OBJECTIVE: To determine which variables from a pool of potential predictors predict General Health Questionnaire 'caseness' in pre-registration nursing students. DESIGN: Cross-sectional survey, utilizing self-report measures of sources of stress, stress (psychological distress) and coping, together with pertinent demographic measures such as sex, ethnicity, educational programme and nursing specialty being pursued, and age, social class and highest qualifications on entry to the programme. METHODS: Questionnaire packs were distributed to all pre-registration nursing students (N=1,362) in a large English university. Completed packs were coded, entered into statistical software and subjected to a series of logistic regression analyses. RESULTS: Of the questionnaire packs 1,005 (74%) were returned, of which up to 973 were available for the regression analyses undertaken. Four logistic regression models were considered and, on the principle of parsimony, a single model was chosen for discussion. This model suggested that the key predictors of caseness in the population studied were self-report of pressure, whether or not respondents had children (specifically, whether these children were pre-school or school-age), scores on a 'personal problems' scale and the type of coping employed. The overall caseness rate among the population was around one-third. CONCLUSIONS: Since self-report and personal, rather than academic, concerns predict stress, personal teachers need to play a key role in supporting students through 'active listening', especially when students self-report high levels of stress and where personal/social problems are evident. The work-life balance of students, especially those with child-care responsibilities, should be a central tenet in curriculum design in nurse education (and, indeed, the education of other professional and occupational groups). There may be some benefit in offering stress management (coping skills) training to nursing students and, indeed, students of other disciplines.