undergraduate Students at Benha University and Their Socio-Demographic Correlates. Egypt J Hosp Med. 2021;86:27–32. Ladi-Akinyemi TW, Okpue AP, Onigbinde OA, Okafor IP, Akodu B, Odeyemi K. Depression and suicidal ideation among undergraduates in state tertiary institutions in Lagos Nigeria. PLOS ONE. 2023;18:e02. https://doi.org/10.1371/journal.pone.0284955 López RB, Navarro NM, Astorga AC. [Relationship between personality organization and the prevalence of symptoms of depression, anxiety and stress among university students in health careers in the Region of Coquimbo, Chile]. Rev Colomb Psiquiatr. 2017;46:20–38. https://doi.org/10.1016/j.rcp.2016.07.005 Mwita M, Makola AM, Beda M. Prevalence of Depression and Suicidality among Medical Students in Mwanza Tanzania: A Cross-Sectional Study. Neurol Res Surg. 2020;3(1):1-5. Hoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49–59. https://doi.org/10.1111/wvn.12415 Kebede MA, Anbessie B, Ayano G. Prevalence and predictors of depression and anxiety among medical students in Addis Ababa, Ethiopia. Int J Ment Health Syst. 2019;13:30. https://doi.org/10.1186/s13033-019-0287-6 Mirza AA, Milaat WA, Ramadan IK, Baig M, Elmorsy SA, Beyari GM, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study. Neurosciences. 2021;26:141–151. https://doi.org/10.17712/nsj.2021.2.20200127 Horgan A, Kelly P, Goodwin J, Behan L. Depressive Symptoms and Suicidal Ideation among Irish Undergraduate College Students. Issues Ment Health Nurs. 2018;39:575–584. https://doi.org/10.1080/01612840.2017.1422199 National Institutes of Health (NIH). Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387355/. Accessed on May 30, 2024. Gbadamosi IT, Henneh IT, Aluko OM, Yawson EO, Fokoua AR, Koomson A, et al. Depression in Sub-Saharan Africa. IBRO Neurosci Rep. 2022;12:309–22. https://doi.org/10.1016/j.ibneur.2022.03.005 Institute for Health Metrics and Evaluation. GBD Results. Available from: https://vizhub.healthdata.org/gbd-results. Accessed on May 30, 2024. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137–50. Adewuya AO, Atilola O, Ola BA, Coker OA, Zachariah MP, Olugbile O, et al. Current prevalence, comorbidity and associated factors for symptoms of depression and generalized anxiety in the Lagos State Mental Health Survey (LSMHS), Nigeria. Compr Psychiatry. 2018;81:60–5. https://doi.org/10.1016/j.comppsych.2017.11.010 World Health Organization (WHO). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide. Accessed on May 29, 2024. World Health Organization (WHO). Suicide worldwide in 2019. Available from: https://www.who.int/publications-detail-redirect/9789240026643. Accessed on June 8, 2024. James BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:382–8. https://doi.org/10.5116/ijme.59c6.3075 University of Lagos [Internet]. Wikipedia; [cited 2025 Sep 22]. Available from: https://en.wikipedia.org/wiki/University_of_Lagos Nyante G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. J Prev Rehabil Med. 2020;2:40–6. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335–43. Adewuya AO, Ola BA, Coker OA, Atilola O, Zachariah MP, Olugbile O, et al. Prevalence and associated factors for suicidal ideation in the Lagos State Mental Health Survey, Nigeria. BJPsych Open. 2016;2:385–9. https://doi.org/10.1192/bjpo.bp.116.004333 Lunn MR, Cui W, Zack MM, Thompson WW, Blank MB, Yehia BR. Sociodemographic Characteristics and Health Outcomes Among Lesbian, Gay, and Bisexual U.S. Adults Using Healthy People 2020 Leading Health Indicators. LGBT Health. 2017;4:83–94. https://doi.org/10.1089/lgbt.2016.0087 Verma S, Nambiar V. Prevalence of Stress among Undergraduate Physiotherapy Students. Indian J Physiother Occup Ther - Int J. 2014;8:2-95. Muhammad DG, Ahmad A, Usman J. Assessment of Level and Sources of Stress Among Allied Health Sciences Students of Bayero University Kano: A Comparison Between Clinical and Pre-Clinical Students. Educ Med J. 2019;11:11–19. Asfaw H, Fekadu G, Tariku M, Oljira A. Anxiety and Stress Among Undergraduate Medical Students of Haramaya University, Eastern Ethiopia. Neuropsychiatr Dis Treat. 2021;17:13–46. https://doi.org/10.2147/ndt.s290879 Haider Z, Khan MU, Yasin A, Abbas T, Ahsan M, Rehman IU, et al. Evaluation of stress and its clinical correlation among the students of Allied Health Sciences. Adv Life Sci. 2023;9:3-14. Shawi AF, Abdullateef AN, Khedher MA, Rejab MS, Khaleel RN. Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study. Pan Afr Med J. 2018;31:96. https://doi.org/10.11604/pamj.2018.31.96.16737 Naidoo S, Van Wyk J, Higgins-Opitz S, Moodley K. An evaluation of stress in medical students at a South African university. South Afr Fam Pract. 2014;56:58–62. Ebrahim OS, Sayed HA, Rabei S, Hegazy N. Perceived stress and anxiety among medical students at Helwan University: A cross-sectional study. J Public Health Res. 2024;13:22-79. https://doi.org/10.1177/22799036241227891 Francis-Edoziuno C, Abiona M, Odetola T. Stressors and coping measures among undergraduate nursing students in western nigeria. PAN Afr Sci J. 2024;4. Okoye OC. Perceived Stress and Stressors among Undergraduate Medical Students of a Nigerian Institution. Malawi Med J. 2022;34:24–51. https://doi.org/10.4314/mmj.v34i4.4 Nyanteh G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. 2020;1:1-15 Henderson RM, Chetty O, Gurayah T. Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review. South Afr J Occup Ther. 2021;51:29–38. Lavoie-Tremblay M, Sanzone L, Aubé T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:26–71. https://doi.org/10.1177/08445621211028076 Leslie K, Brown K, Aiken J. Perceived academic-related sources of stress among graduate nursing students in a Jamaican University. Nurse Educ Pract. 2021;53:10-88. https://doi.org/10.1016/j.nepr.2021.103088 Slimmen S, Timmermans O, Mikolajczak-Degrauwe K, Oenema A. How stress-related factors affect mental wellbeing of university students A cross-sectional study to explore the associations between stressors, perceived stress, and mental wellbeing. PLOS ONE. 2022;17:27-59. https://doi.org/10.1371/journal.pone.0275925 Gazzaz ZJ, Baig M, Al Alhendi BSM, Al Suliman MMO, Al Alhendi AS, Al-Grad MSH, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ. 2018;18:1–9. https://doi.org/10.1186/s12909-018-1133-2 Awotidebe AW, Adamu GN, Ali TM, Mohammed J, Lawal IU, Lawan A. Prevalence and factors associated with symptoms of psychological distress among students of Allied Health Sciences in a Nigerian University. Philipp J Allied Health Sci. 2022;15–22. Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alex J Med. 2017;53:77–84. Chikezie U, Okoro T. Prevalence of Depression and Associated Factors among Medical Students in a Southern Nigerian University. Glob J Health Sci. 2021;13:12. James BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:2–8. https://doi.org/10.5116/ijme.59c6.3075 Arun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment? Indian J Psychol Med. 2022;44:10–26. https://doi.org/10.1177/0253717620982326 Azad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety And Depression In Medical Students Of A Private Medical College. J Ayub Med Coll Abbottabad JAMC. 2017;29:12–73. Abed HA, Abd El-Raouf MS. Stress, Anxiety, Depression Among Medical Undergraduate Students at Benha University and Their Socio-Demographic Correlates. Egypt J Hosp Med. 2021;86:27–32. Ladi-Akinyemi TW, Okpue AP, Onigbinde OA, Okafor IP, Akodu B, Odeyemi K. Depression and suicidal ideation among undergraduates in state tertiary institutions in Lagos Nigeria. PLOS ONE. 2023;18:e02. https://doi.org/10.1371/journal.pone.0284955 López RB, Navarro NM, Astorga AC. [Relationship between personality organization and the prevalence of symptoms of depression, anxiety and stress among university students in health careers in the Region of Coquimbo, Chile]. Rev Colomb Psiquiatr. 2017;46:20–38. https://doi.org/10.1016/j.rcp.2016.07.005 Mwita M, Makola AM, Beda M. Prevalence of Depression and Suicidality among Medical Students in Mwanza Tanzania: A Cross-Sectional Study. Neurol Res Surg. 2020;3(1):1-5. Hoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49–59. https://doi.org/10.1111/wvn.12415 Kebede MA, Anbessie B, Ayano G. Prevalence and predictors of depression and anxiety among medical students in Addis Ababa, Ethiopia. Int J Ment Health Syst. 2019;13:30. https://doi.org/10.1186/s13033-019-0287-6 Mirza AA, Milaat WA, Ramadan IK, Baig M, Elmorsy SA, Beyari GM, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study. Neurosciences. 