Prevalence and associated factors of stress among adolescents in rural Bangladesh: A cross-sectional study

Adolescence is a critical developmental stage characterized by heightened vulnerability to psychological disorders. However, research on adolescent stress in Bangladesh is limited. This study aims to assess the prevalence and associated factors of stress symptoms among adolescents in rural Bangladesh. This study is a secondary analysis of a cross-sectional study conducted among 500 adolescents aged 11-17 years in a rural subdistrict of Bangladesh using the Depression, Anxiety, and Stress Scale-21 Items (DASS-21). Chi-square tests and ordinal logistic regression were conducted to identify predictors. The overall prevalence was 36.2% (mild: 10.6%; 95% CI: 8.2%-13.6%; moderate: 10.8%; 95% CI: 8.4%-13.8%; severe: 9.8%; 95% CI: 7.5%-12.7%; extremely severe: 5.0%; 95% CI: 3.4%-7.3%). Associated factors included older age (AOR: 2.9; 95% CI: 1.7-5.0; p < 0.001), female gender (AOR: 1.8; 95% CI: 1.1-2.9; p = 0.019), being married or in a complex relationship (AOR: 6.1; 95% CI: 1.7-22.5; p = 0.006), high socioeconomic status (AOR: 2.2; 95% CI: 1.2-4.1; p = 0.01), poor parental relationships (AOR: 2.2; 95% CI: 1.2-4.1; p = 0.01), bullying (AOR: 1.9; 95% CI: 1.1-3.5; p = 0.031), peer conflict (AOR: 1.8; 95% CI: 1.1-2.9; p = 0.017), moderate (AOR: 4.9; 95% CI: 1.7-14.3; p = 0.004) and severe educational stress (AOR: 9.1; 95% CI: 2.8-29.9; p < 0.001), and a family history of suicide (AOR: 4.0; 95% CI: 1.6-10.0; p = 0.003). These findings highlight the urgent need for targeted mental health interventions to reduce stress and promote adolescent psychological well-being.