Prevalence and associated factors of depression, anxiety, and stress among undergraduate health professions students in Borama, Somaliland: a cross-sectional study

Mental disorders are characterized by significant impairments in an individual’s thoughts, emotional control, and patterns of behavior. University students frequently suffer from mental disorders like depression, anxiety, and stress. This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among undergraduate health professions students in Borama, Somaliland. An institution-based quantitative cross-sectional study was conducted among 315 undergraduate health professions students from October to December 2025. A simple random sampling technique was employed to select the participants. Data were collected using a structured questionnaire and analyzed using SPSS version 22.0. Depression, anxiety, and stress were assessed via the DASS-21, with subscale scores multiplied by two and classified by severity. Binary logistic regression analysis was performed to assess the association, and statistical significance was defined as p < 0.05. The prevalences of depression, anxiety, and stress among undergraduate health professions students in Borama, Somaliland, were 47.6% (95% CI: 42.2–53.2), 49.5% (95% CI: 43.9–55.0), and 55.6% (95% CI: 50.0–61.0), respectively. Depression was associated with academic failure [AOR = 3.73, 95% CI (1.98; 7.01)], poor time management [AOR = 4.46, 95% CI (1.41; 14.17)], lack of supportive friends/family [AOR = 3.43, 95% CI (1.70; 6.92)], drug use [AOR = 3.69, 95% CI (1.14; 11.95)], and diagnosed health conditions [AOR = 2.45, 95% CI (1.20; 4.97)]. Anxiety was associated with academic failure/probation [AOR = 3.91, 95% CI (2.13; 7.18)], lack of supportive friends/family [AOR = 3.78, 95% CI (1.91; 7.48)], and diagnosed health conditions [AOR = 2.82, 95% CI (1.44; 5.55)], whereas being single was protective [AOR=0.34, 95% CI (0.14; 0.82)]. Stress was associated with feeling academically overwhelmed sometimes [AOR = 2.05, 95% CI (1.12; 3.70)], academic failure/probation [AOR = 3.88, 95% CI (1.99; 7.56)], poor time management [AOR = 4.49, 95% CI (1.27; 15.85)], lack of supportive friends/family [AOR = 2.27, 95% CI (1.12; 4.61)], and diagnosed health conditions [AOR = 3.09, 95% CI (1.46; 6.54)], whereas being single was protective [AOR=0.30, 95% CI (0.11; 0.79)]. This study revealed a high prevalence of depression, anxiety, and stress among undergraduate health professions students. Academic failure, poor time management, lack of social support, marital status, health conditions, drug use, and academic challenge stressors were identified as potential correlates in exploratory analyses. Screening students using DASS-21 every semester and establishing peer support programs would reduce mental health challenges and enhance academic performance.