2021;26:141–151. https://doi.org/10.17712/nsj.2021.2.20200127 Horgan A, Kelly P, Goodwin J, Behan L. Depressive Symptoms and Suicidal Ideation among Irish Undergraduate College Students. Issues Ment Health Nurs. 2018;39:575–584. https://doi.org/10.1080/01612840.2017.1422199 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7802908","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":542636882,"identity":"7664a607-1015-4da3-bb71-9143c6a7a8aa","order_by":0,"name":"Adedapo O. Ogunlewe","email":"","orcid":"","institution":"University of Lagos","correspondingAuthor":false,"prefix":"","firstName":"Adedapo","middleName":"O.","lastName":"Ogunlewe","suffix":""},{"id":542636883,"identity":"bd74a01b-952e-496b-879f-ab3b6d277aff","order_by":1,"name":"Olumide A. Noah","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA70lEQVRIiWNgGAWjYHACNgaGAhCZwPjgQwWQz8zcQIQWA7AWZsMZZ0BaGInUwsCQwCbN2wZiENBizt787MEHg8PRfOzJx6R559VG87cDtfyo2IZTi2XPMXPDGQaHc9t4niVbzt12PHfGYcYGxp4zt3FqMbiRYCbNA9IikWN44+22Y7kNQC3MjG34tKR/g2rJ/yDBO+dY7nzCWnLgtjBJ8jbU5G4gqOXMmTLJGQbpIL8YG844diB3I1DLQbx+Od6+TeJDhXXu/Pbkhw8+1NTlzjt/+OCDHxW4taCDw2DyANHqgaCOFMWjYBSMglEwQgAA+G5egQI2B1oAAAAASUVORK5CYII=","orcid":"","institution":"University of Lagos","correspondingAuthor":true,"prefix":"","firstName":"Olumide","middleName":"A.","lastName":"Noah","suffix":""},{"id":542636884,"identity":"1947f40d-145d-4a22-87d6-f946376e56b2","order_by":2,"name":"Adekemi O. Sekoni","email":"","orcid":"","institution":"University of Lagos","correspondingAuthor":false,"prefix":"","firstName":"Adekemi","middleName":"O.","lastName":"Sekoni","suffix":""}],"badges":[],"createdAt":"2025-10-07 23:23:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7802908/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7802908/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95805978,"identity":"aebd0854-0828-4cff-8160-1e2e9f35ece4","added_by":"auto","created_at":"2025-11-13 08:47:11","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":290576,"visible":true,"origin":"","legend":"","description":"","filename":"OlumideA.NoahBMCPSYCHOLOGY.docx","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/f00c0314aaef9e2e69a9e982.docx"},{"id":95805801,"identity":"02d7ba96-434d-4661-a5e2-ce92ea598f92","added_by":"auto","created_at":"2025-11-13 08:46:52","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5910,"visible":true,"origin":"","legend":"","description":"","filename":"acadca6f98aa428c8736bafebcc47314.json","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/11bcbb27c66907ca0631c580.json"},{"id":95805902,"identity":"30774e97-c7b0-4ade-bfd7-f9716bf3b1da","added_by":"auto","created_at":"2025-11-13 08:47:04","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":140981,"visible":true,"origin":"","legend":"","description":"","filename":"acadca6f98aa428c8736bafebcc473141enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/44b7dae87936586e43656d78.xml"},{"id":95805901,"identity":"cc60df39-74ce-41d3-9168-af18326bebff","added_by":"auto","created_at":"2025-11-13 08:47:04","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":220702,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/2df6d9d7055063146f8fa582.png"},{"id":95805818,"identity":"47afc206-6b2d-422e-8025-9dfaaf1a009d","added_by":"auto","created_at":"2025-11-13 08:46:56","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":30057,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/354580268d0d1db056f4d53d.png"},{"id":95805805,"identity":"89674d2f-6b0b-4c2d-ae28-de0c26c7abe8","added_by":"auto","created_at":"2025-11-13 08:46:54","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":139239,"visible":true,"origin":"","legend":"","description":"","filename":"acadca6f98aa428c8736bafebcc473141structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/482eec0fbe9c8ad83f2919fd.xml"},{"id":95805854,"identity":"f5043240-0f2e-48a6-8734-e9997c50b1c7","added_by":"auto","created_at":"2025-11-13 08:47:00","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":150389,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/2dee40a66e79446af96d603a.html"},{"id":95805899,"identity":"79c9bd1e-e439-4aca-ba49-445b6bbd0139","added_by":"auto","created_at":"2025-11-13 08:47:04","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":162376,"visible":true,"origin":"","legend":"\u003cp\u003eSources of stress among respondents\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/9bc2fcba2b3e3f02a17a88f9.png"},{"id":96362700,"identity":"d720ecd7-7b44-406e-8579-7ce5f454caa6","added_by":"auto","created_at":"2025-11-20 09:45:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1289773,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7802908/v1/0394469e-dab8-452c-9990-01ed3c9f65da.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and correlates of depression, anxiety, stress and suicidal ideation among allied health students in the College of Medicine, University of Lagos: a cross sectional study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eAccording to the World Health Organisation (WHO), stress is defined as \u0026ldquo;a state of worry or mental tension caused by a difficult situation\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Several studies have reported an association between elevated stress levels and the onset of various mental health disorders, including anxiety, depression, and suicidal ideation [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The American Psychological Association (APA) defines anxiety as an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The WHO describes depression as involving a depressed mood or loss of pleasure or interest in activities for long periods of time [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Suicidal ideation is a broad term used to describe a range of contemplations, wishes, and preoccupations with death and suicide [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStressors may arise from major life transitions or daily hassles such as academic demands, financial burdens, or interpersonal conflicts [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Moreover, factors like social isolation, insufficient sleep, maladaptive coping, and personality traits such as neuroticism and perfectionism can intensify an individual's stress response [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Chronic stress, marked by prolonged physiological and psychological activation, has been linked to cognitive impairments, decreased academic and work performance, and long-term mental and physical health consequences [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe WHO categorizes youth as individuals aged 15\u0026ndash;24, a group especially vulnerable to stress-related disorders due to ongoing biological, psychological, and social transitions [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Globally, research has consistently documented the high prevalence of stress, anxiety, and depression among university students, particularly those in healthcare fields such as medicine and allied health. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. These students frequently face pressures from academic workloads, clinical responsibilities, and personal challenges.\u003c/p\u003e\u003cp\u003eThe global prevalence of stress has been estimated by multiple studies at approximately 25.18%, though higher rates have been documented in specific regions [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Depression affects about 4% of the global population and disproportionately impacts women, with prevalence rates in Africa (including Nigeria) ranging between 3.9% and 9% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Anxiety disorders affect over 301\u0026nbsp;million people worldwide, with prevalence and disability burden varying by region; Nigeria reports rates of 2.7% nationally and 3.5% in Lagos [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Suicide remains the fourth leading cause of death among youth aged 15\u0026ndash;29, with over 700,000 global deaths annually, 77% of which occur in low- and middle-income countries [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In Nigeria, the suicide rate is estimated at 17.3 per 100,000 [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDespite growing awareness of mental health issues among medical students, research focusing on allied health students remains limited. Yet, these students are critical to the healthcare workforce and experience significant academic, emotional, and clinical stressors [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The limited literature available suggests a high prevalence of mental health challenges within this group [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This study aims to assess the prevalence of stress, anxiety, depression, and suicidal ideation, and their association with socio-demographic factors among allied health students at the College of Medicine, University of Lagos.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eSTUDY AREA, DESIGN AND PERIOD\u003c/h2\u003e\u003cp\u003eA cross-sectional, institution-based study was conducted between August and September 2024 to assess the mental health status of allied health students at the College of Medicine, University of Lagos (CMUL). It is located in Idi-Araba within the Ikeja division of Lagos State, CMUL shares its premises with the Lagos University Teaching Hospital (LUTH). The college comprises three faculties (clinical sciences, basic medical sciences, and dental sciences) and offers nine undergraduate programmes. Of these, seven are allied health courses: physiology, medical laboratory science, pharmacy, pharmacology, radiography, nursing science, and physiotherapy [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSTUDY POPULATION\u003c/h3\u003e\n\u003cp\u003eThis study was conducted among allied health students at the College of Medicine, University of Lagos (CMUL) in the 2023/2024 academic session.\u003c/p\u003e\n\u003ch3\u003eINCLUSION CRITERIA\u003c/h3\u003e\n\u003cp\u003eAll full-time undergraduate students who had completed at least one semester at the CMUL were included in the study.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEXCLUSION CRITERIA\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eParticipants who did not provide electronic informed consent, were ill, or unable to communicate during data collection were excluded.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eParticipants who did not confirm their studentship via their student ID were excluded.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\n\u003ch3\u003eSAMPLE SIZE ESTIMATION\u003c/h3\u003e\n\u003cp\u003eThe minimum sample size was estimated using Cochran\u0026rsquo;s formula for the calculation of sample size for a cross-sectional study.