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СпутникиРНSpaceXРоскосмосNASABackground Several factors affect the presence of mental health problems in university students and teachers. However, in the Andean region, the identification of these factors is rare. Objective This study sought to evaluate the factors associated with depression, anxiety and perceived stress in students and teachers at a university located in the Andean region. Methods A cross-sectional study was conducted in 2023, including students and teachers with at least one academic cycle at a Peruvian public university in the Andean region. Online surveys were used to collect sociodemographic and clinical data, and validated questionnaires for depression (PHQ-9), anxiety (GAD-7) and stress (PSS-10) were applied. Descriptive analyses and adjusted regressions were performed to identify significant associations. Results A total of 1275 individuals with a median age of 22 years participated; 43.6% were women. A total of 69.3% of the participants reported signs of depression, 62.2% reported anxiety, and 78.4% reported stress. Compared with those aged 20–39 years, students younger than 20 years presented a greater prevalence of mental health problems. A personal mental health history was associated with a greater prevalence of depression, anxiety and stress in students and a greater prevalence of anxiety in teachers. Family history was associated with a greater prevalence of depression and anxiety in students and teachers. Conclusions Sociodemographic and clinical factors are associated with mental health problems in students and teachers in the Andean region. It is essential to consider these particularities to develop effective interventions to address mental health in these settings.
Research Article
[version 1; peer review: awaiting peer review]
https://orcid.org/0000-0001-6820-8607
1, Stefan Escobar-Agredahttps://orcid.org/0000-0002-8355-4310
2, David Villareal-Zegarra3, [...] Wilfredo Manuel Trejo Floreshttps://orcid.org/0000-0002-3613-0187
1, Junior Duberli Sánchez-Broncanohttps://orcid.org/0000-0002-3920-011X
1, Jovanna Hasel Olivares Córdova1, Claudia Alvarez Ysladohttps://orcid.org/0000-0002-0015-5163
1, Leonardo Rojas-Mezarinahttps://orcid.org/0000-0003-0293-7107
4https://orcid.org/0000-0001-6820-8607
1, Stefan Escobar-Agredahttps://orcid.org/0000-0002-8355-4310
2, [...] David Villareal-Zegarra3, Wilfredo Manuel Trejo Floreshttps://orcid.org/0000-0002-3613-0187
1, Junior Duberli Sánchez-Broncanohttps://orcid.org/0000-0002-3920-011X
1, Jovanna Hasel Olivares Córdova1, Claudia Alvarez Ysladohttps://orcid.org/0000-0002-0015-5163
1, Leonardo Rojas-Mezarinahttps://orcid.org/0000-0003-0293-7107
41 Universidad Nacional Santiago Antúnez de Mayolo, Huaraz, Ancash, Peru
2 Escuela de Posgrado, Universidad San Ignacio de Loyola, Lima, Peru
3 Universidad Científica del Sur, Lima, Peru
4 Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
Rosario Yslado-Méndez
Roles: Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing
Stefan Escobar-Agreda
Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing
David Villareal-Zegarra
Roles: Conceptualization, Formal Analysis, Writing – Review & Editing
Wilfredo Manuel Trejo Flores
Roles: Software, Writing – Review & Editing
Junior Duberli Sánchez-Broncano
Roles: Data Curation, Writing – Review & Editing
Jovanna Hasel Olivares Córdova
Roles: Supervision, Writing – Review & Editing
Claudia Alvarez Yslado
Roles: Resources, Writing – Review & Editing
Leonardo Rojas-Mezarina
Roles: Investigation, Writing – Review & Editing
OPEN PEER REVIEW
REVIEWER STATUS AWAITING PEER REVIEW
Corresponding author: Stefan Escobar-Agreda Competing interests: No competing interests were disclosed.
