Prevalence of depression and anxiety among Thai recreational scuba diver

Abstract

Background: Scuba diving accidents linked to psychiatric medication side effects have been reported internationally. Prior studies have identified a significant prevalence of depression and anxiety among divers, with some individuals continuing to dive despite existing physical or psychiatric conditions. However, no such data exist for Thailand.

Objective: To examine the prevalence and associated factors of depression and anxiety among Thai recreational scuba divers.

Methods: A cross-sectional study consecutively recruited 126 certified Thai recreational scuba divers aged 18–60 years visiting Koh Tao, Surat Thani Province, between July and November 2024. Data were collected using an online questionnaire comprising five sections: demographic information, diving profile, health screening, the 9-item Patient Health Questionnaire(PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7). Descriptive statistics and logistic regression analyses were used to identify factors associated with moderate to severe depression and anxiety.

Results: The prevalence of moderate to severe depressive symptoms was 18.3%, while 8.7% of participants reported moderate to severe anxiety. The most frequently reported medical condition was a previous COVID-19 diagnosis. Divers with fewer than 40 logged dives in the past 12 months were significantly more likely to report moderate to severe depression(OR = 4.56; 95% CI: 1.38–15.07;P= 0.013), as were those with a history of depression or suicidal ideation/attempt (OR = 5.61;95% CI: 1.18–26.63;P= 0.030). The presence of bipolar disorder was significantly associated with moderate to severe anxiety (OR = 9.80; 95% CI: 1.54–62.50;P= 0.016).

Conclusion: A substantial proportion of Thai scuba divers exhibit clinically relevant symptoms of depression and anxiety,particularly those with psychiatric histories. Routine mental health assessments, conducted by professionals familiar with both psychiatric care and diving medicine, are essential for ensuring diver safety.