Pronounced Gender Differences in Anxiety, Depression, and Stress Among Adults in Kabul, Afghanistan: A Cross‐Sectional Study

Introduction Psychological distress in adults is a major public health concern, particularly in regions affected by conflict, economic hardship, and limited access to mental health services. Individuals in such settings are at increased risk of anxiety, depression, and stress. This study examined gender‐based differences in psychological distress among adults in Kabul, Afghanistan. The present study is aimed at investigating gender‐based differences in psychological distress among adults residing in Kabul, Afghanistan. Materials and Methods A cross‐sectional survey was conducted from January to November 2025 using convenience sampling. A total of 968 adults aged ≥ 18 years participated (497 women and 471 men), recruited from community settings across Kabul. Psychological distress was measured using the validated Persian version of the Depression Anxiety Stress Scales‐21 (DASS‐21). Subscale scores were calculated by summing item scores and multiplying by two, with severity categories applied accordingly. Data were analyzed using IBM SPSS Statistics Version 24. Group differences were assessed using Mann–Whitney U tests, and multiple linear regression analyses identified predictors of anxiety, depression, and stress. Results Among participants (51.3% female; 92.0% aged 18–29), women reported higher mean scores than men for anxiety (22.8 ± 6.2 vs. 20.9 ± 6.0), depression (22.1 ± 6.4 vs. 20.8 ± 6.1), and stress (23.0 ± 6.3 vs. 21.2 ± 6.1) (all p < 0.001; r = 0.17–0.22). In adjusted models, female gender predicted higher anxiety ( B = 1.40), depression (B = 1.05), and stress (B = 1.45) (all p ≤ 0.003). Lower income and education were associated with higher distress, whereas younger age was linked only to anxiety (B = −0.06, p = 0.020). Models explained 15%–17% of variance. Conclusion Women reported significantly higher psychological distress across all domains. These differences persisted after adjustment, suggesting underlying structural and psychosocial influences. Lower socioeconomic status was also associated with greater distress, underscoring the importance of social determinants of mental health.