Cited by 92Student Stress and CopingDoctoral Education Challenges and SolutionsHealthcare professionals’ stress and burnout

The DOI matches its Crossref record; 74 of the 74 references it cites were found in a registry or an index; none of the 20 sources its claims cite is checked for support yet.

Global prevalence and trend of anxiety among graduate students: A systematic review and meta‐analysis

Open access
Chi, Ting, Cheng, Luying, Zhang, Zhijie·2023·Brain and Behavior

Abstract

Objective: To evaluate the comprehensive prevalence of anxiety among postgraduates and estimate its changes with a meta‐analysis. Method: Systematic retrieval to SAGE, ERIC, EBSCO, Wiley, ScienceDirect, ProQuest, PubMed, EMBASE, and Web of Science database was performed for quantitative studies on the prevalence of anxiety among graduate students published before November 22, 2022. The prevalence of anxiety synthesized with random‐effects model, and subgroup analysis was conducted by study characteristics (publication year, sampling method, and measurements) and subjects’ characteristics (gender, region, and educational level). Result: Fifty studies were included in the meta‐analysis, totaling 39,668 graduate students. The result revealed that 34.8% of graduates suffered from the anxiety (95% CI: 29.5%–40.5%). Specifically, 19.1% (95% CI: 15.4%–23.5%) had mild anxiety, 15.1% (95% C: 11.6%–19.6%) had moderate anxiety, and 10.3% (95% CI: 7.2%–14.6%) had severe anxiety. And this prevalence showed a upward trend since 2005. Besides, master students suffered slightly less than doctoral students (29.2% vs. 34.3%), and female had similar anxiety to male (26.4% vs. 24.9%). Due to the COVID‐19, the prevalence of anxiety is higher after the pandemic than that before (any anxiety: 34.3% vs. 24.8%). Compared with other countries, students from Saudi Arabia, India, and Nepal were more vulnerable. The results of quality assessment showed that, 5 (10%) were in high quality, 21 (42%) were in moderate to high quality, 21 (42%) were in low to moderate quality, and 3 (6%) were in low quality. But, the studies with low quality tend to report a higher prevalence than that with high quality (40.3% vs. 13.0%), studies with nonrandom sampling tend to report a higher prevalence than that with random sampling (33.6% vs. 20.7%). Although we included the data collected based on the standard scales, there were higher heterogeneity among the measure ( Q = 253.1, df = 12, p < .00). Conclusion: More than one‐third postgraduates suffered from anxiety disorder, and this prevalence had a slight upward trend since 2005, school administrators, teachers and students should take joint actions to prevent mental disorder of graduates for deteriorating.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis of 50 studies (39,668 graduate students) estimated pooled anxiety prevalence at 34.8% and reported a slight upward trend in any and severe anxiety since 2005. It found high heterogeneity and no significant gender or COVID-19 before/after differences in the main results, though the abstract reports some conflicting subgroup figures.

Key findings

  • Pooled any anxiety prevalence was 34.8% (95% CI: 29.5%–40.5%); mild anxiety was 19.1% (95% CI: 15.4%–23.5%), moderate anxiety 15.1% (95% CI: 11.6%–19.6%), and severe anxiety 10.3% (95% CI: 7.2%–14.6%), with significant heterogeneity for any anxiety (Q = 4683.1, p < .00; I² = 98.9%).
  • Meta-regression showed any anxiety increased slightly over time (β = .05, p < .00) and severe anxiety increased (β = .07, p < .00), while mild and moderate anxiety decreased (β = –.07 and β = –.09, respectively, p < .00).
  • Subgroup analyses found master’s students had any anxiety prevalence of 29.2% versus 34.3% for doctoral students in the abstract (results text reports 29.2% vs. 34.2%); no significant gender difference was found (any anxiety: 41.2% vs. 35.5%; Q = 0.37, p = .54), and nonrandom sampling reported higher moderate anxiety than random sampling (13.3% vs. 5.9%; Q = 6.88, p = .01).
  • The results section found no significant COVID-19 before/after difference in any anxiety (32.4% vs. 36.2%; Q = 0.45, p = .50), while the abstract states higher after-pandemic prevalence (34.3% vs. 24.8%).

Methods

  • Systematic review and meta-analysis; searched SAGE, ERIC, EBSCO, Wiley, ScienceDirect, ProQuest, PubMed, EMBASE, and Web of Science through November 22, 2022, including cross-sectional English studies of healthy master’s or doctoral students using standardized anxiety measures; 50 studies totaling 39,668 graduate students were included, with data collected between 2005 and 2021 and 14 measures used.
  • Random-effects meta-analysis was used, with subgroup analyses by study characteristics (publication year, sampling method, measurement) and subject characteristics (gender, region, educational level), plus meta-regression for trend, leave-one-out sensitivity analysis, funnel plots, and fail-safe N for publication bias.
  • Quality was assessed with a modified Newcastle-Ottawa scale; 5 studies (10%) were high quality, 21 (42%) moderate to high, 21 (42%) low to moderate, and 3 (6%) low quality.

