Factors Associated with Depression, Anxiety, and Stress among Prisoners in Central Thailand
Keywords:
Anxiety, Depression, Mental health, Prisoners, StressAbstract
Mental health problems among prisoners are a major public health concern and contribute to adverse psychological, social, and rehabilitation outcomes. Depression, anxiety, and stress are highly prevalent in correctional settings; however, evidence regarding associated factors among Thai prisoners remains limited. This study aimed to determine the prevalence of depression, anxiety, and stress and to examine their associated sociodemographic and health-related factors among prisoners in Central Thailand. A cross-sectional analytic study was conducted among 245 prisoners recruited through multi-stage sampling from four prisons in Central Thailand. Sociodemographic and health-related characteristics were collected using a structured questionnaire. Psychological distress was assessed using the validated Thai version of the Depression Anxiety Stress Scale-21 (DASS-21). Descriptive statistics were used to summarize participant characteristics and prevalence rates. Multivariable ordinal logistic regression analysis identified factors associated with symptom severity. Statistical significance was set at p < 0.05. The findings showed that mild-to-moderate symptoms were reported in 15.1% of participants for anxiety, 16.3% for stress, and 21.2% for depression. Participation in music activities was associated with higher anxiety severity (OR = 7.02, 95% CI: 1.13 - 43.48). Increasing age was associated with lower stress severity (OR = 0.96, 95% CI: 0.93 - 0.99) and depression severity (OR = 0.97, 95% CI: 0.94 - 0.99). Higher educational attainment (OR = 0.50, 95% CI: 0.26 - 0.95) and receiving family visits (OR = 0.56, 95% CI: 0.34 - 0.93) were protective factors against stress, whereas chronic disease increased the likelihood of stress (OR = 2.21, 95% CI: 1.11 - 4.42) and depression (OR = 1.87, 95% CI: 1.02 - 3.43). These findings suggest that psychological distress among prisoners is influenced by sociodemographic conditions, chronic health problems, and social support factors. Integrating routine mental health screening with interventions that strengthen chronic disease management, educational engagement, and family support may improve mental health outcomes and rehabilitation effectiveness in correctional settings.
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