\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:n\\:=\\:\\frac{{Z}^{2}pq}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003ewhere n\u0026thinsp;=\u0026thinsp;minimum sample size\u003c/p\u003e\u003cp\u003eZ\u0026thinsp;=\u0026thinsp;the Z-score based on a 95% confidence level: 1.96\u003c/p\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;85.6% (0.856), The prevalence of anxiety as adapted from a study on the prevalence of psychological symptoms and their correlates carried out among physiotherapy students in Nigeria [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eq\u0026thinsp;=\u0026thinsp;1 - p\u0026thinsp;=\u0026thinsp;1\u0026ndash;0.856\u0026thinsp;=\u0026thinsp;0.144\u003c/p\u003e\u003cp\u003ed\u0026thinsp;=\u0026thinsp;acceptable margin of error, (5%)\u0026thinsp;=\u0026thinsp;0.05\u003cdiv id=\"Equb\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$\\:n\\:=\\:\\frac{{1.96}^{2}\\:\\times\\:0.856\\:\\times\\:0.144}{{0.05}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;189.4\u003c/p\u003e\u003cp\u003eThen, to correct for a total target population below 10,000 in this study and calculate the final sample size (n\u003csub\u003ef\u003c/sub\u003e), the formula used will be:\u003c/p\u003e\u003cp\u003en\u003csub\u003ef\u003c/sub\u003e = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{n}{1\\:+\\:\\frac{n\\:-\\:1}{N}}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\u003cp\u003ewhere,\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;sample size when N is greater than 10,000\u0026thinsp;=\u0026thinsp;189.4\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;total target population size: 282 (MLS)\u0026thinsp;+\u0026thinsp;142 (Nursing science)\u0026thinsp;+\u0026thinsp;237 (Physiotherapy)\u0026thinsp;+\u0026thinsp;187 (Radiography)\u0026thinsp;=\u0026thinsp;848\u003c/p\u003e\u003cp\u003en\u003csub\u003ef\u003c/sub\u003e = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{189.4}{1\\:+\\left(\\frac{189.4\\:-1}{894}\\right)}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\u003cp\u003en\u003csub\u003ef\u003c/sub\u003e = 156\u003c/p\u003e\u003cp\u003eTherefore, the minimum sample size is 156.\u003c/p\u003e\u003cp\u003eA final sample size of 200 allied health students was employed, based on considerations of the expected variability in stress, anxiety, depression, and suicidal ideation scores, as well as the need to ensure sufficient statistical power to detect meaningful associations.\u003c/p\u003e\n\u003ch3\u003eSAMPLING TECHNIQUE\u003c/h3\u003e\n\u003cp\u003e The study employed a multistage sampling technique to select participants from allied health programs at the College of Medicine, University of Lagos. The process involved three stages. In the first stage, four out of seven allied health departments (Medical Laboratory Science, Nursing Science, Physiotherapy, and Radiography) were selected through simple random sampling via balloting. Each selected department was treated as a distinct stratum for the second stage, where two years of study within each department were randomly chosen, again by balloting. This approach was adopted for its efficiency and to account for the relatively homogeneous nature of students within each department.\u003c/p\u003e\u003cp\u003eIn the third stage, the number of respondents from each selected year group was determined using proportional sampling, based on the population size of each program. Sample weights were calculated by dividing the number of students in each department by the total allied health student population, then multiplying the result by the target sample size of 200. Each department\u0026rsquo;s sample was split evenly between its two selected year groups.\u003c/p\u003e\u003cp\u003eStudents within each designated group were selected via simple random sampling using computer-generated random numbers. Comprehensive class lists were obtained in collaboration with the Medical Student Associations and departmental student body presidents. Each student was assigned a unique number, and selected individuals were contacted privately and provided a link to the anonymous online questionnaire. To preserve the integrity of the sampling, once selected, students were removed from the pool to avoid duplication. If a student declined to participate, a replacement was randomly selected from the same stratum, maintaining the intended sample size and representativeness.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eDATA COLLECTION TOOLS AND TECHNIQUES\u003c/h2\u003e\u003cp\u003eThis study employed a structured, self-administered questionnaire delivered electronically via an online survey platform (Google Forms). The questionnaire was developed based on validated instruments used in prior research [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. A pilot test (n\u0026thinsp;=\u0026thinsp;30) confirmed the reliability of the study instrument, with Cronbach\u0026rsquo;s α values of 0.84 for the stress scale, 0.87 for the anxiety scale, 0.85 for the depression scale, and 0.81 for the suicidal ideation scale. The questionnaire had 4 parts, section A to D.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSection A\u003c/b\u003e collected basic demographic information, including age, gender identity, year of study, and program of study, to understand the characteristics of the respondents. \u003cb\u003eSection B\u003c/b\u003e explored perceived sources of stress using an adapted version of the Undergraduate Sources of Stress (USOS) questionnaire, which has been validated among allied health students in Ghana. It contained 13 self-reported items evaluating perceived sources of stress over the past semester. Responses were rated on a 5-point Likert scale ranging from 0 (\"not at all\") to 4 (\"a great deal\"). To identify the most significant stressors, the mean score for each item was calculated across all participants. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. \u003cb\u003eSection C\u003c/b\u003e measured the prevalence of stress, anxiety, and depression using the Depression, Anxiety, and Stress Scale (DASS-21), a validated 21-item instrument comprising three subscales, each assessing symptoms related to depression, anxiety, and stress. Participants rated how often they experienced each symptom in the past week using a 4-point Likert scale (0 = \"did not apply to me at all\" to 3 = \"applied to me very much or most of the time\"). Subscale scores ranged from 0 to 21, which were then doubled (following the tool developers' guidance) to yield final scores ranging from 0 to 42 for each emotional state [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. \u003cb\u003eSection D\u003c/b\u003e assessed suicidal ideation using an adapted item from the Patient Health Questionnaire-9 (PHQ-9). Respondents indicated how often they had thoughts of self-harm or that they would be better off dead over the past two weeks, using a scale from 0 (\"not at all\") to 3 (\"nearly every day\"). Any response greater than zero was classified as indicative of suicidal ideation [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Data collection was conducted anonymously via a Google Forms link shared individually with selected participants.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eDATA MANAGEMENT AND ANALYSIS\u003c/h3\u003e\n\u003cp\u003eAfter collecting all the data, it was exported from Google Forms to Microsoft Excel and then imported into the Statistical Package for the Social Sciences (SPSS) version 22 for Windows. Descriptive statistics was employed to summarise the collected data. This involved calculating frequencies, percentages, and measures of central tendency (median) and dispersion (interquartile ranges) for continuous variables. Additionally, categorical variables were presented using frequencies and tables. The Pearson\u0026rsquo;s Chi-squared test was employed to evaluate potential associations between categorical variables and levels of stress or mental health. A significance threshold of alpha (α)\u0026thinsp;=\u0026thinsp;0.05 was adopted, whereby a p-value less than 0.05 was deemed statistically significant.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eSocio-demographic Characteristics\u003c/h2\u003e\u003cp\u003eA total of 450 respondents completed the questionnaire of which 149 (74.5%) identified as cis female and 51 (25.5%) identified as cis male, with a mean age of 21.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4 years. The sample was fairly distributed across the four allied health programmes. Radiography had the highest representation (30.5%), followed by Medical Laboratory Science (28.0%). Nearly half of the respondents (44.5%) were in their 500 level (fifth year). Almost all respondents were single (99.5%). Living arrangements were mainly on-campus (81.0%). Sociodemographic characteristics of the respondents are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic characteristics of the respondents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocio-demographics variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eAge Category (Years)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u0026ndash;23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24\u0026ndash;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eMean age\u0026thinsp;\u0026plusmn;\u0026thinsp;SD: 21.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender Identity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCis woman (assigned female at birth, currently identifies as female)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCis man (assigned male at birth, currently identifies as male)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSexual Orientation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeterosexual/Straight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e94.