Limitations

  • Stated by the paper: most participants were assessed through self-report inventories rather than gold-standard diagnostic clinical interviews; different anxiety criteria across self-rating scales caused significant heterogeneity; most included studies used nonrandom sampling, which may overestimate moderate anxiety; and 36% of studies had sample sizes under 300.
  • Evident from the text: heterogeneity was very high (I² = 98.9% for any anxiety), and reported figures are inconsistent across sections—e.g., any anxiety 34.8% in the abstract/results versus 34.1% in the discussion, severe anxiety 10.3% versus 1.3%, and conflicting COVID-19 and gender subgroup numbers.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/brb3.2909

Cites

74 of 74 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

FIGURE 1 Flow diagram of literature search and processing of records.
FIGURE 1 Flow diagram of literature search and processing of records.CC BY · PubMed Central
FIGURE 2 Funnel plot of anxiety prevalence among graduate students.
FIGURE 2 Funnel plot of anxiety prevalence among graduate students.CC BY · PubMed Central
FIGURE 3 The prevalence of any anxiety among graduates through the year.
FIGURE 3 The prevalence of any anxiety among graduates through the year.CC BY · PubMed Central

Verification

Claims the paper makes

60 Own result · 7 Own interpretation · 7 No basis given · 6 Sources not found · 4 No full text of the sources · 4 Own method · 3 Check pending · 3 Not checked yet

Verify all 4 references — free account
  • It may state two separate claims as one. 12
  • Probably not a substantial claim. 15
  • The quote only partly states this claim. 3
26 of 26
  • The paper relies on this without support.

    The trajectory of change in anxiety prevalence among graduate students remained unclear before this review.

    “and the trajectory of the change remained unclear.”
  • The paper relies on this without support.

    The year of data collection accurately reflects whether the study was conducted before or after the COVID-19 pandemic.

    “To explore the effect of COVID‐19, we compared the prevalence of anxiety between before pandemic (before 202) and after (2020–2021) based on the data collection year.”
  • The paper relies on this without support.

    The different standardized anxiety scales used in the included studies measure a comparable construct and can be pooled.

    “Although we included the data collected based on the standard scales, there were higher heterogeneity among the measure (Q = 253.1, df = 12, p < .00).”
  • The paper relies on this without support.

    The systematic search captured all relevant studies on anxiety prevalence among graduate students.

    “Systematic retrieval of the electronic database was performed, including SAGE, ERIC, EBSCO, Wiley, ScienceDirect, ProQuest, PubMed, EMBASE, and Web of Science database.”
4 of 4

Claims other papers make about this one

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

12 of 12

Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

1 of 1

Citations

Cites

1 retracted

Show all 74 references

Research works printed but not linked: 5

  1. 10.23736/s0391‐1772.2.02074‐9 · DOI
  2. 10.1080/07448481.202.1725020 · DOI
  3. 10.1096/fasebj.31.1_supplement.75.7 · DOI
  4. 10.1080/07448481.202.1865975 · DOI
  5. 10.3389/fpsyt.202.588693 · DOI

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Metadata

Authors
Chi, T., Cheng, L., & Zhang, Z.
Affiliations
  • Gansu Provincial Cancer Hospital Gansu Provincial Academic Instiute for Medical Research (CN)
  • Lanzhou University (CN)
  • Gansu Provincial Hospital (CN)
Corresponding author
Zhang, Zhijie
Venue
Brain and Behavior
Publisher
Wiley
Published
2023-02-27
Volume
13
Issue
4
Pages
e2909-e2909
ISSN
  • 2157-9032 (ISSN-L)
  • 2162-3279
OpenAlex
W4322617409
Cited by
92
References
74
Citations by year
2026: 40 · 2025: 32 · 2024: 11 · 2023: 9
FWCI
3.20
Type
journal article
Language
en
Open access
Locations
  • Brain and Behavior (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Education › Doctoral Education Challenges and Solutions
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
anxiety, graduate students, prevalence, temporal trends, master's students, doctoral students, gender differences, COVID-19 pandemic, international students, study quality, measurement heterogeneity, student mental health, Saudi Arabia, India, Nepal, South America
MeSH terms
COVID-19, Anxiety, Anxiety Disorders, Depression, Female, Humans, Male, Students, Prevalence

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