Psychological problems and associated factors among high school students during COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia

Background: Depression, anxiety, and stress (DAS) are common among high school students, and they have a negative impact on their academic performance and future lives. Pandemics, such as coronavirus disease 2019 (COVID-19), exacerbate these issues. Although psychological problems are studied in developed countries, they are overlooked in developing countries such as Ethiopia. Therefore, this study was aimed to assess the prevalence of psychological problems and associated factors among high school students during the COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 663 randomly selected high school students from March 1 to 31, 2021. The data was collected using the depression, anxiety, and stress scale (DASS-21) questionnaire and analyzed using SPSS version 26.0. Bivariable and multivariable analyses were computed to identify factors associated with DAS. An adjusted odds ratio with 95% CI was used to see the strength of the association and statistical significance was declared at p-value <0.05. Results: The overall prevalence of depression, anxiety, and stress were 52.1% [95% CI: 48.3, 55.98], 52.6% [95% CI: 48.8, 56.4], and 22.6% [95% CI: 19.4, 25], respectively. Being rural residence (AOR: 4.88, 95% CI: 3.02, 7.88), living in a prison house or with a husband (AOR: 5.94, 95% CI: 1.65, 21.3), having a lower academic level (AOR: 6.23, 95% CI: 3.42), having poor knowledge about COVID-19 (AOR: 1.75, 95% CI: 1.21, 2.53) and poor COVID-19 prevention practices (AOR: 1.74, 95% CI: 1.09, 2.79) were associated with depression. Similarly, being a rural resident (AOR: 3.73, 95% CI: 2.38, 5.84), being a lower academic level (AOR: 2.54, 95% CI: 1.50, 4.30), having poor knowledge about COVID-19 (AOR: 1.54, 95% CI: 1.08, 2.19), and poor COVID-19 prevention practices (AOR: 2.12, 95% CI: 1.36, 3.32) were associated with anxiety. Furthermore, stress was associated with rural residence (AOR: 2.24, 95% CI: 1.42, 3.53), lower academic level (AOR: 4.70, 95% CI: 2.12, 10.4), and poor knowledge of COVID-19 (AOR: 1.71, 95% CI: 1.13, 2.58). Conclusions: Depression, anxiety, and stress were all prevalent among high school students in the area. Rural residence, lower academic level, and poor knowledge about COVID-19, as well as poor COVID-19 prevention practices, all increase the likelihood of DAS. As a result, school-based psychological counseling interventions, particularly during pandemics, are critical.