title: Stress, anxiety, and depression among call handlers employed in international call centers in the national capital region of Delhi.
abstract: BACKGROUND
  Call handlers employed in call centers repeatedly undergo stress in their day-to-day lives and this can have deleterious effects on their health.
  
  
  OBJECTIVE
  The objectives were to study the levels of stress, anxiety, and depression, and their predictors among call handlers employed in international call centers in the National Capital Region (NCR) of Delhi.
  
  
  METHODS
  A cross-sectional questionnaire-based survey was conducted among 375 call handlers aged 18-39 years. Depression Anxiety Stress Scale- 42 (DASS-42) was used to measure stress, anxiety, and depression along with a pretested sociodemographic questionnaire. Univariate analysis was done to find out the association of stress, anxiety, and depression with various factors. Variables with P < 0.25 were included in multiple logistic regression and three models were developed each for stress, anxiety, and depression.
  
  
  RESULTS
  The prevalence of stress, anxiety, and depression among call handlers was 46.7%, 57.1%, and 62.9% respectively. Abnormal sleep quality, prolonged travel time, and lack of relaxation facilities at the office were predictors of stress and depression. The presence of physical ailments, the absence of hobbies, temporary/part-time employment, and traveling long-distance to office were significant predictors of anxiety among call handlers.
  
  
  CONCLUSIONS
  Call handlers face a high burden of stress, anxiety, and depression. Public health specialists need to pay adequate attention to their health problems.
authors.affiliation: Assistant Professor, Department of Community Medicine, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Dinesh Raja
authors.initials: DR
authors.lastname: Jeyapal
authors.forename: Sanjiv Kumar
authors.initials: SK
authors.lastname: Bhasin
authors.forename: Anjur Tupil
authors.initials: AT
authors.lastname: Kannan
authors.forename: Manjeet Singh
authors.initials: MS
authors.lastname: Bhatia