Assessment of anxiety, stress, and depression among medical students using a Zalo OA Chatbot and associated factors

Aims: This study aimed to assess the prevalence of anxiety, stress, and depression among medical students using a Zalo OA chatbot and to identify associated factors. Study design: Cross-sectional study. Place and Duration of Study: Conducted from September to October 2025 at a private university with health programs in Ho Chi Minh City, Vietnam. Methodology: A total of 399 students completed a self-administered questionnaire via the Zalo OA chatbot, including demographic data, lifestyle, social and family factors, and mental health assessment using the DASS-21 scale. Descriptive statistics and multivariate logistic regression were applied to identify factors related to anxiety, stress, and depression. Results:Females comprised 51% of participants. Most were Kinh (89.2%) and from urban areas (60.4%). Over half were Buddhists (53.1%) and 32.1% reported no religious affiliation. About 36.6% reported difficulty making new friends, 62.2% belonged to peer groups, and 28.8% had challenges adapting to living environments. Regular exercise was reported by 30.3%, and 19.1% had experienced self-harming thoughts. Mental health prevalence was as follows: anxiety – normal 37.1%, mild 10.8%, moderate 20.8%, severe 12.5%, extremely severe 18.8%; stress – normal 63.4%, mild 10.8%, moderate 16%, severe 6.0%, extremely severe 3.8%; depression – normal 47.6%, mild 17.3%, moderate 22.6%, severe 8.0%, extremely severe 4.5%. Multivariate analysis indicated that difficulty adapting to living environments, female gender, having a close friend, and frequent exposure to parental conflict were significantly associated with anxiety, stress, or depression (p < 0.05). Conclusion: Mental health problems are common among medical students, influenced by individual, social, environmental, and family factors. Early identification via digital tools and timely interventions are necessary to reduce anxiety, stress, and depression in this population.