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Article

Prevalence and Associated Risk Factors of Mental Health Disorders in Makkah’s Primary Care, Saudi Arabia: A Cross-Sectional Study from Secondary Data

by
Turky J. Arbaein
1,
Afnan A. Alandijani
1,
Mohammad Shah
2,
Khulud K. Alharbi
1,*,
Sahal Alzahrani
3,
Soukaina Ennaceur
3,
Afrah A. Alfahmi
1 and
Khawlah O. Alharthi
1
1
Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah 24383, Saudi Arabia
2
Department of Epidemiology and Medical Statistics, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah 24383, Saudi Arabia
3
Public Health Department, College of Health Science, Saudi Electronic University, Riyadh 11673, Saudi Arabia
*
Author to whom correspondence should be addressed.
J. Mind Med. Sci. 2026, 13(1), 1; https://doi.org/10.3390/jmms13010001
Submission received: 9 November 2025 / Revised: 24 December 2025 / Accepted: 26 December 2025 / Published: 29 December 2025
Browse Figure
Versions Notes

Abstract

Objectives: The present study examined the prevalence of depression, anxiety, and other mental disorders among patients visiting primary healthcare centers (PHCs) in Makkah, Saudi Arabia, and explored demographic, lifestyle, and socioeconomic determinants associated with these conditions. Methods: The study analyzed regional-level data from PHC patients diagnosed with mental health illnesses. The prevalence rates of depression, anxiety, and other mental health disorders were calculated and associated risk factors were assessed using binary variables. Results: The study found that 40% of the population was diagnosed with depression, 25% with anxiety, and 35% with other mental disorders. Depression was most prevalent among patients aged 50–64 years, while anxiety was highest among those aged 19–34 years. The lowest rates were observed in patients aged 65 years or older. Females exhibited higher rates of depression and anxiety than males. Saudi nationals accounted for most cases, with unemployment having the highest prevalence. Single individuals reported the highest prevalence of depression and anxiety. Conclusions: The research indicates a significant prevalence of depression, anxiety, and other mental disorders among primary healthcare patients in Makkah, with females, the unemployed, and younger individuals at elevated risk. Low follow-up rates suggest barriers to ongoing mental health care and highlight the need for targeted interventions.

1. Introduction

Mental disorders are conditions that impair an individual’s thinking, mood, feelings, behavior, or ability to function. Their etiology is multifactorial, and their sustainability can impact on a person’s overall well-being and quality of life [1,2]. Worldwide, mental health disorders are a major public health concern, affecting individuals across all ages, cultures, and socioeconomic backgrounds. According to the World Health Organization (WHO), approximately one in eight people worldwide experience a mental health disorder at some point in their lives [3]. There are many different types of mental disorders, each with their own unique set of symptoms and treatment approaches, including anxiety disorders, major depressive disorders (MDD), bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, eating disorders, disruptive behavior and dissocial disorders, and neurodevelopmental disorders [3].
In Saudi Arabia, mental health disorders present a challenge similar to global trends but often remain underrecognized in primary healthcare settings [4,5,6,7]. The Saudi National Mental Health Survey (SNMHS) in 2019 reported that 34% of Saudis, aged between 15 and 65, were diagnosed with a mental health condition at some point in their life. Notably, psychiatric morbidities were more prevalent among youth and individuals with a high level of education in Saudi Arabia [8], with 13.6% of those with mental health conditions seeking professional care annually [5].
Among mental disorders, anxiety and depressive disorders are the most common disorders diagnosed in clinical practices [9,10,11]. Statistics showed that, within a year, the prevalence rates for anxiety and major depressive disorder raised by 26% and 28%, respectively [3]. Moreover, the Coronavirus Disease-19 (COVID-19) pandemic had a profound impact on mental health, leading to a significant increase in anxiety and depressive disorders in 2020 [3]. It has been noticed from global epidemiological data that fear of infection, economic instability, social isolation, and disruptions to everyday life were among the primary factors that significantly increased the prevalence of anxiety and depression disorders over the first year of the pandemic [12]. In addition, a large international modeling study projected millions of new cases of anxiety and depression associated with the COVID-19 pandemic in 2020, showing a major effect on population mental health [13]. Also, according to a report from WHO, the pandemic proved that it greatly affected mental health across different populations, with anxiety and depressive symptoms placed among the most often referred-to disorders [14]. The existing literature revealed that females are more likely to have MDD and anxiety than males [6,9]. In Saudi Arabia, depression is three times more common in females than in males [5,15], with prevalence rates of 9% and 3%, respectively [5]. The Kingdom’s rapid social and economic changes, alongside cultural factors, may contribute to the increased incidence of these disorders among the population [16]. This emphasizes the importance of understanding the prevalence of mental health disorders and factors that contribute to their development.
Mental illness in Saudi Arabia correlates with stroke, diabetes, obesity, and neurodegenerative disorders, underscoring the necessity for awareness, stigma eradication, and suitable care and referrals in primary clinics [17]. The burden of anxiety and depression continues to rise [18], presenting a significant challenge to individuals, families, and societies worldwide [19], adversely affecting future career opportunities, with various illnesses exerting distinct impacts [20].
Primary healthcare centers (PHCs) in Saudi Arabia serve as vital access points for patients seeking medical attention, making them essential locations for identifying and addressing mental health issues. Studies from Saudi Arabia reported that a higher prevalence of screened depression was estimated in PHCs among female and more educated patients [21], and identified demographic and sociodemographic factors associated with mental health illness [22]. The findings of the SNMH also reported prevalence rates of 13% for separation anxiety disorder, 7% for social anxiety disorder, and 3% for generalized anxiety disorder among females, compared to 11%, 4.3%, and 1% among males, respectively [5]. Several previous epidemiological studies in Saudi Arabia have investigated depression and anxiety. However, these studies primarily relied on cross-sectional surveys [5,7,23]. The observed disparities in depression diagnoses among the population visiting PHCs across regions highlight the need for further research to understand the underlying factors contributing to these differences.
To date, no studies have utilized electronic medical record (EMR) data from PHCs in Makkah City to investigate the prevalence of anxiety and depression among patients seeking primary care services. Understanding the prevalence of mental disorders within this population is crucial for developing effective interventions and improving healthcare services. This study aims to explore the prevalence of depression, anxiety, and other mental disorders among patients attending Makkah PHCs and to identify associated factors, including demographic characteristics, lifestyle choices, and social determinants of health. By gaining insights into these aspects, healthcare providers can better tailor mental health services to meet the community’s needs, ultimately enhancing the quality of care and improving health outcomes for patients in Makkah.

