Coffee consumption and symptoms of anxiety, depression, and stress among Chilean university students: a cross-sectional study

Background Coffee contains multiple bioactive compounds that may influence mental health through neurochemical, inflammatory, and behavioral pathways. However, evidence regarding its relationship with anxiety, depression, and stress remains inconsistent, particularly in university populations. The aim of this study was to evaluate the association between coffee consumption and symptoms of anxiety, depression, and stress among Chilean university students Methods A cross-sectional study was conducted among undergraduate students from a private higher education institution in southern Chile. Participants completed an online questionnaire that included general background information, a targeted anamnesis on coffee consumption, and the Depression, Anxiety and Stress Scale (DASS-21). Associations between coffee-related variables and psychological outcomes were explored using bivariate analyses, multivariable logistic regression models, linear regression models, and Random Forest models as an exploratory approach to examine the relative importance of variables Results A total of 367 students were included, of whom 82.6% reported habitual coffee consumption. The prevalence of stress, depressive, and anxiety symptoms was 43.3%, 51.5%, and 55.6%, respectively. Overall coffee consumption was not associated with the presence of anxiety, depression, or stress symptoms in adjusted logistic regression models. Likewise, no significant dose-response relationships were observed for consumption frequency. In contrast, coffee consumption was associated with lower continuous stress scores in adjusted linear models (β = −1.38; 95% CI: −2.69 to −0.07; p = 0.039). The amount of coffee used per cup was significantly associated with stress symptoms in bivariate analyses and was the most important coffee-related variable for stress in the Random Forest models Conclusions Among Chilean university students, overall coffee consumption was not independently associated with the prevalence of anxiety, depression, or stress symptoms. However, the associations observed with continuous stress scores and the amount of coffee used per cup suggest that the mental health correlates of coffee may depend more on exposure intensity than on consumption status alone.