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuestioning (not sure of sexual orientation)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBisexual female\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProgramme of Study\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadiography\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMLS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysiotherapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNursing sciences\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLevel of Study\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e500L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e400L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e300L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e200L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYoruba\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003csup\u003e\u003cem\u003ea\u003c/em\u003e\u003c/sup\u003e: \u003cem\u003eEdo, Efik, Egun, Hausa, Ibibio, Idoma, Ijaw, Tarok, Urhobo\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIgbo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChristianity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIslam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e: \u003cem\u003eAtheism, Traditional\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e99.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLiving Arrangement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOn-campus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e162\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOff-campus alone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOff-campus with family\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOff-campus with friends\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOff-campus with spouse/partner\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eSources of Stress\u003c/h2\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates the sources of stress among the study participants. The subscale scores are listed in descending order from the participants. \"Amount of material to be learnt in the course\" recorded the highest mean score (2.83), followed by \"Personal Finances\" (2.67). The lowest-ranked sources of stress include \"Relationship with family members\" (1.18) and \"Relationship with partner\" (0.77).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003ePrevalence of depression, anxiety, and stress among participants.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe overall prevalence of depression, anxiety, and stress showed that 48.5%, 39.5%, and 62.5% of the respondents had normal levels, respectively. Collectively, the prevalence rate ranging from mild to extremely severe forms for depression, anxiety, and stress among the students was 51.5%, 60.5%, and 37.5%, respectively. Prevalence of depression, anxiety, and stress are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of depression, anxiety and stress\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategories\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNumber (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97 (48.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42 (21.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34 (17.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20 (10.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExtremely severe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7 (3.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79 (39.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e55 (27.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38 (19.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24 (12.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExtremely severe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4 (2.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eStress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e125 (62.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47 (23.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15 (7.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10 (5.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExtremely severe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003ePrevalence of Suicidal Ideation symptoms among participants\u003c/h2\u003e\u003cp\u003eThe prevalence of suicidal ideation among participants was 28.5%, with 20.0% reporting such thoughts on several days, 5.0% on more than half the days, and 3.5% nearly every day. In contrast, 71.5% reported no suicidal ideation \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSuicidal Ideation Among Participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable (n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentages (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eThoughts that you would be better off dead or hurting dead of hurting yourself in someway\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot at all\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e143\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeveral days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than half the days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNearly everyday\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eAssociations between Stress, Anxiety, Depression and Suicidal Ideation\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the correlation matrix, which demonstrates strong positive relationships among depression, anxiety, and stress, with all associations reaching statistical significance (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Depression was strongly correlated with both anxiety and stress, while anxiety also showed a strong positive correlation with stress. In addition, suicidal ideation exhibited a moderate but significant correlation with depression.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation Analysis of Depression, Anxiety, Stress, and Suicidal Ideation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDepression,\u003c/p\u003e\u003cp\u003er(p\u003csup\u003e1\u003c/sup\u003e)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAnxiety,\u003c/p\u003e\u003cp\u003er(p\u003csup\u003e1\u003c/sup\u003e)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStress,\u003c/p\u003e\u003cp\u003er(p\u003csup\u003e1\u003c/sup\u003e)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSuicidal Ideation,\u003c/p\u003e\u003cp\u003er(p\u003csup\u003e1\u003c/sup\u003e)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.760\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.850\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.579\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.760\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.862\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.477\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.850\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.862\u003c/p\u003e\u003cp\u003e (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.485\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSuicidal Ideation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.579\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.477\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.485\u003c/p\u003e\u003cp\u003e (\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003er\u0026thinsp;=\u0026thinsp;Correlation coefficient; p\u0026thinsp;=\u0026thinsp;p-value; \u003csup\u003e1\u003c/sup\u003e T-test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eAssociations Between Selected Sociodemographic Factors and Mental Health Outcomes\u003c/h2\u003e\u003cp\u003eOff-campus residence was significantly associated with higher rates of depression (χ\u0026sup2; = 8.148, p\u0026thinsp;=\u0026thinsp;0.047) and anxiety (χ\u0026sup2; = 9.239, p\u0026thinsp;=\u0026thinsp;0.016). Students of Nursing Sciences exhibited greater levels of stress compared with their peers (χ\u0026sup2; = 18.859, p\u0026thinsp;=\u0026thinsp;0.026); and questioning one\u0026rsquo;s sexual orientation correlated with an increased prevalence of suicidal ideation (χ\u0026sup2; = 5.780, p\u0026thinsp;=\u0026thinsp;0.036). In contrast, age, gender, and religion were not significantly associated with any of the assessed mental health outcomes.\u003c/p\u003e\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe prevalence of stress among students in this study was found to be 37.5%. This finding aligns closely with similar studies in India (38.6%) [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], Nigeria (42.6%) [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], and Ethiopia (44%) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], suggesting that a significant proportion of university students globally experience stress due to shared academic and social pressures. Higher prevalence rates reported in studies from Pakistan (63.1%) [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], Iraq (77.5%) [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], South Africa (78%) [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], and Egypt (93%) [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], may reflect differences in academic demands, socio-political conditions, cultural expectations, and availability of mental health support. Particularly in medical students, stress levels tend to be elevated due to the rigorous nature of training and heightened performance expectations.\u003c/p\u003e\u003cp\u003eThe key sources of stress among allied health students in this study were identified to be \"amount of material to be learnt in the course,\" \"personal finances,\" \"uncertainty about expectations in the course,\" \"time demands of the course,\" \"intellectual demands of the course,\" \"physical demands of the course,\" and \u0026ldquo;university fees.