2. Methods

2.1. Data Source and Collection

The data used in this study were extracted from the electronic medical records of the Makkah Health Cluster, which was extracted by trained data specialists and health information management personnel in the population health management department. This data has been routinely managed by these personnel, who received formal training in data governance, medical coding and secure handling of patient records. The department guarantees that all information is precise, thorough, and gathered in compliance with ethical and privacy norms through systematic data collection and analysis of pertinent health measures. This comprehensive dataset underpins the identification of health trends, informs policy decisions, and enhances healthcare outcomes in the region. Ethical approval for the study was obtained from the Ministry of Health Institutional Review Board (IRB log No: 24-85 E) on 19/06/2025.

2.2. Study Design

The present cross-sectional study analyzed regional-level data from Makkah City and its surrounding areas. The study was designed to evaluate the prevalence of depression, anxiety, and other mental health disorders and identify associated risk factors. All adult patients diagnosed with a mental health illness based on ICD-10 who visited the PHCs in Makkah between January 2022 and May 2024 were included in the study. Mental health disorders were categorized into three groups based on prevalence: depression, anxiety, and other mental disorders. To assess risk factors, depression and anxiety were coded as a binary variable (depressed vs. other mental health illnesses) and (anxious vs. other mental health illnesses).
The electronic medical records system became fully operational across all participating PHCs in January 2022, marking the earliest point at which consistent and complete digital diagnosis records were available. Data collection concluded in May 2024 due to administrative timelines and ethical clearance requirements linked to the study protocol, preventing the inclusion of the remaining months of 2024. For these reasons, the observation period is considered ‘unusual’ in duration rather than a standard three-year cycle.

2.3. Patient Characteristics

Patient characteristics included age, gender, Nationality, occupation, and marital status. To evaluate the patient characteristics, age was categorized into four age groups: 19–34, 35–49, 50–64, and 65 or older. These age categories were chosen based on life-course epidemiological models, and they reflect the developmental and socio-behavioral phases related to mental health. The 19–34 group represents early adulthood and the transition to higher education, employment and independence. The 35–49 age group represents the mid-life responsibilities and potential exposure to work-family stress. The 50–64 group corresponds to late career and pre-retirement transitions. The ≥65 group represents older adulthood, which might be typically characterized by retirement, aging-related health and possible social changes. Gender and Nationality were coded as binary variables: male/female and Saudi/Non-Saudi, respectively. Occupation represented the patient’s employment status and was classified as public employee, private employee, retired, or unemployed. Marital status was categorized into three groups: single, married, and separated/widowed/divorced. The region in this study was defined based on the location of PHCs in Makkah City, categorized into six areas: central, West, East, North, South, and peripheries. The number of visits was classified as follows: one visit for patients who attended once, two visits for those who attended twice, and three or more visits for those who visited more than twice during the study period.

