Prevalence of and factors associated with depressive symptoms among the working population in Thimphu, Bhutan: A cross-sectional study

Abstract

Background The working population contributes significantly to the economic and social development of a country. Despite an increase in mental health concerns in the working population, research on the mental health of Bhutan’s workforce is lacking. Objective To evaluate the prevalence of depressive symptoms and identify associated factors in the working population in Thimphu, Bhutan. Method A cross-sectional study was used to collect information from employees working in both the government and private sectors. The participants (aged 18–60 years) were selected using a stratified random sampling technique. A self-administered validated questionnaire was used to collect information. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results A total of 379 participants were recruited. The overall prevalence of depressive symptoms among the working population in Thimphu, Bhutan was 45.9%. Participants with primary school, high school, or a bachelor’s degree or higher education had significantly lower odds of depressive symptoms than those with no education. Likewise, those in supervisory and operational roles had lower odds than executives. Lower odds of depressive symptoms were also found among those without kidney disease, those with a family history of severe mental illness, and those whose job needs were understood to a limited or great extent. In contrast, moderate-to-severe anxiety and high levels of depersonalization were strongly associated with increased odds of depressive symptoms. Conclusion Depressive symptoms were highly prevalent among formal-sector workers in Thimphu, Bhutan, indicating a substantial burden of mental health concerns within this specific urban workforce. The findings suggest the need for targeted workplace mental health interventions, particularly those that address supervisory support and individual vulnerabilities related to health and psychosocial stressors. While this study contributes valuable insights, it reflects an urban, formal employment context, limiting its generalizability to Bhutan’s broader or informal labor force. These findings highlight the critical need for incorporating mental health promotion into workplace policies, particularly within urban employment settings. Moreover, a national mental health policy should formally recognize the role of occupational settings in promoting psychological well-being and allocating resources accordingly.