\" This observation aligns with findings from other studies conducted in various regions of Nigeria, where academic workload and financial strain were also reported as major stressors [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Comparable trends have been noted in studies from other parts of Africa, including Ghana and South Africa, where academic pressure consistently emerged as the leading source of stress among health science students [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. International studies in Canada, Jamaica, the Netherlands, and Saudi Arabia likewise highlight academic workload, clinical responsibilities, financial difficulties, and future uncertainty as major stress contributors [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. While there is corroboration across these studies regarding the prominence of academic stress, differences in the reported stressors, such as financial or personal stress, may be attributed to variations in socio-economic conditions, access to resources, cultural norms, and the availability of institutional support across different regions and institutions. Differences in study designs, sample sizes, and specific stress measurement criteria could also account for the observed variations in stress prevalence and contributing factors.\u003c/p\u003e\u003cp\u003eThe prevalence of anxiety among students in this study was found to be 60.5%. This aligns with findings from Bayero University, Kano (66.1%) [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] and Fayoum University, Egypt (64.3%) [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e], suggesting high anxiety levels are common among allied health and medical students, likely due to similar academic demands. In contrast, lower prevalence rates were observed in institutions such as Niger Delta University (29.5%) [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e] and a multi-center Nigerian study (28.1%) [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e], possibly reflecting methodological differences or institutional support variations. International studies report even lower rates (e.g., 20.2% in South India [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], 19% in Pakistan [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]), though some African studies report higher rates up to 85.6% [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. These discrepancies may reflect contextual factors such as cultural attitudes, coping strategies, and socio-economic conditions.\u003c/p\u003e\u003cp\u003eThe prevalence of depression among students in this study was determined to be 51.5%. This finding align with a cross-sectional study in Pakistan among medical students, with a reported prevalence rate of 51.46% [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Similarly, a study among allied health students at Bayero University, Kano, found a prevalence rate of 58.86% [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. These results suggest a significant burden of depressive symptoms among students in health-related fields, potentially exacerbated by academic pressures and limited access to mental health resources. However, lower rates were reported in other Nigerian institutions (21.3%\u0026ndash;22.5%) [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e] and international contexts like Chile (23%) [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e], highlighting potential variations in population characteristics and assessment tools.\u003c/p\u003e\u003cp\u003eThe prevalence of suicidal ideation among students in this study was found to be 28.5%, which is higher than the rates reported Bayelsa (14.8%) [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e], South India (12.5%) [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], and Tanzania (11.6%) [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. This elevated prevalence may reflect institutional or regional disparities in mental health literacy, service availability, or stigma-related underreporting in other studies.\u003c/p\u003e\u003cp\u003eThis study identified strong positive correlations between depression, anxiety, and stress, highlighting depression as an independent factor significantly associated with these conditions. Furthermore, individuals residing off-campus demonstrated a higher prevalence of depression. These findings are consistent with studies from the United States [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e], Ethiopia [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e], Saudi Arabia [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e], and Ireland [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e], which identified financial stress, extended commute times, and life events as key contributors to depressive symptoms. Suicidal ideation showed a significant correlation with depression, further validating depression as a major predictor of suicidal thoughts, as documented in prior studies [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Students questioning their sexual orientation reported higher rates of suicidal ideation, consistent with research highlighting the mental health vulnerabilities of sexual minorities [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]. These findings emphasize the need for inclusive and targeted mental health strategies within university settings.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study highlights a substantial burden of mental health challenges among allied health students at the College of Medicine, University of Lagos, with high prevalence rates of anxiety, depression, stress, and suicidal ideation. Key stressors identified included academic pressures, financial constraints, and time management challenges, emphasizing the varied nature of stressors within this population. Strong correlations were identified among the conditions, with specific sociodemographic factors such as off-campus residence, program of study, and sexual orientation emerging as significant predictors of adverse outcomes. These findings highlight the urgent need for targeted mental health interventions, including readily accessible counseling services, comprehensive financial and academic support systems, and policies that address the distinct vulnerabilities of allied health students.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAPA - The American Psychological Association\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCMUL - College of Medicine, University of Lagos\u003c/p\u003e\n\u003cp\u003eGBD - Global Burden of Disease\u003c/p\u003e\n\u003cp\u003eLASUCOM - Lagos State University College of Medicine\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLUTH - Lagos University Teaching Hospital\u003c/p\u003e\n\u003cp\u003eMLS - Medical Laboratory Science\u003c/p\u003e\n\u003cp\u003eUSOS - Undergraduate Sources of Stress\u003c/p\u003e\n\u003cp\u003eWMH-ICS - World Mental Health - International College Student\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWHO - World Health Organization\u003c/p\u003e\n\u003cp\u003eYLD - Years Lived with Disability\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Health Research and Ethics Committee of Lagos University Teaching Hospital with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Health Research and Ethics Committee of Lagos University Teaching Hospital (ADM/DCST/HREC/APP/871). The survey was anonymous, and data confidentiality was maintained. Electronic informed consent was obtained before survey participation, and participants could withdraw from the study at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical trial number\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConception of study: AOO. Data Collection: AOO, OAN. Data analysis: AOO, AOS. Writing of the first draft: AOO, OAN, AOS. Manuscript revisions: AOO, OAN, AOS. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization (WHO). Stress. Available from:https://www.who.int/news-room/questions-and-answers/item/stress. Accessed on April 5, 2024. \u003c/li\u003e\n\u003cli\u003eOkechukwu FO, Ogba KTU, Nwufo JI, Ogba MO, Onyekachi BN, Nwanosike CI, et al. Academic stress and suicidal ideation: moderating roles of coping style and resilience. BMC Psychiatry. 2022;22:546. https://doi.org/10.1186/s12888-022-04063-2\u003c/li\u003e\n\u003cli\u003ePark C, Rosenblat JD, Brietzke E, Pan Z, Lee Y, Cao B, et al. Stress, epigenetics and depression: A systematic review. Neurosci Biobehav Rev. 2019;102:139\u0026ndash;52. https://doi.org/10.1016/j.neubiorev.2019.04.010\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Chapter One - Stress, Anxiety, and Immunomodulation: A Pharmacological Analysis. Available from: https://www.sciencedirect.com/science/article/pii/S0083672916300498. Accessed on May 21, 2024.\u003c/li\u003e\n\u003cli\u003eAmerican Psychological Association (APA). Anxiety. Available from: https://www.apa.org/topics/anxiety. Accessed on May 12, 2024. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Depressive disorder (depression). Available from: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed on May 12, 2024. \u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Suicidal Ideation. Available from: http://www.ncbi.nlm.nih.gov/books/NBK565877/. Accessed on May 12, 2024.\u003c/li\u003e\n\u003cli\u003eEpel ES, Lithgow GJ. Stress Biology and Aging Mechanisms: Toward Understanding the Deep Connection Between Adaptation to Stress and Longevity. J Gerontol Ser A. 2014;69:S10\u0026ndash;6. https://doi.org/10.1093/gerona/glu055\u003c/li\u003e\n\u003cli\u003eRyu S, Fan L. The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults. J Fam Econ Issues. 2023;44:16\u0026ndash;33. https://doi.org/10.1007/s10834-022-09820-9\u003c/li\u003e\n\u003cli\u003eMumtaz F, Khan MI, Zubair M, Dehpour AR. Neurobiology and consequences of social isolation stress in animal model\u0026mdash;A comprehensive review. Biomed Pharmacother. 