2.4. Statistical Analysis

The present study used descriptive analysis to summarize the total of mental health patients and the prevalence of specific disorders—depression, anxiety, and other mental illnesses—separately. Descriptive analysis included patient demographics such as age, gender, Nationality, occupation, and marital status. Since all the variables in the present study were categorical, they were summarized with frequencies and percentages. Logistic regression models were used to assess predictors of depression and anxiety, and results were reported as odd ratios (OR) and 95% confidence intervals (CI). All tests were two-sided with a significance level set to 0.05. Statistical analyses were performed in Stata/IC 17 [24]. The visualization of mental health disorders trends over time was performed by RStudio 2024.12.1 [25].

3. Results

3.1. Sociodemographic Characteristics of the Population

A total of 6233 patients were included in the present study. The majority (n = 2726; 44%) were aged 19–34 years, with Saudi patients making up the largest proportion of the population (n = 5749; 92%). The population was evenly distributed by gender, with females and males each constituting 50% of the sample. In terms of occupation, most patients were unemployed (n = 4642; 74%), while public employees and private employees comprised 12% (n = 754) and 10% (n = 634) of the sample, respectively. Moreover, single individuals constituted the largest marital group (n = 2558; 41%), while the West region had the highest geographical representation (n = 1616; 26%). Most patients (n = 4977; 80%) attended only one healthcare visit, and the highest number of cases was recorded in 2023 (n = 2667; 43%) (Table 1).

3.2. Prevalence of Mental Disorders

Among the studied population, 2520 (40%) were diagnosed with depression, 1545 (25%) with anxiety, and 2168 (35%) with other mental disorders. Depression was most prevalent among patients aged 19–34 years (41%), while anxiety was highest among those aged 19–34 years (47%). Other mental disorders were also most common among the 19–34 age group (44%), with lower prevalence in older groups. The lowest rates for all mental health conditions were observed in patients aged 65 years or older (7% for depression, 4% for anxiety, and 7% for other mental disorders). Gender differences were notable: The proportion of depression (58%) and anxiety (55%) was higher among females than males (42% and 45%, respectively). Saudi patients accounted for the majority of depression (93%), anxiety (92%), and other mental disorder cases (92%). Unemployed individuals exhibited the highest prevalence across all conditions: depression (76%), anxiety (75%), and other mental disorders (93%). Public and private employees showed significantly lower rates for all three disorders, with other mental disorders slightly higher in public employees (13%). Regarding marital status, single individuals reported the highest prevalence of depression (44%) and anxiety (43%), while married individuals exhibited slightly lower rates (30% and 33%, respectively). Regionally, depression was most common in the South (28%), anxiety was most prevalent in the East (26%), and other mental disorders were highest in the West (27%). Patients with only one healthcare visit accounted for the most significant proportions of depression (76%), anxiety (81%), and other mental disorders (83%), while those with three or more visits had lower prevalence across all three conditions. Across the study period, depression, anxiety, and other mental disorders were most prevalent in 2023, accounting for 44%, 41%, and 43% of cases, respectively (Table 2).

3.3. Determinants of Mental Health Disorders

Among the mental disorders observed in the present study, anxiety and depression were the most prevalent and clinically relevant conditions, prompting a focused analysis of these two variables (Table 3).

3.4. Depression

The logistic regression analysis identified several significant predictors of depression. Females were associated with higher odds of depression compared to males (OR = 1.74, 95% CI: [1.52, 1.95], p < 0.001). Non-Saudi Nationality also showed an increased likelihood of depression compared to Saudis (OR = 1.25, 95% CI: [1.02, 1.54], p = 0.026). Among marital statuses, being married was associated with reduced odds of depression compared to being single (OR = 0.84, 95% CI: [0.72, 0.96], p = 0.013). Geographically, the South (OR = 1.31, 95% CI: [1.13, 1.51], p = 0.001) and Central regions (OR = 1.28, 95% CI: [1.05, 1.58], p = 0.015) exhibited significantly higher odds of depression compared to the East. Patients with two visits (OR = 1.37, 95% CI: [1.18, 1.61], p = 0.001) and three or more visits (OR = 1.38, 95% CI: [1.13, 1.67], p = 0.001) had greater odds of depression compared to those with a single visit. Age showed no statistically significant association with depression, although the odds were slightly elevated in older age groups compared to those aged 19–34 years. Similarly, occupation did not significantly influence depression prevalence.

3.5. Anxiety

Regarding anxiety, females also emerged as a significant predictor (OR = 1.32, 95% CI: [1.16, 1.48], p < 0.001). Age showed an inverse relationship, with decreasing odds of anxiety as age increased. Compared to the 19–34 age group, the odds of anxiety were significantly lower for patients aged 35–49 (OR = 0.85, 95% CI: [0.73, 0.97], p = 0.022), 50–64 (OR = 0.76, 95% CI: [0.64, 0.92], p = 0.004), and 65 or above (OR = 0.54, 95% CI: [0.41, 0.72], p < 0.001). Marital status was also a significant factor, with married individuals (OR = 0.86, 95% CI: [0.73, 0.99], p = 0.039) and divorced, separated, or widowed individuals (OR = 0.79, 95% CI: [0.68, 0.93], p = 0.003) showing reduced odds of anxiety compared to single individuals. Regionally, the West had significantly lower odds of anxiety compared to the East (OR = 0.72, 95% CI: [0.61, 0.86], p < 0.001), as did the Central region (OR = 0.78, 95% CI: [0.62, 0.98], p = 0.039). Time was a significant predictor for anxiety, with odds increasing over the study period (OR = 1.02, 95% CI: [1.01, 1.03], p = 0.002). However, occupation and number of healthcare visits did not show significant associations with anxiety.

