Prevalence of Depression and Anxiety and Their Sociodemographic, Stigma, and Help-Seeking Correlates Among Adults in Bangladesh: A Multi-Site Cross-Sectional Study

Abstract

Abstract Background: There is a significant health burden of depression and anxiety in Bangladesh, but there is limited data on depression and anxiety prevalence in the community using multi-site studies that include psychosocial determinants. The independent association of mental health stigma and help-seeking attitudes with risk should be explored. Objectives: To estimate the prevalence of moderate-to-severe depression and anxiety among adults in Bangladesh and examine their associations with sociodemographic characteristics, mental health stigma, and attitudes toward seeking professional psychological help. Methods: A cross-sectional study was conducted from February 1 to June 20, 2026, across three divisions of Bangladesh (urban Dhaka, semi-urban Chattogram, rural Sylhet). Stratified multistage sampling recruited 400 adults aged 18-60 years from government primary care facilities. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively . Mental health stigma was measured using the Community Attitudes Toward Mental Illness-Bangla (CAMI-B), and help-seeking attitudes using the Attitudes Toward Seeking Professional Psychological Help-Short Form (ATSPPH-SF). Multivariable binary logistic regression examined independent predictors of depression and anxiety, controlling for sociodemographic variables. Results: Depression prevalence was 39.0% (n = 156; M = 8.13, SD = 5.72) and anxiety prevalence was 29.8% (n = 119; M = 7.21, SD = 5.14). In adjusted models, each additional unit of CAMI-B stigma increased odds of depression (adjusted odds ratio [aOR] = 1.08, 95% confidence interval [CI] [1.03-1.13], p = .001) and anxiety (aOR = 1.07, 95% CI [1.02-1.12], p = .004). Each additional unit of positive help-seeking attitude reduced the odds of depression (aOR = 0.92, 95% CI [0.88-0.97], p = .001) and anxiety (aOR = 0.93, 95% CI [0.89-0.97], p = .001). Age predicted depression (aOR = 1.04 per year, p = .009) but not anxiety (aOR = 1.02, p = .439). Sex, education, and household income were not significant independent predictors in adjusted models. Descriptive analysis showed higher depression prevalence in rural (47.0%) versus urban (33.8%) settings, though rural residence was not significant in adjusted models. Conclusions: Depression and anxiety are highly prevalent among Bangladeshi adults. Mental health stigma and positive help-seeking attitudes emerge as independent psychological determinants, stronger than conventional sociodemographic factors. These modifiable psychosocial factors represent key intervention targets. Comprehensive strategies combining community-level stigma reduction, individual help-seeking enhancement, and healthcare system strengthening are essential to reduce depression and anxiety burden and address Bangladesh's substantial mental health treatment gap.