Mental health status may vary by nationality among expatriate workers; no conclusive data is available in Saudi Arabia. We invited expatriate nurses employed in governmental hospitals in Al-Qassim, Saudi Arabia to fill out an electronic survey that contained questions on demography (including nationality), lifestyle, job, depression, anxiety, and stress (assessed with DASS-21 scale). We categorized each outcome into normal, mild to moderate, and severe, and used adjusted multinomial logistic regressions for analyses. Nurses (n = 999) were from India (54.1%), the Philippines/Indonesia (37.0%), Pakistan (4.9%) and Arab countries (4.0%). Indian nurses were three times (OR = 2.93; 95% CI 1.84, 4.67), Pakistani nurses were 2.5 times (OR = 2.54; 95% CI 1.07, 6.00), and Arab nurses were five times (OR = 5.65; 95% CI 2.40-13.31) more likely to suffer from severe depression compared to Filipino/Indonesian nurses (reference group). Results were similar for stress. Depression and stress varied significantly by nationality among expatriate nurses.
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