3.6. The Trend of Mental Health Disorders over Time

The temporal distribution of depression, anxiety, and other mental disorders from January 2022 to May 2024 reveals distinct fluctuations in prevalence across different periods (Figure 1). Depression consistently exhibited the highest frequency, followed by anxiety, while other mental disorders showed more variability. A notable increase in depression and anxiety cases was observed between September and December 2022, reaching a peak in January 2023. This was followed by a relative stabilization during February to May 2023, before another increase from June to September 2023. A subsequent decline was observed from October to December 2023, continuing into early 2024. By April and May 2024, the frequency of all three mental health conditions appeared to decrease compared to previous peaks.

4. Discussion

The aim of this study was to examine the prevalence of depression, anxiety, and other mental disorders among patients attending PHCs in Makkah City and to investigate the possible associated factors, including sociodemographic characteristics. The study showed that gender, Nationality, and residency of specific regions were more likely associated with experiencing depression and anxiety. Marital status and aging were more likely to be protective factors. The more significant number of visits to healthcare units was associated with depression. This study has provided valuable perspectives about sociodemographic characteristics and prevalence of depression and anxiety in a large sample of patients in the KSA.
Studies report a significant increase in psychiatric emergency department visits during and after the COVID-19 pandemic, with the post-pandemic period showing the highest increases. These visits were highly related to anxiety, suicidal thoughts, and social stressors, while cases of psychotic disorders declined. Thus, rise reflects widespread pandemic-related stress and greater demand of mental health services [26,27,28].
Younger individuals were especially affected, with reporting higher level of anxiety and depression due to uncertainty, isolation, remote learning, and concerns about the future [29,30,31]. Older adults also showed increased level of depressive symptoms, particularly those experienced reduced family interaction, social isolation, or financial difficulties [32,33]. Overall, the pandemic created significant mental health issue across age groups, driving greater demand for emergency mental health care.
Most of the study participants (44%) were young, particularly at the age between 19 and 34 years. Notable age-related differences in the prevalence of anxiety and depression among patients in Makkah City attending PHCs. Depression was mainly observed among middle-aged patients (50–64 years). Similar findings were found in a cross-sectional study performed in Taif City, Saudi Arabia, where authors found that older age was significantly associated with depression among elderly patients aged 60 years and older attending the primary healthcare units [34]. The greater prevalence of depression among older patients might be associated with the cumulative impact of work-related pressures, financial commitments, caregiving responsibilities, or the presence of various chronic illnesses over the lifetime. Approaching retirement and the dynamic changes in the family could be more prevalent among adult patients at this life stage, which might increase their likelihood of depressive disorders. Anxiety levels, in contrast, were primarily prevalent among younger patients (19–34 years). A cross-sectional study conducted in the South of the Kingdom (Jazan and Najran) concluded with similar results. The authors reported that mental disorders were 40.10% prevalent among young adult Saudis and that anxiety disorders affected almost 27% of them [8]. Our results are also in line with other studies showing that this age group is also most likely to suffer from anxiety and other mental health disorders; like in many countries, this age group is susceptible to problems related to mental health [35,36]. This period in life among young adults is usually characterized by key transitional phases, such as entering adulthood, academic and employment-related pursuits, and the endeavor of economic and social independence, which may increase their anxiety symptoms. Digital technology, social media, and the fast-paced nature of modern life may also negatively influence anxiety disorders in this age group. In our results, an inverse relationship between the prevalence of anxiety and age was noted in our results, with older patients having lower odds for anxiety compared with younger patients. The accumulated life experience, emotional stability, and relatively better financial and social stability among older patients may reduce their likelihood of anxiety disorders.
The prevalence of anxiety and depression were more prevalent among female subjects as compared to male subjects. Similar results were reported in other studies. A systematic review and meta-analysis study investigated the prevalence of depression among more than 25,000 Saudi adults. The authors found that depression was more predominant among females (34.5%) and that the female gender is a statistically significant risk factor for depression [37]. Another cross-sectional study on the general Saudi population from all regions of Saudi Arabia revealed that females had greater odds of developing anxiety [38]. Variations in hormones throughout the lifespan are known to affect the emotional stability and mood regulations among females. These hormonal variations may increase the likelihood of mood disorders among female subjects [39]. The cumulative stress arising from various obligations, such as social expectations requiring women to manage various responsibilities, may elevate the risk of mental health disorders among females [40].
The results of our study revealed that unemployment was associated with anxiety, depression, and other mental disorders. Alsaif et al. reported that Saudis who lost their job during the COVID-19 pandemic had a greater risk for both anxiety and depression as compared to employed Saudis [38]. Our results are also consistent with the global trends. A study that examined the association between unemployment and mental disorders using fifty-year lifetime data from 201 countries confirmed a significant positive correlation between unemployment and depression and anxiety [41]. Occupation is known to support financial stability and socialization, which are important to maintain mental health [42]. Economic insecurity is associated with unemployment, which could result in an increased risk of mental disorders [43,44]. Moreover, social isolation could be highly experienced among unemployed patients, which was recognized to be a risk factor for depression [45]. In the regression model, employment status was not identified as a statistically significant predictor for depression or anxiety. Other social, demographic, or health-related factors might be associated with unemployment and increase the odds of both depression and anxiety.
