In Spain, mental health problems are highly prevalent in the general population, as well as in specific groups. Thus, it is necessary to identify those students who are at a higher risk of developing mental health problems during college life. Early diagnosis and management of psychological distress lead to better management and patient outcomes. Globally, studies conducted on different samples of undergraduate students have identified a moderate to high prevalence of depression, anxiety and stress in this population. Causes of stress during college life include academic pressure stemming from factors such as exams and workload, lack of leisure time, competition, concerns about not meeting parentsвЂ™ expectations, establishing new personal relationships and moving to a strange location biological factors such as age and gender, specifically being female and financial burden. Worldwide, it is estimated that 12вЂ“50% of college students present at least one diagnostic criterion for one or more mental disorders. College students are at risk of experiencing stress, anxiety and depression, which cause psychological distress and may impact on their academic performance.

Furthermore, mental health issues in this population are associated with higher incidence of physical and emotional problems in the mid to long term, labor market marginalization, worse quality of sleep and dysfunctional relationships, among others. Most mental health problems appear by early adulthood, yet young adults rarely get any support for their mental health.

Depression is characterized by a set of symptoms including a lack of interest in daily activities, significant weight loss or gain, sleep pattern alterations, lack of energy, loss of concentration, feelings of worthlessness or guilt and even recurrent thoughts of death or suicide. Whereas stress is usually caused by an external factor and can be short-term, anxiety is persistent, even in the absence of a stressor. According to the American Psychological Association, anxiety and depression are both emotional responses leading to a very similar set of symptoms, including difficulty sleeping, fatigue, muscle tension and irritability. Specifically, depression, anxiety and stress are considered important indicators for mental health which, if untreated, can have a negative effect on individuals. Yet, mental health problems are the first cause of disability and a major public health issue worldwide due to disease progression, difficulties in therapeutic management and increasing prevalence. In its plan for the prevention, treatment and overcoming of mental health disorders, the World Health Organization described mental health as fundamental to human health. Interventions aimed at promoting mental health among college students should be implemented.

Conclusion: We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress lacking a stable partner was significantly associated with depressive symptoms and frequent consumption of alcohol was significantly associated with symptoms of anxiety. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Results: We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Method: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students. Aim: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students.

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