Grant information: The study was funded by the Universidad Nacional Santiago Antúnez de Mayolo (Ancash, Peru). Funding was approved by Resolution of the University Council - Rector N 703-2022-UNASAM.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright: © 2026 Yslado-Méndez R et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Yslado-Méndez R, Escobar-Agreda S, Villareal-Zegarra D et al. Sociodemographic and clinical factors associated with depression, anxiety and stress in students and teachers of a public university in the Andean region: a cross-sectional study [version 1; peer review: awaiting peer review]. F1000Research 2026, 15:1349 (https://doi.org/10.12688/f1000research.169745.1) First published: 11 Aug 2026, 15:1349 (https://doi.org/10.12688/f1000research.169745.1) Latest published: 11 Aug 2026, 15:1349 (https://doi.org/10.12688/f1000research.169745.1)
Mental health problems such as depression, anxiety and perceived stress presented by university students and teachers affect various areas of personal and social development; in the case of students, these problems trigger low academic performance, dropout, and chronic disease1 and an increase in the economic burden due to reduced employability and productivity.2 In teachers, it has an impact on job performance, the quality of teaching and research and other substantive functions they perform3,4 The prevalence in the university population varies in different contexts at the international level; however, it is highly prevalent in low- to middle-income countries (LMICs). In these contexts, there is usually a lack of social and economic support, which is crucial for mental well-being.5 Additionally, universities in these countries lack adequate mental health services due to the scarce funding allocated, limiting the support that students with these problems can receive.6 Furthermore, economic instability in these contexts can increase levels of stress and anxiety among students, affecting their mental health.7
Different international studies have reported high prevalences of anxiety, depression and stress in university teachers and students, which are associated with different psychological, biological, social, financial, academic and lifestyle factors.8,9 Similarly, factors related to mental health problems in LMIC college students have been explored, identifying sociodemographic factors such as female gender10 and belonging to more advanced academic years.11 Other factors identified include academic stress, social isolation, economic precariousness, preexisting mental health conditions, substance abuse, lack of sleep, and family history.12 On the other hand, evidence on these factors in the Andean region is scarce. This context is particular, as cultural stereotypes and stigma toward mental health may prevent students from seeking help and timely treatment.6 In the Peruvian highlands, problems such as depression are not considered13; in addition, there are other aspects, such as difficulty accessing treatment, because there are not enough professionals or specialized mental health facilities.14
Studies conducted in Peru, an LMIC country, report that Peruvian university students present different levels of anxiety, depression and stress associated with sociodemographic, academic, economic and health factors, such as being female, being 16 to 25 years old, having a relatively high academic load, studying and working,15,16 and having a history of chronic disease.17 There is evidence of a high prevalence of mental health problems in university students, such as anxiety, stress and violence.18 This situation extends to the mental health of teaching staff, whose well-being is linked to the mental health of students due to their close relationship with it19 and due to associated problems, such as inadequate working conditions and a medium- to low-level work climate.20
Although some studies mentioned in this report have identified factors related to mental health problems in university students, the behavior of these factors in the Andean region, including teaching staff, has not been studied; therefore, it is necessary to have greater knowledge and understanding of the factors that predispose the presence of these problems in the population evaluated and to implement strategies and programs for mental health prevention to contribute to the well-being and long-term academic and professional success of students and teachers. In the context described, the present study evaluated the factors associated with depression, anxiety and perceived stress in students and teachers of a public university in the Andean region.
An observational, cross-sectional and analytical study was conducted to establish the associations between sociodemographic and clinical variables and the presence of depression, anxiety and perceived stress in teachers and students of a public university located in the Peruvian highlands.
The population consisted of students and teachers from a public university in the Peruvian Andean region, who were invited to complete the questionnaire via a web platform during February and March 2024. Students enrolled in at least one cycle corresponding to the second semester of 2022 were included. As for the teachers, those appointed or hired who had at least one academic cycle working as teachers at the university were included. Based on these characteristics, a total population of 7,000 enrolled students was identified, according to information provided by the general studies office, and 589 teachers, according to a report from the university’s human resources office. In both cases, those who did not give their informed consent or were absent during the study period were excluded.
Outcomes: Mental health problems
Valid (confirmatory factorial validity) and reliable (internal consistency) questionnaires were included to measure the presence of mental health problems, including depression, anxiety and perceived stress.