This study has recognized the association between marital status and mental health. Single individuals were more likely to have both anxiety and depression. These two conditions, however, were less prevalent among married subjects. The COVID-19 study cited above similarly reported that single individuals had greater odds of anxiety and depression as compared with married individuals [38]. Another study investigated factors associated with psychological disorders in the Kingdom of Saudi Arabia and found that single individuals more often experience mental health problems [46]. In the regression model, our study showed that marital status has significantly predicted mental health outcomes, as married individuals have shown lower odds of anxiety and depression. Moreover, married as well as divorced, separated, or widowed subjects reported lower odds for anxiety as compared with single subjects. It has been recognized that marriage is protective against mental disorders [47]. Being married is frequently associated with social support and emotional security, which may protect against mental distress. Having a supportive partner in life, husband or wife, can mitigate the effect of life stressors and be emotionally reassuring, which could improve psychological distress [48]. Studies also showed that married people more often enroll in positive health behaviors and are more likely to maintain a balanced lifestyle, potentially leading to better mental health [49]. Single individuals had a greater risk for mental distress, which could relate to social isolation and emotional instability support. The absence of a life partner may be accompanied by a lack of social and emotional support, which could increase their risk for poorer mental health outcomes [50]. Divorced, widowed, or separated individuals interestingly experienced lower odds for anxiety as compared with single individuals. At the onset of separation, emotional distress might be dominant, yet separated individuals may later develop coping strategies or become financially independent, which could mitigate their potential psychological distress [51]. Psychological relief among separated people, especially if they had marriage-related challenges, could improve their mental health over time. It is important to promote robust social and emotional support, especially among single individuals, by strengthening social cohesion and enhancing psychological coping strategies for people lacking support.
We also found that anxiety and depression were more predominant among Saudi individuals, whereas non-Saudi individuals had greater odds of developing depression as compared with Saudis. Our results are similar to another cross-sectional study in Saudi Arabia, in which the authors found that non-Saudi residents had a more significant risk of developing depression as compared to Saudis [52]. Another cross-sectional Saudi study reported that non-Saudi residents were more likely to have depression and anxiety [53]. The demographic characteristics of the study participants, the majority of them were Saudis, might explain the greater prevalence of anxiety and depression among them. Despite their lower representation, non-Saudi individuals reported greater odds of depression as compared with Saudis. Indeed, the possible causes of these variations cannot be readily determined. However, this could be attributed to, confounded by, a range of socioeconomic or environmental stressors among migrant workers. Non-Saudi employers working in low-wage or labor-intensive sectors may face significant financial, employment, or language challenges. These might increase their likelihood of depression [54]. It is known that expatriates live away from their families, which could worsen their emotional deprivation and isolation and increase their risk for mental health issues [55].
In our study, regional variations were found to be associated with the prevalence of mental health disorders. Depression and anxiety were mostly reported among individuals from southern and eastern regions, respectively. Other mental disorders were prevalent among individuals from the Western region. The odds of developing depression were much greater among individuals from southern and central regions than those from the eastern region. At the same time, patients who attended health care units from the western and central regions had significantly lower odds for anxiety in comparison with those from the East. Areas with limited access to mental healthcare facilities, higher unemployment rates, or lower socioeconomic conditions may increase financial stress among individuals from these areas, which may increase their risk for anxiety and depression [56]. There might be region-specific stressors in the eastern region, which might increase the psychological distress among individuals from the east attending healthcare units in Makkah. This might be attributed to other factors, such as economic-related pressures, urbanization, or occupation-related stress. Urbanization may worsen the anxiety among individuals living in these areas. The fast-paced nature of developed areas may heighten exposure to daily life stressors, which could increase the risk for anxiety among residents living in these regions [57]. Having lower odds for anxiety among individuals from western and central regions, in contrast, may suggest that these regions acquire protective factors that might help in mitigating psychological distress among residents. Differences in social, cultural, and other lifestyle factors may improve emotional stability and reduce anxiety levels [58].
Furthermore, our findings revealed that the rate of visitation was a key variable associated with anxiety and depression. Surprisingly, most (80%) patients had only one visit. The finding is by other research where individuals with mental disorders are not consistent in following up on visits and treatment. This may be due to social stigma, low level of awareness, or inaccessibility [55]. A cross-sectional study was conducted in Riyadh’s PHCs utilizing the Patient Health Questionnaire (PHQ) as a screening tool to identify depressive symptoms among the participants. A consistent picture was revealed where mental health disorders, such as anxiety and depression, presented with a low rate of follow-up visitation [56].
The temporal trends in the frequency of mental health-related visits of depression, anxiety, and other mental issues observed in this study from January 2022 to May 2024. Overall, our results showed an uptrend in the number of visits for all mental health conditions, reflecting a growing demand for mental health services in PHCs in Makkah. However, fluctuations are also observed, e.g., in April 2023, presumably due to the Eid holidays, most PHCs close or run at low capacity. The increasing rate of consultations is suggestive of an enhanced mental health burden, and there is a requirement for enhanced mental health care and specialized health personnel in PHCs in Makkah. The Saudi National Mental Health Survey (SNMHS, 2019) also observed such uptrends with enhanced incidence rates of mental disorders at specific times, presumably due to scholastic, occupational, and financial stressors [57]. In addition to seasonal and holiday-related effects, the observed spikes and troughs may also reflect healthcare system–related and operational factors. Variations in patient attendance, timing of report documentation, referral or transfer of patients to other healthcare facilities, and differences in clinical assessment practices among medical professionals may have contributed to the temporal fluctuations. However, as these factors were not directly captured in the study dataset, their specific contribution to the observed temporal variations could not be assessed and warrants further investigation in future studies.
Comparison of the findings with those of other studies confirms that mental health-related visits—especially for depression and anxiety—have risen steadily since early 2022 across primary care in Saudi Arabia [59]. This finding broadly supports the work of international studies from Spain and Germany, which show similar post-2022 increases, with anxiety and depression reaching their highest levels in years [60,61].