2018;105:1205\u0026ndash;22. https://doi.org/10.1016/j.biopha.2018.05.086\u003c/li\u003e\n\u003cli\u003eNollet M, Wisden W, Franks NP. Sleep deprivation and stress: a reciprocal relationship. Interface Focus. 2020;10:20190092. https://doi.org/10.1098/rsfs.2019.0092\u003c/li\u003e\n\u003cli\u003eRodriquez EJ, Gregorich SE, Livaudais-Toman J, P\u0026eacute;rez-Stable EJ. Coping With Chronic Stress by Unhealthy Behaviors: A Re-Evaluation Among Older Adults by Race/Ethnicity. J Aging Health. 2017;29:805\u0026ndash;25. https://doi.org/10.1177/0898264316645548\u003c/li\u003e\n\u003cli\u003eLeger KA, Charles ST, Turiano NA, Almeida DM. Personality and Stressor-Related Affect. J Pers Soc Psychol. 2016;111:917\u0026ndash;28. https://doi.org/10.1037/pspp0000083\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Physiology, Stress Reaction. Available from: http://www.ncbi.nlm.nih.gov/books/NBK541120/. Accessed on April 5, 2024.\u003c/li\u003e\n\u003cli\u003eKulshreshtha A, Alonso A, McClure LA, Hajjar I, Manly JJ, Judd S. Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA Netw Open. 2023;6:e231860. https://doi.org/10.1001/jamanetworkopen.2023.1860\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Adolescent health SEARO. Available from: https://www.who.int/southeastasia/health-topics/adolescent-health. Accesed on May 18, 2024. \u003c/li\u003e\n\u003cli\u003eThe American Institute of Stress. Stress: An Epidemic Among College Students. Available from: https://www.stress.org/stress-an-epidemic-among-college-students. Accessed on May 18, 2024\u003c/li\u003e\n\u003cli\u003eAljohani W, Banakhar M, Sharif L, Alsaggaf F, Felemban O, Wright R. Sources of Stress among Saudi Arabian Nursing Students: A Cross-Sectional Study. Int J Environ Res Public Health. 2021;18:11958. https://doi.org/10.3390/ijerph182211958\u003c/li\u003e\n\u003cli\u003eLavoie-Tremblay M, Sanzone L, Aub\u0026eacute; T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:261\u0026ndash;71. https://doi.org/10.1177/08445621211028076\u003c/li\u003e\n\u003cli\u003eAmanya SB, Nakitende J, Ngabirano TD. A cross‐sectional study of stress and its sources among health professional students at Makerere University, Uganda. Nurs Open. 2017;5:70\u0026ndash;6. https://doi.org/10.1002/nop2.113\u003c/li\u003e\n\u003cli\u003eYakasai AM, Dermody G, Maharaj SS, Hassan AB, Abdullahi A, Usman JS, et al. Prevalence of psychological symptoms and their correlates among physiotherapy clinical students: A cross-sectional study. South Afr J Physiother. 2022;78:1795. https://doi.org/10.4102/sajp.v78i1.1795\u003c/li\u003e\n\u003cli\u003eMahmud S, Mohsin M, Dewan MdN, Muyeed A. The Global Prevalence of Depression, Anxiety, Stress, and Insomnia Among General Population During COVID-19 Pandemic: A Systematic Review and Meta-analysis. Trends Psychol. 2023;31:143\u0026ndash;70. https://doi.org/ 10.1007/s43076-021-00116-9\u003c/li\u003e\n\u003cli\u003eSalari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob Health. 2020;16:57. https://doi.org/10.1186/s12992-020-00589-w\u003c/li\u003e\u003col\u003e\n\u003cli\u003eWorld Health Organization (WHO). Stress. Available from:https://www.who.int/news-room/questions-and-answers/item/stress. Accessed on April 5, 2024. \u003c/li\u003e\n\u003cli\u003eOkechukwu FO, Ogba KTU, Nwufo JI, Ogba MO, Onyekachi BN, Nwanosike CI, et al. Academic stress and suicidal ideation: moderating roles of coping style and resilience. BMC Psychiatry. 2022;22:546. https://doi.org/10.1186/s12888-022-04063-2\u003c/li\u003e\n\u003cli\u003ePark C, Rosenblat JD, Brietzke E, Pan Z, Lee Y, Cao B, et al. Stress, epigenetics and depression: A systematic review. Neurosci Biobehav Rev. 2019;102:139\u0026ndash;52. https://doi.org/10.1016/j.neubiorev.2019.04.010\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Chapter One - Stress, Anxiety, and Immunomodulation: A Pharmacological Analysis. Available from: https://www.sciencedirect.com/science/article/pii/S0083672916300498. Accessed on May 21, 2024.\u003c/li\u003e\n\u003cli\u003eAmerican Psychological Association (APA). Anxiety. Available from: https://www.apa.org/topics/anxiety. Accessed on May 12, 2024. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Depressive disorder (depression). Available from: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed on May 12, 2024. \u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Suicidal Ideation. Available from: http://www.ncbi.nlm.nih.gov/books/NBK565877/. Accessed on May 12, 2024.\u003c/li\u003e\n\u003cli\u003eEpel ES, Lithgow GJ. Stress Biology and Aging Mechanisms: Toward Understanding the Deep Connection Between Adaptation to Stress and Longevity. J Gerontol Ser A. 2014;69:S10\u0026ndash;6. https://doi.org/10.1093/gerona/glu055\u003c/li\u003e\n\u003cli\u003eRyu S, Fan L. The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults. J Fam Econ Issues. 2023;44:16\u0026ndash;33. https://doi.org/10.1007/s10834-022-09820-9\u003c/li\u003e\n\u003cli\u003eMumtaz F, Khan MI, Zubair M, Dehpour AR. Neurobiology and consequences of social isolation stress in animal model\u0026mdash;A comprehensive review. Biomed Pharmacother. 2018;105:1205\u0026ndash;22. https://doi.org/10.1016/j.biopha.2018.05.086\u003c/li\u003e\n\u003cli\u003eNollet M, Wisden W, Franks NP. Sleep deprivation and stress: a reciprocal relationship. Interface Focus. 2020;10:20190092. https://doi.org/10.1098/rsfs.2019.0092\u003c/li\u003e\n\u003cli\u003eRodriquez EJ, Gregorich SE, Livaudais-Toman J, P\u0026eacute;rez-Stable EJ. Coping With Chronic Stress by Unhealthy Behaviors: A Re-Evaluation Among Older Adults by Race/Ethnicity. J Aging Health. 2017;29:805\u0026ndash;25. https://doi.org/10.1177/0898264316645548\u003c/li\u003e\n\u003cli\u003eLeger KA, Charles ST, Turiano NA, Almeida DM. Personality and Stressor-Related Affect. J Pers Soc Psychol. 2016;111:917\u0026ndash;28. https://doi.org/10.1037/pspp0000083\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Physiology, Stress Reaction. Available from: http://www.ncbi.nlm.nih.gov/books/NBK541120/. Accessed on April 5, 2024.\u003c/li\u003e\n\u003cli\u003eKulshreshtha A, Alonso A, McClure LA, Hajjar I, Manly JJ, Judd S. Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA Netw Open. 2023;6:e231860. https://doi.org/10.1001/jamanetworkopen.2023.1860\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Adolescent health SEARO. Available from: https://www.who.int/southeastasia/health-topics/adolescent-health. Accesed on May 18, 2024. \u003c/li\u003e\n\u003cli\u003eThe American Institute of Stress. Stress: An Epidemic Among College Students. Available from: https://www.stress.org/stress-an-epidemic-among-college-students. Accessed on May 18, 2024\u003c/li\u003e\n\u003cli\u003eAljohani W, Banakhar M, Sharif L, Alsaggaf F, Felemban O, Wright R. Sources of Stress among Saudi Arabian Nursing Students: A Cross-Sectional Study. Int J Environ Res Public Health. 2021;18:11958. https://doi.org/10.3390/ijerph182211958\u003c/li\u003e\n\u003cli\u003eLavoie-Tremblay M, Sanzone L, Aub\u0026eacute; T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:261\u0026ndash;71. https://doi.org/10.1177/08445621211028076\u003c/li\u003e\n\u003cli\u003eAmanya SB, Nakitende J, Ngabirano TD. A cross‐sectional study of stress and its sources among health professional students at Makerere University, Uganda. 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Glob Health. 2020;16:57. https://doi.org/10.1186/s12992-020-00589-w\u003c/li\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387355/. Accessed on May 30, 2024.\u003c/li\u003e\n\u003cli\u003eGbadamosi IT, Henneh IT, Aluko OM, Yawson EO, Fokoua AR, Koomson A, et al. Depression in Sub-Saharan Africa. IBRO Neurosci Rep. 2022;12:309\u0026ndash;22. https://doi.org/10.1016/j.ibneur.2022.03.005\u003c/li\u003e\n\u003cli\u003eInstitute for Health Metrics and Evaluation. GBD Results. Available from: https://vizhub.healthdata.org/gbd-results. Accessed on May 30, 2024.\u003c/li\u003e\n\u003cli\u003eGlobal, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137\u0026ndash;50.\u003c/li\u003e\n\u003cli\u003eAdewuya AO, Atilola O, Ola BA, Coker OA, Zachariah MP, Olugbile O, et al. Current prevalence, comorbidity and associated factors for symptoms of depression and generalized anxiety in the Lagos State Mental Health Survey (LSMHS), Nigeria. Compr Psychiatry. 2018;81:60\u0026ndash;5. https://doi.org/10.1016/j.comppsych.2017.11.010\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide. Accessed on May 29, 2024. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Suicide worldwide in 2019. Available from: https://www.who.int/publications-detail-redirect/9789240026643. Accessed on June 8, 2024.\u003c/li\u003e\n\u003cli\u003eJames BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:382\u0026ndash;8. https://doi.org/10.5116/ijme.59c6.3075\u003c/li\u003e\n\u003cli\u003eUniversity of Lagos [Internet]. Wikipedia; [cited 2025 Sep 22]. Available from: https://en.wikipedia.org/wiki/University_of_Lagos\u003c/li\u003e\n\u003cli\u003eNyante G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. J Prev Rehabil Med. 2020;2:40\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eLovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eAdewuya AO, Ola BA, Coker OA, Atilola O, Zachariah MP, Olugbile O, et al. Prevalence and associated factors for suicidal ideation in the Lagos State Mental Health Survey, Nigeria. BJPsych Open. 2016;2:385\u0026ndash;9. https://doi.org/10.1192/bjpo.bp.116.004333\u003c/li\u003e\n\u003cli\u003eLunn MR, Cui W, Zack MM, Thompson WW, Blank MB, Yehia BR. Sociodemographic Characteristics and Health Outcomes Among Lesbian, Gay, and Bisexual U.S. Adults Using Healthy People 2020 Leading Health Indicators. LGBT Health. 