Perceived parental academic pressure and its association with depression, anxiety and stress among high school students of Kathmandu, Nepal: a cross-sectional study

Background Worldwide, approximately one in seven adolescents aged 10-19 have some form of mental health disorder as reported by World Health Organization (WHO). Poor mental health among students is a growing public health concern, with evidence indicating an increase in persistent feelings of sadness or hopelessness. High parental expectations and academic pressure have been identified as significant contributors to mental health issues like depression, anxiety, and stress, affecting students’ academic performance and overall well-being. Therefore, this study aims to determine the association of perceived parental academic pressure with depression, anxiety, and stress among high school students of Kathmandu Nepal. Methods This study, based on the positivist philosophy, adopted a quantitative research method and a descriptive cross-sectional design to explore mental health and its association with parental academic pressure among high school students in Kathmandu Metropolitan City of Nepal. A structured self-administered questionnaire was used to collect data. Using multistage stratified sampling, 1,248 students were selected stratified by school type and faculty, with equal allocation of sample across grades. Bivariate analysis was conducted using odds ratios, and variables with p < 0.25 were included in multivariate logistic regression. Results The prevalence of depression, anxiety, and stress was 45.5% (95% CI: 42.8–48.3),49.6% (95% CI: 46.7–52.2), and 36.8% (95% CI: 34.0–38.6), respectively. The study found that 39.9% (95% CI: 37.2–42.4) of students experienced parental academic pressure, which was significantly associated with depression (AOR = 2.60, 95% CI: 2.00–3.38), anxiety (AOR = 2.53, 95% CI: 1.9–3.26), and stress (AOR = 1.38, 95%CI: 1.06–1.80). Among the domains, “too high expectations” had the greatest impact, while “restriction” had the least impact in development of parental academic pressure. Conclusion There was a strong association between parental academic pressure and depression, anxiety and stress suggesting the need for parenting education about setting realistic expectations for their children’s academic performance.