4.1. Practical Implications

The results of this study have several of major implications for primary healthcare centers in Makkah city.
These findings highlight the necessity for mental health interventions that might be applicable to various age groups among patients in Makkah City’s PHCs. Younger patients (19–34 years) may benefit from structured anxiety management initiatives that might incorporate stress reduction techniques. Middle-aged patients (50–64 years), may require additional support in managing their work-related and financial-related stress, as well as chronic disease prevention. Among older subjects, targeted efforts should focus on improving their mental health screening and increasing awareness for better prevention of mental health diseases. Implementing age-specific mental health strategies within primary healthcare settings is crucial to effectively addressing the burden of common mental disorders among patients in Makkah City.
Additionally, gender-specific considerations are needed. The higher prevalence of anxiety and depression among women patients highlights the necessity to implement gender-specific mental health interventions within primary healthcare settings in Makkah City. Adopting gender-specific mental health programs that could address specific stressors among women is essential for effective prevention and intervention.
Another key area for practical intervention is occupational status. Mental health intervention within employment assistance programs specified for unemployed individuals is essential to address the mental health challenges experienced by them. Such these strategies might assist with mitigating the psychological distress associated with unemployment.
The differences noticed between Saudi and non-Saudi patients suggest the focuses on addressing the population-specific difficulties. Among Saudis, mental health interventions should include raising awareness and promoting access to early detection and intervention programs. For non-Saudis, appropriate strategies are required to overcome the possible existing barriers to mental healthcare units. Strategies may include providing cultural-specific psychological services and ensuring better accessibility to mental health resources. Interventions specified within workplaces might help to mitigate occupational stressors and promote psychological resilience among expatriates.
Regional differences in the prevalence of mental health issues highlight the significance of geographically targeted interventions. Community-based mental health interventions and expansion of mental healthcare services, particularly in high-risk areas, may help to reduce the risk of anxiety and depression among people living in these regions.
Finally, the low rate of follow-up visits observed among patients with mental health disorders highlights the need for enhanced continuity of care. Improve follow-up strategies and mechanisms to mitigate the barriers to continuous care are crucial in order to improve the long-term outcomes and treatment adherence.

