Prevalence and Predictors of Anxiety Severity Among Health Sciences Students: A Cross-Sectional Study Using the GAD-7 Scale
Keywords:
Anxiety Disorders, Students, Health Occupations, Mental HealthAbstract
Introduction: Anxiety symptoms were highly prevalent among university students, particularly those enrolled in healthcare programs, and were associated with significant academic and functional impairment. Objective: This study aimed to evaluate the prevalence and severity of anxiety symptoms using the GAD-7 scale and to identify associated factors among healthcare undergraduate students. Methodology: A cross-sectional study was conducted with 336 undergraduate students from eight healthcare programs at a Brazilian university. Data were collected through an online questionnaire including sociodemographic variables and the Generalized Anxiety Disorder-7 (GAD-7) scale. Ordinal logistic regression was performed to assess associations between anxiety severity (minimal, mild, moderate, and severe) and predictors such as age, sex, course type (Medicine vs. non-medical), and academic year. Results: The mean age was 22.0 years (SD = 4.6), and 70% of participants were female. Most students (75.3%) were enrolled in Medicine. The mean GAD-7 score was 8.0 (SD = 5.4). Anxiety severity was classified as minimal (27.4%), mild (38.1%), moderate (20.2%), and severe (14.3%), with 34.5% presenting moderate to severe anxiety. Female sex (OR = 2.3; p < 0.001) and enrollment in non-medical courses (OR = 3.2; p < 0.001) were significantly associated with greater anxiety severity. Increasing age was inversely associated with anxiety (p = 0.037). Conclusion: Anxiety symptoms were highly prevalent among healthcare students. Female sex and enrollment in non-medical programs were independent predictors of higher anxiety severity, while older age was associated with lower levels.
Downloads
References
1. Quek TTC, Tam WWS, Tran BX, Zhang M, Zhang Z, Ho CSH, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735. https://doi.org/10.3390/ijerph16152735
2. Shao R, He P, Ling B, Tan L, Xu L, Hou Y, et al. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychol. 2020;8(1):38. https://doi.org/10.1186/s40359-020-00402-8
3. Capdevila-Gaudens P, García-Abajo JM, Flores-Funes D, García-Barbero M, García-Estañ J. Depression, anxiety, burnout and empathy among Spanish medical students. PLoS One. 2021;16(12):e0260359. https://doi.org/10.1371/journal.pone.0260359
4. Juul MV, Andersen JH, Søndergaard J, Vestergaard M. High levels of anxiety and stress in medical students and junior doctors. Dan Med J. 2022;69(11):A03220162. https://ugeskriftet.dk/dmj/high-levels-anxiety-and-stress-medical-students-and-junior-doctors
5. Bertani DE, Mattei G, Ferrari S, Pingani L, Galeazzi GM. Anxiety, depression and personality traits in Italian medical students. Riv Psichiatr. 2020;55(6):342-8. https://doi.org/10.1708/3503.34892
6. Piscoya-Tenorio JL, Heredia-Rioja WV, Morocho-Alburqueque N, Zeña-Ñañez S, Hernández-Yépez PJ, Díaz-Vélez C, et al. Prevalence and factors associated with anxiety and depression in Peruvian medical students. Int J Environ Res Public Health. 2023;20(4):2907. https://doi.org/10.3390/ijerph20042907
7. Mishra AK, Varma AR. A comprehensive review of the generalized anxiety disorder. Cureus. 2023;15(9):e46115. https://doi.org/10.7759/cureus.46115
8. Munir S, Takov V. Generalized anxiety disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK441870/
9. Cintra GS, Cristovão AX, Silva MVA, Japiassú LFF, Corazza AV. Prevalência de transtorno de ansiedade generalizada em estudantes de medicina: revisão da literatura. Arch Health Invest. 2022;11(5):832-5. https://doi.org/10.21270/archi.v11i5.6020
10. Barros GFO, Coimbra Neto JBR, Campanholo EM, Ritter GP, Silva AMTC, Almeida RJ. Fatores associados a ansiedade, depressão e estresse em estudantes de Medicina na pandemia da Covid-19. Rev Bras Educ Med. 2022;46(4):e135. https://doi.org/10.1590/1981-5271v46.4-20210482
