Generalized anxiety disorder and its associated factors among undergraduate health students of Chitwan District, Nepal

BMC Public Health. 2026 Jul 20. doi: 10.1186/s12889-026-28645-x. Online ahead of print.

ABSTRACT

BACKGROUND: Generalized Anxiety Disorder (GAD), one of the most common anxiety disorders, is more prevalent among undergraduate health students than in the general population. Despite its adverse effects on academic performance and well-being, it often remains underrecognized in academic settings. Therefore, this study assessed GAD and its associated factors among undergraduate health students of Chitwan District, Nepal.

METHODOLOGY: A cross-sectional study was conducted among 274 undergraduate health students of Chitwan Medical College using two-stage stratified random sampling. Data were collected through a self-administered questionnaire using the GAD-7 tool. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Version 25. Chi-square tests and binary logistic regression were applied to identify associated factors. Variables with p-values < 0.2 were included into the multivariate logistic regression model. Model fit was assessed using the Hosmer-Lemeshow goodness of fit test and Nagelkerke R². All the tests were set at a 95% Confidence Interval (CI) and variables with a p-value of < 0.05 were considered statistically significant in this study.

RESULTS: The mean (± SD) age of participants was 21.2 ± 2.1 years. The prevalence of GAD was 52%. Among students with GAD, 64.8% had mild, 22.6% moderate, and 12.6% severe levels. The most commonly reported problems were academic difficulties (17.9%), bullying (10.6%), and physical abuse (8.1%). The study found significant associations between GAD and family type (AOR = 1.42, 95% CI: 1.09-2.14), perceived financial stress in the family (AOR = 2.20, 95% CI: 1.10-4.41), stressful life events (AOR = 2.40, 95% CI: 1.16-2.97), presence of psychosocial risk factors (AOR = 2.18, 95% CI: 1.09-3.37), smoking (AOR = 2.85, 95% CI: 1.03-4.89), and physical inactivity (AOR = 2.92, 95% CI: 1.25-6.84).

CONCLUSION: The high prevalence of GAD among undergraduate health students highlights the important role of family, academic, financial, psychosocial, and lifestyle-related factors in students’ mental health. Strengthening family and psychosocial support, addressing financial stress, promoting healthy lifestyles, and helping students cope with study-related pressure and stressful life events may help reduce the burden of GAD. Universities should prioritize early screening, accessible mental health services, and stress management programs to improve students’ mental well-being.

PMID:42477628 | DOI:10.1186/s12889-026-28645-x