4.2. Strengths and Limitations

This study has several strengths, such as utilizing a secondary dataset in the Makkah Healthcare Cluster, giving a record of the mental health disorders in Makkah PHCs seeking mental health care. In contrast with previous cross-sectional surveys, this research is enhanced with objective clinician diagnoses, avoiding the risk of self-reported information in surveys. In addition, time trends in the dataset have been examined to identify how mental health disorders evolve in the population of Makkah during the selected timeframe. This provides vital insights for healthcare policymakers.
Despite these strengths, this study has limitations. Our research is retrospective, and such a design cannot identify the undiagnosed mental health disorders in the general population, especially among the population not seeking healthcare. Another is the fact that there is no information on treatment compliance and follow-up care, and such information would better elucidate healthcare usage. The duration of the research is only a relatively brief period and would not identify longer trends. A longer research duration would be needed in order to identify whether observed variability in mental health disorders is seasonal variability or has other triggers.
In future research, there is a need to have qualitative measurement, longer-duration follow-up, and longer research durations in order to understand better the longer-duration impact on mental health disorders and the efficiency of interventions in Saudi Arabia.

5. Conclusions

This study reveals the prevalence of depression, anxiety, and other mental disorders among PHC patients in Makkah. Female patients, unemployed individuals, and young people are at higher risk of experiencing these conditions. Overall, there is an increasing trend, with slight fluctuations in the number of visits for mental health disorders throughout the study period in Makkah. However, the low follow-up rate among patients with mental disorders indicates a potential gap or barriers in mental health care and service utilization.

Author Contributions

S.A. and S.E. analyzed and interpreted the data. All authors contributed to developing the research question. K.K.A., K.O.A., T.J.A., A.A.A. (Afnan A. Alandijani), A.A.A. (Afrah A. Alfahmi) and M.S. drafted the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki. Ethical approval for the study was obtained from the Ministry of Health Institutional Review Board (IRB log No: 24-85 E) on 19/06/2025.

Informed Consent Statement

Not applicable.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors on request.

Conflicts of Interest

The authors declare that they have no competing interests.

Abbreviations

PHCsPrimary Healthcare Centers
MDDMajor Depressive Disorders
SNMHSSaudi National Mental Health Survey
KSAKingdom of Saudi Arabia
COVID-19Coronavirus Disease-19

