Prevalence and associated factors of depression, anxiety, and stress among university athletes in Bangladesh

Background University athletes face substantial academic, physical, and psychosocial pressures that may heighten vulnerability to psychological distress, despite the perceived mental health benefits of sports participation. This study aimed to determine the prevalence of depression, anxiety, and stress among university athletes in Bangladesh and to examine how these conditions are associated with lifestyle and sociodemographic factors. Methods This cross-sectional study was conducted from March to September 2025 among 249 university athletes aged 18–26 years at six randomly selected universities in Bangladesh. Data were collected online and in person. Psychological distress was assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21), and health-promoting lifestyle behaviors were evaluated with the Health-Promoting Lifestyle Profile II (HPLP-II). Descriptive statistics, chi-square tests, Mann–Whitney U tests, Spearman’s correlations, and binary logistic regression analyses were conducted. Results The prevalence of depression, anxiety, and stress was 42.6%, 42.6%, and 43.8%, respectively. Depression, anxiety, and stress were significantly associated with relationship status, fatigue, socioeconomic status, smoking, sleep duration, sports participation frequency, and satisfaction with sports (all p < 0.05). Participants with depression, anxiety, and stress had significantly lower scores across all HPLP-II domains (all p < 0.01). Higher physical activity was independently associated with lower odds of depression (OR = 0.462, 95% CI: 0.286–0.746), anxiety (OR = 0.756, 95% CI: 0.677–0.845), and stress (OR = 0.773, 95% CI: 0.677–0.882). Better stress management and stronger interpersonal relationships were also significantly associated, whereas other factors were not. Conclusions Depression, anxiety, and stress were highly prevalent among university athletes in Bangladesh and strongly associated with modifiable lifestyle factors. These findings support integrated, athlete-centered mental health strategies emphasizing physical activity, stress management, and psychosocial support. However, the cross-sectional design precludes causal inference and determination of the directionality of these associations. Clinical trial number Not applicable.