2017;4:83\u0026ndash;94. https://doi.org/10.1089/lgbt.2016.0087\u003c/li\u003e\n\u003cli\u003eVerma S, Nambiar V. Prevalence of Stress among Undergraduate Physiotherapy Students. Indian J Physiother Occup Ther - Int J. 2014;8:2-95.\u003c/li\u003e\n\u003cli\u003eMuhammad DG, Ahmad A, Usman J. Assessment of Level and Sources of Stress Among Allied Health Sciences Students of Bayero University Kano: A Comparison Between Clinical and Pre-Clinical Students. Educ Med J. 2019;11:11\u0026ndash;19.\u003c/li\u003e\n\u003cli\u003eAsfaw H, Fekadu G, Tariku M, Oljira A. Anxiety and Stress Among Undergraduate Medical Students of Haramaya University, Eastern Ethiopia. Neuropsychiatr Dis Treat. 2021;17:13\u0026ndash;46. https://doi.org/10.2147/ndt.s290879\u003c/li\u003e\n\u003cli\u003eHaider Z, Khan MU, Yasin A, Abbas T, Ahsan M, Rehman IU, et al. Evaluation of stress and its clinical correlation among the students of Allied Health Sciences. Adv Life Sci. 2023;9:3-14.\u003c/li\u003e\n\u003cli\u003eShawi AF, Abdullateef AN, Khedher MA, Rejab MS, Khaleel RN. Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study. Pan Afr Med J. 2018;31:96. https://doi.org/10.11604/pamj.2018.31.96.16737\u003c/li\u003e\n\u003cli\u003eNaidoo S, Van Wyk J, Higgins-Opitz S, Moodley K. An evaluation of stress in medical students at a South African university. South Afr Fam Pract. 2014;56:58\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eEbrahim OS, Sayed HA, Rabei S, Hegazy N. Perceived stress and anxiety among medical students at Helwan University: A cross-sectional study. J Public Health Res. 2024;13:22-79. https://doi.org/10.1177/22799036241227891\u003c/li\u003e\n\u003cli\u003eFrancis-Edoziuno C, Abiona M, Odetola T. Stressors and coping measures among undergraduate nursing students in western nigeria. PAN Afr Sci J. 2024;4.\u003c/li\u003e\n\u003cli\u003eOkoye OC. Perceived Stress and Stressors among Undergraduate Medical Students of a Nigerian Institution. Malawi Med J. 2022;34:24\u0026ndash;51. https://doi.org/10.4314/mmj.v34i4.4 \u003c/li\u003e\n\u003cli\u003eNyanteh G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. 2020;1:1-15\u003c/li\u003e\n\u003cli\u003eHenderson RM, Chetty O, Gurayah T. Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review. South Afr J Occup Ther. 2021;51:29\u0026ndash;38.\u003c/li\u003e\n\u003cli\u003eLavoie-Tremblay M, Sanzone L, Aub\u0026eacute; T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:26\u0026ndash;71. https://doi.org/10.1177/08445621211028076\u003c/li\u003e\n\u003cli\u003eLeslie K, Brown K, Aiken J. Perceived academic-related sources of stress among graduate nursing students in a Jamaican University. Nurse Educ Pract. 2021;53:10-88. https://doi.org/10.1016/j.nepr.2021.103088\u003c/li\u003e\n\u003cli\u003eSlimmen S, Timmermans O, Mikolajczak-Degrauwe K, Oenema A. How stress-related factors affect mental wellbeing of university students A cross-sectional study to explore the associations between stressors, perceived stress, and mental wellbeing. PLOS ONE. 2022;17:27-59. https://doi.org/10.1371/journal.pone.0275925\u003c/li\u003e\n\u003cli\u003eGazzaz ZJ, Baig M, Al Alhendi BSM, Al Suliman MMO, Al Alhendi AS, Al-Grad MSH, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ. 2018;18:1\u0026ndash;9. https://doi.org/10.1186/s12909-018-1133-2\u003c/li\u003e\n\u003cli\u003eAwotidebe AW, Adamu GN, Ali TM, Mohammed J, Lawal IU, Lawan A. Prevalence and factors associated with symptoms of psychological distress among students of Allied Health Sciences in a Nigerian University. Philipp J Allied Health Sci. 2022;15\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003eAbdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alex J Med. 2017;53:77\u0026ndash;84.\u003c/li\u003e\n\u003cli\u003eChikezie U, Okoro T. Prevalence of Depression and Associated Factors among Medical Students in a Southern Nigerian University. Glob J Health Sci. 2021;13:12.\u003c/li\u003e\n\u003cli\u003eJames BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:2\u0026ndash;8. https://doi.org/10.5116/ijme.59c6.3075\u003c/li\u003e\n\u003cli\u003eArun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment? Indian J Psychol Med. 2022;44:10\u0026ndash;26. https://doi.org/10.1177/0253717620982326\u003c/li\u003e\n\u003cli\u003eAzad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety And Depression In Medical Students Of A Private Medical College. J Ayub Med Coll Abbottabad JAMC. 2017;29:12\u0026ndash;73. \u003c/li\u003e\n\u003cli\u003eAbed HA, Abd El-Raouf MS. Stress, Anxiety, Depression Among Medical Undergraduate Students at Benha University and Their Socio-Demographic Correlates. Egypt J Hosp Med. 2021;86:27\u0026ndash;32.\u003c/li\u003e\n\u003cli\u003eLadi-Akinyemi TW, Okpue AP, Onigbinde OA, Okafor IP, Akodu B, Odeyemi K. Depression and suicidal ideation among undergraduates in state tertiary institutions in Lagos Nigeria. PLOS ONE. 2023;18:e02. https://doi.org/10.1371/journal.pone.0284955\u003c/li\u003e\n\u003cli\u003eL\u0026oacute;pez RB, Navarro NM, Astorga AC. [Relationship between personality organization and the prevalence of symptoms of depression, anxiety and stress among university students in health careers in the Region of Coquimbo, Chile]. Rev Colomb Psiquiatr. 2017;46:20\u0026ndash;38. https://doi.org/10.1016/j.rcp.2016.07.005\u003c/li\u003e\n\u003cli\u003eMwita M, Makola AM, Beda M. Prevalence of Depression and Suicidality among Medical Students in Mwanza Tanzania: A Cross-Sectional Study. Neurol Res Surg. 2020;3(1):1-5.\u003c/li\u003e\n\u003cli\u003eHoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49\u0026ndash;59. https://doi.org/10.1111/wvn.12415\u003c/li\u003e\n\u003cli\u003eKebede MA, Anbessie B, Ayano G. Prevalence and predictors of depression and anxiety among medical students in Addis Ababa, Ethiopia. Int J Ment Health Syst. 2019;13:30. https://doi.org/10.1186/s13033-019-0287-6\u003c/li\u003e\n\u003cli\u003eMirza AA, Milaat WA, Ramadan IK, Baig M, Elmorsy SA, Beyari GM, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study. Neurosciences. 2021;26:141\u0026ndash;151. https://doi.org/10.17712/nsj.2021.2.20200127\u003c/li\u003e\n\u003cli\u003eHorgan A, Kelly P, Goodwin J, Behan L. Depressive Symptoms and Suicidal Ideation among Irish Undergraduate College Students. Issues Ment Health Nurs. 2018;39:575\u0026ndash;584. https://doi.org/10.1080/01612840.2017.1422199\u003c/li\u003e\n\u003c/ol\u003e\n\u003cli\u003eNational Institutes of Health (NIH). Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387355/. Accessed on May 30, 2024.\u003c/li\u003e\n\u003cli\u003eGbadamosi IT, Henneh IT, Aluko OM, Yawson EO, Fokoua AR, Koomson A, et al. Depression in Sub-Saharan Africa. IBRO Neurosci Rep. 2022;12:309\u0026ndash;22. https://doi.org/10.1016/j.ibneur.2022.03.005\u003c/li\u003e\n\u003cli\u003eInstitute for Health Metrics and Evaluation. GBD Results. Available from: https://vizhub.healthdata.org/gbd-results. Accessed on May 30, 2024.\u003c/li\u003e\n\u003cli\u003eGlobal, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137\u0026ndash;50.\u003c/li\u003e\n\u003cli\u003eAdewuya AO, Atilola O, Ola BA, Coker OA, Zachariah MP, Olugbile O, et al. Current prevalence, comorbidity and associated factors for symptoms of depression and generalized anxiety in the Lagos State Mental Health Survey (LSMHS), Nigeria. Compr Psychiatry. 2018;81:60\u0026ndash;5. https://doi.org/10.1016/j.comppsych.2017.11.010\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide. Accessed on May 29, 2024. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Suicide worldwide in 2019. Available from: https://www.who.int/publications-detail-redirect/9789240026643. Accessed on June 8, 2024.\u003c/li\u003e\n\u003cli\u003eJames BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:382\u0026ndash;8. https://doi.org/10.5116/ijme.59c6.3075\u003c/li\u003e\n\u003cli\u003eUniversity of Lagos [Internet]. Wikipedia; [cited 2025 Sep 22]. Available from: https://en.wikipedia.org/wiki/University_of_Lagos\u003c/li\u003e\n\u003cli\u003eNyante G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. J Prev Rehabil Med. 2020;2:40\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eLovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eAdewuya AO, Ola BA, Coker OA, Atilola O, Zachariah MP, Olugbile O, et al. Prevalence and associated factors for suicidal ideation in the Lagos State Mental Health Survey, Nigeria. BJPsych Open. 2016;2:385\u0026ndash;9. https://doi.org/10.1192/bjpo.bp.116.004333\u003c/li\u003e\n\u003cli\u003eLunn MR, Cui W, Zack MM, Thompson WW, Blank MB, Yehia BR. Sociodemographic Characteristics and Health Outcomes Among Lesbian, Gay, and Bisexual U.S. Adults Using Healthy People 2020 Leading Health Indicators. LGBT Health. 2017;4:83\u0026ndash;94. https://doi.org/10.1089/lgbt.2016.0087\u003c/li\u003e\n\u003cli\u003eVerma S, Nambiar V. Prevalence of Stress among Undergraduate Physiotherapy Students. Indian J Physiother Occup Ther - Int J. 2014;8:2-95.\u003c/li\u003e\n\u003cli\u003eMuhammad DG, Ahmad A, Usman J. Assessment of Level and Sources of Stress Among Allied Health Sciences Students of Bayero University Kano: A Comparison Between Clinical and Pre-Clinical Students. Educ Med J. 2019;11:11\u0026ndash;19.\u003c/li\u003e\n\u003cli\u003eAsfaw H, Fekadu G, Tariku M, Oljira A. Anxiety and Stress Among Undergraduate Medical Students of Haramaya University, Eastern Ethiopia. Neuropsychiatr Dis Treat. 2021;17:13\u0026ndash;46. https://doi.org/10.2147/ndt.s290879\u003c/li\u003e\n\u003cli\u003eHaider Z, Khan MU, Yasin A, Abbas T, Ahsan M, Rehman IU, et al. Evaluation of stress and its clinical correlation among the students of Allied Health Sciences. Adv Life Sci. 2023;9:3-14.