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Jmms 13 00001 g001
Figure 1. Trends in mental health disorders (Depression, Anxiety, and Other Disorders) among PHC patients in Makkah, January 2022–May 2024.
Figure 1. Trends in mental health disorders (Depression, Anxiety, and Other Disorders) among PHC patients in Makkah, January 2022–May 2024.
Jmms 13 00001 g001
Table 1. Sociodemographic characteristics of the studied population (N = 6233).
Table 1. Sociodemographic characteristics of the studied population (N = 6233).
VariableNumberFrequency
Age group
  19–34272644%
  35–49206433%
  50–64105217%
  65 or above3916%
Gender
  Female310050%
  Male313350%
Nationality
  Saudi574992%
  Non-Saudi4848%
Occupation
  Public employee75412%
  Private employee63410%
  Unemployed464274%
  Retired2033%
Marital Status
  Single255841%
  Married203333%
  Divorced, separated, or widowed164226%
Region
  Central5479%
  East146324%
  North65411%
  South153225%
  West161626%
  Periphery4217%
Number of visits
  One visit497780%
  2 visits79815%
  3 or more visits4587%
Year
  2022206533%
  2023266743%
  2024 (until May)150224%
Table 2. Prevalence of depression, anxiety, and other identified mental disorders.
Table 2. Prevalence of depression, anxiety, and other identified mental disorders.
VariableTotal PopulationDepressionAnxietyOther Mental Disorder
Age group
19–342726 (44%)1033 (41%)729 (47%)964 (44%)
35–492064 (33%)844 (33%)507 (33%)713 (33%)
50–641052 (17%)469 (19%)242 (16%)341 (16%)
65 or above391 (6%)174 (7%)67 (4%)150 (7%)
Gender
Female3100 (50%)1467 (58%)842 (55%)791 (36%)
Male3133 (50%)1053 (42%)703 (45%)1377 (64%)
Nationality
Saudi5749 (92%)2348 (93%)1415 (92%)1986 (92%)
Non-Saudi484 (8%)172 (7%)130 (8%)182 (8%)
Occupation
Public employee754 (12%)281 (11%)193 (12%)280 (13%)
Private employee634 (10%)249 (10%)158 (11%)227 (10%)
Unemployed4642 (74%)1907 (76%)1159 (75%)1576 (93%)
Retired203 (3%)83 (3%)35 (2%)85 (4%)
Marital Status
Single2558 (41%)1112 (44%)662 (43%)784 (36%)
Married2033 (33%)758(30%)510 (33%)765 (35%)
Divorced, separated or
Widowed		1642 (26%)650 (26%)373 (24%)619 (29%)
Region
Central547 (9%)229 (9%)124 (8%)194 (23%)
East1463 (24%)549 (22%)396 (26%)518 (24%)
North654 (11%)226 (9%)179 (11%)249 (11%)
South1532 (25%)702 (28%)377 (24%)453 (21%)
West1616 (26%)668 (27%)344 (22%)604 (27%)
Periphery421 (7%)146 (6%)125 (8%)150 (7%)
Number of visits
One visit4977 (80%)1926 (76%)1246 (81%)1805 (83%)
2 visits798 (15%)374 (15%)188 (12%)236 (11%)
3 or more visits458 (7%)220 (9%)111 (7%)127 (6%)
Year
20222065 (33%)851 (34%)511 (33%)702 (32%)
20232667 (43%)1100 (44%)634 (41%)933 (43%)
2024 (until May)1502 (24%)569 (23%)400 (26%)533 (26%)
Total6233 (100%)25201.5452168
Table 3. Logistic Regression of Depression and Anxiety.
Table 3. Logistic Regression of Depression and Anxiety.
VariableDepressionAnxiety
OR [CI]p-ValueOR [CI]p-Value
Age group (Refs: [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34])
  35–491.09 [0.96, 1.24]0.1570.85 [0.73, 0.97]0.022
  50–641.16 [0.99, 1.37]0.0590.76 [0.64, 0.92] 0.004
  65 or above1.15 [0.91, 1.45]0.2240.54 [0.41, 0.72] 0.000
Sex (Ref: Male)
  Female1.74 [1.52, 1.95]0.0001.32 [1.16, 1.48]0.000
Nationality (Ref: Saudi)
  Non-Saudi1.25 [1.02, 1.54]0.0261.23 [0.69, 1.07]0.181
Occupation (Ref: Unemployed)
  Public employee0.94 [0.79, 1.12] 0.5011.08 [0.89, 1.31]0.393
  Public employee1.09 [0.91, 1.31]0.3111.03 [0.86, 1.26]0.724
  Retired1.11 [0.83, 1.51]0.5030.86 [0.54, 1.19]0.279
Marital Status (Ref: Single)
  Married0.84 [0.72, 0.96]0.0130.86 [0.73, 0.99]0.039
  Divorced, separated or
  Widowed		0.89 [0.77, 1.02]0.0960.79 [0.68, 0.93]0.003
Region (Ref: East)
  Central1.28 [1.05, 1.58]0.0150.78 [0.62, 0.98]0.039
  North0.83 [0.68, 1.02]0.0671.02 [0.85, 1.23]0.972
  South1.31 [1.13, 1.51]0.0010.86 [0.74, 1.02]0.091
  West1.13 [0.96, 1.31]0.1170.72 [0.61, 0.86]0.000
  Periphery0.84 [0.66, 1.06] 0.1431.11 [0.88, 1.42]0.375
Number of visits (Ref: One visit
  2 visits1.37 [1.18, 1.61]0.0010.92 [0.77, 1.09]0.334
  3 or more visits1.38 [1.13, 1.67] 0.0010.95 [0.76, 1.18]0.630
Year (from January 2022 to June 2022)
0.99 [0.98, 1.02] 0.1961.02 [1.01, 1.03]0.002
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Arbaein, T.J.; Alandijani, A.A.; Shah, M.; Alharbi, K.K.; Alzahrani, S.; Ennaceur, S.; Alfahmi, A.A.; Alharthi, K.O. Prevalence and Associated Risk Factors of Mental Health Disorders in Makkah’s Primary Care, Saudi Arabia: A Cross-Sectional Study from Secondary Data. J. Mind Med. Sci. 2026, 13, 1. https://doi.org/10.3390/jmms13010001

AMA Style

Arbaein TJ, Alandijani AA, Shah M, Alharbi KK, Alzahrani S, Ennaceur S, Alfahmi AA, Alharthi KO. Prevalence and Associated Risk Factors of Mental Health Disorders in Makkah’s Primary Care, Saudi Arabia: A Cross-Sectional Study from Secondary Data. Journal of Mind and Medical Sciences. 2026; 13(1):1. https://doi.org/10.3390/jmms13010001

Chicago/Turabian Style

Arbaein, Turky J., Afnan A. Alandijani, Mohammad Shah, Khulud K. Alharbi, Sahal Alzahrani, Soukaina Ennaceur, Afrah A. Alfahmi, and Khawlah O. Alharthi. 2026. "Prevalence and Associated Risk Factors of Mental Health Disorders in Makkah’s Primary Care, Saudi Arabia: A Cross-Sectional Study from Secondary Data" Journal of Mind and Medical Sciences 13, no. 1: 1. https://doi.org/10.3390/jmms13010001

APA Style

Arbaein, T. J., Alandijani, A. A., Shah, M., Alharbi, K. K., Alzahrani, S., Ennaceur, S., Alfahmi, A. A., & Alharthi, K. O. (2026). Prevalence and Associated Risk Factors of Mental Health Disorders in Makkah’s Primary Care, Saudi Arabia: A Cross-Sectional Study from Secondary Data. Journal of Mind and Medical Sciences, 13(1), 1. https://doi.org/10.3390/jmms13010001

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