Prevalence and risk factors of mental disorders in a cross-sectional study of adolescents in South China

Abstract Background The mental health of adolescents is a critical global public health priority. This large-scale, cross-sectional study investigated the prevalence of depression, anxiety, and stress, along with their key associated risk factors, among school-attending adolescents in South China. Methods An online anonymous survey utilizing the validated Depression Anxiety Stress Scales-21 (DASS-21) and the Mental Health Test (MHT) was administered to 23,856 students (mean age = 13.57 ± 1.94 years) from primary, middle, and high schools. Results The results revealed concerning prevalence rates of mild-to-extreme symptoms: 27.9% for anxiety, 25.15% for depression, and 7.63% for stress. Severe study pressure (reported by 52%), loneliness (59%), and poor social relationships (50%) were identified as the predominant risk factors, with multivariate logistic regression confirming their significant associations with worse mental health outcomes (ORs ranging from 1.74 to 1.95). Conclusions This large-scale study quantifies high anxiety and depression prevalence among South Chinese adolescents, identifying study pressure, loneliness, social difficulties, and self-harm as key modifiable risk factors. This study calls for school-based mental health interventions and provides timely empirical evidence to promote student well-being.