\u003c/li\u003e\n\u003cli\u003eShawi AF, Abdullateef AN, Khedher MA, Rejab MS, Khaleel RN. Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study. Pan Afr Med J. 2018;31:96. https://doi.org/10.11604/pamj.2018.31.96.16737\u003c/li\u003e\n\u003cli\u003eNaidoo S, Van Wyk J, Higgins-Opitz S, Moodley K. An evaluation of stress in medical students at a South African university. South Afr Fam Pract. 2014;56:58\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eEbrahim OS, Sayed HA, Rabei S, Hegazy N. Perceived stress and anxiety among medical students at Helwan University: A cross-sectional study. J Public Health Res. 2024;13:22-79. https://doi.org/10.1177/22799036241227891\u003c/li\u003e\n\u003cli\u003eFrancis-Edoziuno C, Abiona M, Odetola T. Stressors and coping measures among undergraduate nursing students in western nigeria. PAN Afr Sci J. 2024;4.\u003c/li\u003e\n\u003cli\u003eOkoye OC. Perceived Stress and Stressors among Undergraduate Medical Students of a Nigerian Institution. Malawi Med J. 2022;34:24\u0026ndash;51. https://doi.org/10.4314/mmj.v34i4.4 \u003c/li\u003e\n\u003cli\u003eNyanteh G, Yeh A, Quartey J, Kwakye S. Evaluating Stress in Undergraduate Allied Health Science Students at a University in Ghana. 2020;1:1-15\u003c/li\u003e\n\u003cli\u003eHenderson RM, Chetty O, Gurayah T. Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review. South Afr J Occup Ther. 2021;51:29\u0026ndash;38.\u003c/li\u003e\n\u003cli\u003eLavoie-Tremblay M, Sanzone L, Aub\u0026eacute; T, Paquet M. Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years. Can J Nurs Res. 2022;54:26\u0026ndash;71. https://doi.org/10.1177/08445621211028076\u003c/li\u003e\n\u003cli\u003eLeslie K, Brown K, Aiken J. Perceived academic-related sources of stress among graduate nursing students in a Jamaican University. Nurse Educ Pract. 2021;53:10-88. https://doi.org/10.1016/j.nepr.2021.103088\u003c/li\u003e\n\u003cli\u003eSlimmen S, Timmermans O, Mikolajczak-Degrauwe K, Oenema A. How stress-related factors affect mental wellbeing of university students A cross-sectional study to explore the associations between stressors, perceived stress, and mental wellbeing. PLOS ONE. 2022;17:27-59. https://doi.org/10.1371/journal.pone.0275925\u003c/li\u003e\n\u003cli\u003eGazzaz ZJ, Baig M, Al Alhendi BSM, Al Suliman MMO, Al Alhendi AS, Al-Grad MSH, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ. 2018;18:1\u0026ndash;9. https://doi.org/10.1186/s12909-018-1133-2\u003c/li\u003e\n\u003cli\u003eAwotidebe AW, Adamu GN, Ali TM, Mohammed J, Lawal IU, Lawan A. Prevalence and factors associated with symptoms of psychological distress among students of Allied Health Sciences in a Nigerian University. Philipp J Allied Health Sci. 2022;15\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003eAbdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alex J Med. 2017;53:77\u0026ndash;84.\u003c/li\u003e\n\u003cli\u003eChikezie U, Okoro T. Prevalence of Depression and Associated Factors among Medical Students in a Southern Nigerian University. Glob J Health Sci. 2021;13:12.\u003c/li\u003e\n\u003cli\u003eJames BO, Thomas IF, Omoaregba JO, Okogbenin EO, Okonoda KM, Ibrahim AW, et al. Psychosocial correlates of perceived stress among undergraduate medical students in Nigeria. Int J Med Educ. 2017;8:2\u0026ndash;8. https://doi.org/10.5116/ijme.59c6.3075\u003c/li\u003e\n\u003cli\u003eArun P, Ramamurthy P, Thilakan P. Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment? Indian J Psychol Med. 2022;44:10\u0026ndash;26. https://doi.org/10.1177/0253717620982326\u003c/li\u003e\n\u003cli\u003eAzad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety And Depression In Medical Students Of A Private Medical College. J Ayub Med Coll Abbottabad JAMC. 2017;29:12\u0026ndash;73. \u003c/li\u003e\n\u003cli\u003eAbed HA, Abd El-Raouf MS. Stress, Anxiety, Depression Among Medical Undergraduate Students at Benha University and Their Socio-Demographic Correlates. Egypt J Hosp Med. 2021;86:27\u0026ndash;32.\u003c/li\u003e\n\u003cli\u003eLadi-Akinyemi TW, Okpue AP, Onigbinde OA, Okafor IP, Akodu B, Odeyemi K. Depression and suicidal ideation among undergraduates in state tertiary institutions in Lagos Nigeria. PLOS ONE. 2023;18:e02. https://doi.org/10.1371/journal.pone.0284955\u003c/li\u003e\n\u003cli\u003eL\u0026oacute;pez RB, Navarro NM, Astorga AC. [Relationship between personality organization and the prevalence of symptoms of depression, anxiety and stress among university students in health careers in the Region of Coquimbo, Chile]. Rev Colomb Psiquiatr. 2017;46:20\u0026ndash;38. https://doi.org/10.1016/j.rcp.2016.07.005\u003c/li\u003e\n\u003cli\u003eMwita M, Makola AM, Beda M. Prevalence of Depression and Suicidality among Medical Students in Mwanza Tanzania: A Cross-Sectional Study. Neurol Res Surg. 2020;3(1):1-5.\u003c/li\u003e\n\u003cli\u003eHoying J, Melnyk BM, Hutson E, Tan A. Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students. Worldviews Evid Based Nurs. 2020;17:49\u0026ndash;59. https://doi.org/10.1111/wvn.12415\u003c/li\u003e\n\u003cli\u003eKebede MA, Anbessie B, Ayano G. Prevalence and predictors of depression and anxiety among medical students in Addis Ababa, Ethiopia. Int J Ment Health Syst. 2019;13:30. https://doi.org/10.1186/s13033-019-0287-6\u003c/li\u003e\n\u003cli\u003eMirza AA, Milaat WA, Ramadan IK, Baig M, Elmorsy SA, Beyari GM, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study. Neurosciences. 2021;26:141\u0026ndash;151. https://doi.org/10.17712/nsj.2021.2.20200127\u003c/li\u003e\n\u003cli\u003eHorgan A, Kelly P, Goodwin J, Behan L. Depressive Symptoms and Suicidal Ideation among Irish Undergraduate College Students. Issues Ment Health Nurs. 2018;39:575\u0026ndash;584. https://doi.org/10.1080/01612840.2017.1422199\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mental health, Stress, Anxiety, Depression, Suicidal ideation, Allied health students","lastPublishedDoi":"10.21203/rs.3.rs-7802908/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7802908/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDepression, anxiety, stress, and suicidal ideation are increasingly recognized as major public health concerns among university students, particularly those in health-related fields. Psychological distress and suicidal ideation are increasingly prevalent, particularly among young adults. These concerns are more pressing in low- and middle-income countries, where mental health resources are limited. This study assessed the prevalence of depression, anxiety, stress and suicidal ideation and their associations with sociodemographic factors among allied health students at the College of Medicine, University of Lagos.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional, institution-based study was conducted among 200 randomly selected allied health students. Data were collected using a structured online questionnaire comprising the Undergraduate Sources of Stress (USOS) tool, the 21-item Depression, Anxiety, and Stress Scale (DASS-21), and an adapted suicidal ideation item from the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics were used to estimate prevalence, while Pearson\u0026rsquo;s Chi-square test and correlation analyses assessed associations between variables.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe prevalence of depression, anxiety, and stress (mild to extremely severe forms) was 51.5%, 60.5%, and 37.5%, respectively. Suicidal ideation was reported by 28.5% of respondents. Depression, anxiety, and stress were strongly and positively correlated (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while suicidal ideation demonstrated a moderate but significant correlation with depression (r\u0026thinsp;=\u0026thinsp;0.579, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Off-campus residence was significantly associated with higher depression and anxiety, nursing students reported greater stress, and students uncertain about their sexual orientation were more likely to experience suicidal ideation, while no significant associations were observed for age, gender, or religion.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe high prevalence of mental health issues among allied health students, particularly anxiety, underscores a critical public health concern. Significant associations with residence, program of study, and sexual orientation point to the necessity for context-specific and inclusive mental health interventions within Nigerian universities to enhance student wellbeing and optimize academic outcomes.\u003c/p\u003e","manuscriptTitle":"Prevalence and correlates of depression, anxiety, stress and suicidal ideation among allied health students in the College of Medicine, University of Lagos: a cross sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-13 07:47:01","doi":"10.21203/rs.3.rs-7802908/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-11-15T03:04:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"145231245278711201713592609963329623990","date":"2025-11-10T01:09:24+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-31T11:21:55+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-10T15:42:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-09T00:26:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-09T00:26:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-10-07T23:13:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2449eacd-d1d9-495d-b40a-eeefee75e420","owner":[],"postedDate":"November 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-13T07:47:01+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-13 07:47:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7802908","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7802908","identity":"rs-7802908","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}