For the assessment of depression, the Patient Health Questionnaire (PHQ-9) was used in Spanish and validated in a university population in Peru.21 The instrument contains 9 questions with a four-option Likert-type response format: 0 (no days); 1 (several days, between 1 and 6 days); 2 (more than half of the days, between 7 and 11 days); and 3 (almost every day, 12 or more days). The presence of depressive symptoms was considered in those participants with a total score of 10 points or more on the test.
The Generalized Anxiety Disorder Scale (GAD-7), adapted to Spanish and validated in the Peruvian university population, was used to evaluate anxiety.22 The instrument consists of 7 questions with a Likert-type response format with four options: 0 (no day); 1 (several days, between 1 and 6 days); 2 (more than half of the days, between 7 and 11 days); and 3 (almost every day, 12 or more days). Accordingly, participants were categorized into those without anxious symptoms (scores of 0--4) and those with mild (5--9), moderate (10--14) or severe (15--4) anxious symptoms.
The Perceived Stress Scale (PSS-10), adapted to Spanish and validated in the Peruvian population,23 was used to evaluate stress. The instrument consists of 10 questions with a five-option Likert-type response format: 0 (Never); 1 (Almost never); 2 (Occasionally); 3 (Often); and 4 (Very often). Accordingly, participants were categorized into those with mild (scores from 0--13), moderate (scores from 14--26) and severe stress (scores from 27--40).
Exposure: Sociodemographic and clinical factors
The covariates evaluated included sociodemographic characteristics such as sex and age, which were evaluated quantitatively and categorized as “less than 20 years”, “20 to 39 years”, “40 to 59 years”, and “60 years and older”, and having health insurance, which was categorized as “no insurance”, “public insurance” or “private insurance”. In addition, clinical characteristics, such as having a history of a mental health problem, having received treatment for a mental health problem, and having a family member or close friend with a mental health problem, were evaluated.
Eligible study participants, including teachers and students, were contacted via e-mail from the contact information provided by the university. The participants were evaluated via an online survey that was administered after acceptance of voluntary participation through a virtual informed consent form. Both the survey and the consent form were developed and shared through REDCap, which is a specialized web platform for the collection of scientific information, of free use that allows the design of virtual questionnaires, which can be shared and filled out through any electronic device (PC, laptop, tablet or smartphone) with internet access.
Data processing was performed using SPSS Statistics 27.0 software. A descriptive analysis was carried out to describe the sociodemographic and clinical characteristics of the participants, as well as the presence of mental health problems. Qualitative variables are summarized as frequencies and percentages. The age variable is expressed as the median and interquartile range because its distribution is skewed to the left.
A bivariate analysis was performed to explore the associations between sociodemographic and clinical characteristics and the presence of mental health problems through the chi-square test and Fisher’s exact test. A multivariate analysis was subsequently applied to evaluate these associations, including adjustment for covariates. For this purpose, Poisson regressions with robust variance were used to estimate adjusted prevalence ratios (PRs) with 95% confidence intervals (95% CIs). The covariates of each model were selected theoretically according to the causal diagram proposed for each association.
Additionally, an analysis was added to evaluate the associations between the factors evaluated and mental health problems expressed as scores. For this purpose, multiple linear regressions were used to estimate the difference in the scores on the depression, anxiety and stress scales according to each factor through models adjusted for the remaining covariates, estimating beta coefficients (β) with 95% CI.
The research protocol was reviewed and approved by the Research Ethics Committee of the Santiago Antunez de Mayolo National University (UNASAM), through Official Letter No. 0512–2023-UNASAM-DII/D dated December 29, 2023. This study was conducted in accordance with the ethical principles outlined in the World Medical Association.24 It should be noted that this research was part of the study “Effectiveness, usability, and satisfaction of the digital mental health self-care service for teachers, students, and administrative staff at the Santiago Antunez de Mayolo National University.” Data were collected through a secure digital platform specifically developed for the study. Prior to accessing the questionnaire, all participants were presented with an electronic informed consent form explaining the voluntary nature of participation, confidentiality safeguards, and the right to withdraw at any time without any academic or personal consequences. Only participants who provided electronic consent were allowed to proceed with the survey.
