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This cross-sectional study assesses the burden of depression, anxiety, and stress among students aged 18+ taking the Medical and Dental College Admission Test, and identifies associated factors. Among 743 participants, prevalence of depressive, anxiety, and stress symptoms reached 75.2%, 77.1%, and 65.3%, respectively.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prevalence-of-mental-health-disorders-and-associated-factors-among-premedical-students-preparing-for-medical-entrance-exams-a-cross-sectional-study-in-pakistan/451481/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prevalence-of-mental-health-disorders-and-associated-factors-among-premedical-students-preparing-for-medical-entrance-exams-a-cross-sectional-study-in-pakistan/451481.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What mental health outcomes does the study measure among premedical students in Pakistan?","Question",{"text":112,"@type":113},"The study evaluates the prevalence and severity of depression, anxiety, and stress symptoms among premedical students preparing for medical entrance exams.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the study conducted?",{"text":117,"@type":113},"It used a cross-sectional design among premedical students aged 18 and above in Pakistan who sat for the Medical and Dental College Admission Test.",{"name":119,"@type":110,"acceptedAnswer":120},"What factors were associated with worse mental health outcomes?",{"text":121,"@type":113},"Female gender was associated with increased odds of severe anxiety, while it was associated with decreased odds of being in higher categories of depression and stress.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},451481,1791032204,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":26,"preview_page_count":4},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Prevalence of mental health disorders and associated factors among premedical students preparing for medical entrance exams: A crosssectional study in Pakistan  \nSyed Muhammad Arsalan  \nAga Khan University Hospital  \nSyed Ibrahim  \nAga Khan University Hospital  \nZayan Noor  \nAga Khan University Hospital  \nAhsan Ahmad  \nAga Khan University Hospital  \nUmaima Khan  \nNorthwest School of Medicine  \nHamnah Binte Zafar  \nJinnah Sindh Medical University  \nShaheryar Ali Mirza  \nUnited Medical and Dental College  \nAyesha Siddiqa  \nWah Medical College  \nAfreen Sadia  \nAga Khan University Hospital  \nResearch Article  \nKeywords: Mental Health, Depression, Anxiety, Stress Disorders, Developing Countries  \nPosted Date: February 18th, 2026  \nDOI: [https://doi.org/10.21203/rs.3.rs-8864622/v1](https://doi.org/10.21203/rs.3.rs-8864622/v1)  \nLicense: 􀁱 􀅏 This work is licensed under a Creative Commons Attribution 4.0 International License.  \nRead Full License  \nAdditional Declarations: No competing interests reported.  \nAbstract  \nPurpose  \nIn low-and middle-income countries like Pakistan, premedical students preparing for competitive medical entrance examinations experience increasing academic, emotional, and societal pressures that affect their mental health. This study aims to assess the burden of depression, anxiety, and stress and determine associated factors within this population, with our research question being: What is the prevalence of mental health problems (stress, anxiety, and depression), and what are the associated factors contributing to mental health outcomes among premedical students in Pakistan?  \nMethods  \nA cross-sectional study was conducted among premedical students aged 18 and above in Pakistan who appeared for the Medical and Dental College Admission Test.  \nResults  \nA total of 743 premedical students participated in the study (69 .4% female; mean age 20.06 ± 1.37 years) . Prevalence of mental health symptoms, including depression, anxiety, and stress, was 75 .2%, 77. 1%, and 65.3% respectively. Extremely severe levels of depression, anxiety, and stress were observed in 25%, 13. 6%, and 12.7% . Female gender was significantly associated with increased odds of severe anxiety (OR 2 .27, 95% CI 1.56–3.29, p\u003C0 .001) but decreased odds of being in higher categories of depression (Normal vs Mild+: OR 0 .48, 95% CI 0.35–0. 65, p\u003C0 .001; Mild vs Moderate+: OR 0 .49, 95% CI 0.37–0. 66, p\u003C0 .001) and stress (Normal vs Mild+: OR 0 .47, 95% CI 0.36–0. 60, p\u003C0 .001; Mild vs Moderate+: OR 0 .47, 95% CI 0.36–0. 60, p\u003C0 .001; Moderate vs Severe+: OR 0 .44, 95% CI 0.34–0. 57, p\u003C0 .001) .  \nConclusions  \nMental health symptoms were highly prevalent among premedical students, with anxiety, depression, and stress affecting a substantial majority. These findings underscore the urgent need for policy-level interventions to support the mental health of MDCAT aspirants.  \nBackground  \nMental health disorders are rapidly increasing among children and adolescents. Globally, depression and anxiety have been estimated at 33 . 6% and 39 .0%, respectively, among college students ( 1) . Furthermore, a systematic review reported that both of these symptoms are highest among medical students in lowerand middle-income countries (LMICs) ( 1) . A study in Bangladesh reported that among students applying to undergraduate programs, the proportion of students with mild to extremely severe levels of depression, anxiety, and stress was 57 .7%, 61 .4% and 44 . 6%, respectively (2) . This raises the concern of mental health issues among premedical students in LMICs, including Pakistan.  \nLevels of stress tend to be high in premedical students due to the overwhelming demands of their coursework and preparations for competitive exams. They face high pressures to achieve good results in their exams, take part in extracurricular activities such as research and volunteering, and meet the expectations of their parents (3, 4) . A study reported that such students, with hi","cbCaiqPkABUGSB1v","https://ap.wps.com/l/cbCaiqPkABUGSB1v","pdf",486041,24,"English","# Abstract\n## Purpose\n## Methods\n## Results\n## Conclusions\n## Background","[{\"question\":\"What mental health outcomes does the study measure among premedical students in Pakistan?\",\"answer\":\"The study evaluates the prevalence and severity of depression, anxiety, and stress symptoms among premedical students preparing for medical entrance exams.\"},{\"question\":\"How was the study conducted?\",\"answer\":\"It used a cross-sectional design among premedical students aged 18 and above in Pakistan who sat for the Medical and Dental College Admission Test.\"},{\"question\":\"What factors were associated with worse mental health outcomes?\",\"answer\":\"Female gender was associated with increased odds of severe anxiety, while it was associated with decreased odds of being in higher categories of depression and stress.\"}]","Prevalence of Mental Health Disorders and Associated Factors Among Premedical Students Preparing for Medical Entrance Exams - A Cross-Sectional Study in Pakistan | PDF",1790735202]