Background Nurses are the foundation of healthcare systems, providing clinical care, emotional support, health
education, and patient advocacy. Their frontline role and dedication significantly enhance patient outcomes and
healthcare system efficiency. However, the high-pressure nature of nursing exposes them to increased risk of mental
health disorders, particularly depression, anxiety, and stress, which can undermine both personal well-being and
the quality of patient care. Despite global recognition of this issue, data from resource-limited and conflict-affected
settings, such as Somalia, remain scarce. This study therefore aimed to assess the prevalence of depression, anxiety,
and stress symptoms and to identify associated factors among nurses in Mogadishu, Somalia.
Methods A multicenter, cross-sectional study was conducted between November and December 2024 among
372 nurses across four hospitals in Mogadishu. Data were collected using self-administered online questionnaires
comprising a demographic section, the 21-item Depression, Anxiety, and Stress Scale, the Pittsburgh Sleep Quality
Index, and the Oslo Social Support Scale–3. Statistical analysis was performed using SPSS version 26, including
descriptive statistics, bivariate analyses, and multivariable logistic regression. Statistical significance was set at p<0.05.
Results The prevalence of depression, anxiety, and stress symptoms among participants was 29% (95% CI: 24.5–
33.9%), 32.5% (95% CI: 27.8–37.5%), and 15.1% (95% CI: 11.6–19.1%), respectively. Female was significantly associated
with depression (AOR=1.72; 95% CI: 1.01–2.92; p=0.045) and anxiety (AOR=1.69; 95% CI: 1.03–2.80; p=0.040), while
being over 30 years old was linked to anxiety (AOR=2.59; 95% CI: 1.34–5.01; p=0.005) and stress (AOR=2.34; 95% CI:
1.09–5.02; p=0.029). Stress was further associated with physical inactivity (AOR=2.00; 95% CI: 1.02–3.81; p=0.044)
and ICU work assignments (AOR=3.39; 95% CI: 1.08–10.65; p=0.036). Notably, poor sleep quality and limited social
support consistently were strongly associated with all outcomes, with adjusted odds ratios ranging from 4.60 to 8.18
for sleep and 2.46 to 3.86 for social support.