Among the 1266 participants included in the study, the median age was 25 years (interquartile range of 5), 551 (43.5%) were female, and 810 (64.0%) reported having public health insurance. With respect to mental health problems, 874 (69.0%) patients presented with some sign of depression, 784 (61.9%) presented with some sign of anxiety, and 1000 (79.0%) presented with some sign of perceived stress. The distribution of these characteristics differed between the students and teachers, especially in terms of age (over 20 years of age), health insurance (greater access to teachers) and the presence of signs of depression and anxiety (more frequent in the students); perceived stress was present indistinctly in the students and teachers ( Table 1).
In relation to the presence of mental health problems according to sociodemographic and clinical characteristics, significant differences were found in the prevalence of depression, anxiety and stress according to age (under 20 years of age). With respect to sex, women presented higher percentages than men did, with significant differences in anxiety and perceived stress, but not in depression. A history of presenting a mental health problem or receiving treatment for it was associated with a higher prevalence of mental health problems, with significant differences in depression, anxiety and perceived stress. The participants whose family members had mental health problems presented significant differences in depression, anxiety and perceived stress. Only the presence of anxiety and depression was different among those who had health insurance versus those who did not; it was not significant for the presence of perceived stress ( Table 2).
With respect to the associations of sociodemographic factors and background with the presence of mental health problems in the students evaluated, a higher prevalence of anxiety was found in those students between 20 and 39 years of age than in those younger than 20 years of age. Similarly, a higher prevalence of depression, anxiety and perceived stress was found in those students with a previous history of mental health (between 15% and 32% more) and those with a family member with a mental health problem (between 12% and 13% more), although for stress this association was not statistically significant ( Table 3).
Table 4 shows the associations of sociodemographic factors and background with the presence of mental health problems in teachers; a higher prevalence of anxiety and perceived stress (approximately 3.3 times greater) was found in those with a history of mental health problems. Additionally, a higher prevalence of depression (approximately 2.5 times greater) was found in those with a family member with mental health problems, whereas no statistically significant differences were observed for anxiety and perceived stress ( Table 4).
The present study reveals the relationships between sociodemographic and clinical factors and the presence of mental health problems in the student and faculty populations of a public university located in the Andean region. Although some findings are consistent with the existing scientific evidence, some results are different for this specific context. Thus, the prevalence of depression and anxiety is greater in students than in teachers. Other studies conducted with samples of university students and teachers in North and South America reported that problems of depression, anxiety and stress are common in both groups and that almost a third of the university community has severe depression.8,25
In terms of age, our study revealed that among university students, young adults (20–39 years old) showed differences only in anxiety compared with adolescent students (under 20 years old). The evidence indicates that the frequency of mental health problems is high in both age groups and has increased during the COVID-19 pandemic,26,27 together with suicidal ideation.28 Consistent with our findings, a systematic review revealed that adolescents are more likely to experience depression, anxiety or stress than young adults.29 This could be related to the transition process between adolescence and adulthood, the presence of stress, risk behaviors and reluctance to seek psychological support among adolescents.30
Studies in Latin America have shown an association between gender and the presence of mental health problems in university students, although with varied results. Thus, in Chile and Paraguay, being female was a significant variable associated with higher rates of depression, anxiety and stress among university students.31,32 Additionally, in China, university students’ anxiety is a more prevalent and severe problem for females, and the prevalence of depression is higher for males; however, for stress, no significant differences were found.33 Another study conducted in Asia among university students revealed that being female increased the risk of anxiety and depression.34 Similarly, our study revealed that the prevalence of mental health problems is greater for women; but it was not significant. In contrast, during the pandemic in Peru, these conditions were less common in females than in males.16