11. Souza JPA, Demenech LM, Dumith SC, Neiva-Silva L. Sintomas de ansiedade generalizada entre estudantes de graduação: prevalência, fatores associados e possíveis consequências. J Bras Psiquiatr. 2022;71(3):193-203. https://www.scielo.br/j/jbpsiq/a/phdLZspxdbSmbRtqGs5WtGh/
12. Toussaint A, Hüsing P, Gumz A, Wingenfeld K, Härter M, Schramm E, et al. Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7). J Affect Disord. 2020;265:395-401. https://doi.org/10.1016/j.jad.2020.01.032
13. Camargo L, Herrera-Pino J, Shelach S, Soto-Añari M, Porto MF, Alonso M, et al. Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad. Rev Colomb Psiquiatr. 2023;52(3):245-50. https://doi.org/10.1016/j.rcp.2021.06.003
14. Byrd-Bredbenner C, Eck K, Quick V. GAD-7, GAD-2, and GAD-mini: psychometric properties and norms of university students in the United States. Gen Hosp Psychiatry. 2021;69:61-6. https://doi.org/10.1016/j.genhosppsych.2021.01.002
15. Lin S, Chong AC, Su EH, Chen SL, Chwa WJ, Young C, et al. Medical student anxiety and depression in the COVID-19 Era: unique needs of underrepresented students. Educ Health (Abingdon). 2022;35(2):41-7. https://doi.org/10.4103/efh.efh_112_22
16. Yu Y, Yu Y, Lin Y. Anxiety and depression aggravate impulsiveness: the mediating and moderating role of cognitive flexibility. Psychol Health Med. 2020;25(1):25-36. https://doi.org/10.1080/13548506.2019.1601748
17. Evans O, Rodríguez-Borillo O, Font L, Currie PJ, Pastor R. Alcohol binge drinking and anxiety-like behavior in socialized versus isolated C57BL/6J mice. Alcohol Clin Exp Res. 2020;44(1):244-54. https://doi.org/10.1111/acer.14236
18. Wijeratne C, Johnco C, Draper B, Earl J. Doctors' reporting of mental health stigma and barriers to help-seeking. Occup Med (Lond). 2021;71(8):366-74. https://doi.org/10.1093/occmed/kqab119
19. Rahman MA, Dhira TA, Sarker AR, Mehareen J. Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh. PLoS One. 2022;17(6):e0269634. https://doi.org/10.1371/journal.pone.0269634
20. Shangraw AM, Silvers J, Warholak T, Vadiei N. Prevalence of anxiety and depressive symptoms among pharmacy students. Am J Pharm Educ. 2021;85(2):8166. https://doi.org/10.5688/ajpe8166
21. Santander-Hernández FM, Peralta CI, Guevara-Morales MA, Díaz-Vélez C, Valladares-Garrido MJ. Smartphone overuse, depression and anxiety in medical students during the COVID-19 pandemic. PLoS One. 2022;17(8):e0273575. https://doi.org/10.1371/journal.pone.0273575
22. Reise SP, Moore TM, Sabb FW, Brown AK, London ED. The Barratt Impulsiveness Scale-11: reassessment of its structure in a community sample. Psychol Assess. 2013;25(2):631-42. https://doi.org/10.1037/a0032161
23. von Diemen L, Szobot CM, Kessler F, Pechansky F. Adaptation and construct validation of the Barratt Impulsiveness Scale (BIS 11) to Brazilian Portuguese for use in adolescents. Rev Bras Psiquiatr. 2007;29(2):153-6. https://doi.org/10.1590/S1516-44462006005000020
24. Reinert DF, Allen JP. The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcohol Clin Exp Res. 2002;26(2):272-9. https://doi.org/10.1111/j.1530-0277.2002.tb02534.x
25. Chow MSC, Poon SHL, Lui KL, Chan CCY, Lam WWT. Alcohol consumption and depression among university students and their perception of alcohol use. East Asian Arch Psychiatry. 2021;31(4):87-96. https://doi.org/10.12809/eaap20108
Downloads
Published
Data Availability Statement
Data supporting the findings of this study are available from the corresponding author upon reasonable request. This manuscript has not been previously published and is not under consideration for publication elsewhere.
Issue
Section
License
Copyright (c) 2026 Vivian Kaori Segawa, Julia Miwa Torata Nakano, Israel Kanaan Blaas, João Maurício Castaldelli-Maia
This work is licensed under a Creative Commons Attribution 4.0 International License.