With respect to clinical history, several studies have identified a greater risk of mental health problems in college students with a previous history of these conditions,35,36 which is consistent with our findings and is associated with anxiety, depression and perceived stress in this population. This could be explained by the persistence of problems developed during childhood or adolescence, which tend to be maintained or even chronic in early adulthood.37 In the case of teachers, studies have also noted that a history of mental health problems constitutes a risk factor, although with a lesser magnitude than that of students.38 Consistent with this, our findings identified a significant association between clinical history and anxiety and perceived stress in this population. This could suggest that, over time, teachers have developed coping strategies that have allowed them to overcome their previous difficulties, in contrast to students, who, owing to their young age, are more vulnerable to current problems.38
Our study revealed that a history of mental health problems among family members represents a risk factor for the presence of mental health problems in both students and teachers; however, for students it was not significant for stress, and in the case of teachers it was not significant for anxiety. These results are consistent with international studies conducted in university students,39,40 whereas in teachers, the evidence is limited. In Paraguay and Thailand, a family history of mental health problems is a risk factor, increasing the prevalence of these conditions among university students by up to 2 times.41,42 According to the literature, this relationship could be explained by a combination of genetic and environmental factors. At the genetic level, a greater influence of mental health problems has been demonstrated in parents than in grandparents because of the lower genetic load shared with the latter.43
This study has the strength of providing relevant information on the mental health of university students and teachers in a context that has been little researched, which is a population at risk for being exposed to constant academic stressors and insufficient mental health services, which could increase vulnerability to major mental disorders and suicidal behaviors, which can lead to mortality and potentially loss of life. Having family members with mental health problems could generate greater awareness of these pathologies, generating less stigmatization, better access to mental health services and greater education on the importance of early intervention, and the implementation of preventive-promotional programs based on postpandemic scientific research could be necessary to compare temporal patterns and psychological changes, identify risk and protective factors, and positive predictors to design more effective interventions to promote more resilient, prevented and healthy societies in the future.
The limitations of this study are as follows: the response rate was relatively low, and in studies with online surveys, self-selection of more interested or mental health-conscious participants is possible, which influences the reported prevalence. The use of self-administered online surveys may introduce social desirability biases, as participants may underestimate their symptoms or history due to the stigma associated with mental health problems specific to the Andean region. Although these aspects could underestimate or overestimate the prevalence of mental health problems, in general, they do not condition a differential bias among the associated factors assessed. Another limitation is that the sample was from a single public university in Peru, which limits the generalizability of the results to other regions or educational contexts; however, the choice of this university allows us to understand the particularities of mental health in a unique context with cultural and geographic factors, which may influence the prevalence and manifestation of problems. In addition, the sample size was considerable for the group of students, but the sample of teachers was relatively small, which limits the statistical power for the identification of associations with the factors assessed in this study. However, the results allowed the identification of several associated factors in this population, which is related to the evidence reported at the international level.
The present study identified important associations between sociodemographic factors, clinical history and the presence of mental health problems in students and teachers of a public university in the Andean region. The findings highlight that adolescent students (under 20 years of age) have a greater prevalence of anxiety than young adults do. Similarly, it was observed that being a woman was significantly associated with anxiety and perceived stress problems in this population and that personal and family history of mental health are relevant factors for the presence of these conditions. The results are consistent with those reported in most previous studies and emphasize the need to address mental health, considering sociodemographic and clinical factors and the cultural, geographic and socioeconomic particularities of each context.
The study was reviewed and approved by the Research Ethics Committee of the Santiago Antúnez de Mayolo National University (UNASAM), through Official Letter No. 0512–2023-UNASAM-DII/D dated December 29, 2023. Informed consent was obtained from all participants to take part in the study. Consent was provided via web platform. Consent for publication is not applicable.
To all the participants in the study. To the administrative assistants who supported the execution of the project.
The study was funded by the Universidad Nacional Santiago Antúnez de Mayolo (Ancash, Peru). Funding was approved by Resolution of the University Council - Rector N 703-2022-UNASAM.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
© 2026 Yslado-Méndez R et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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