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The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis
Open accessAbstract
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
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“a meta-analysis revealed that approximately 1 in 3 medical students worldwide experiences anxiety, a rate significantly exceeding that of the general population [5].”
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“8% in a recent meta-analysis [14], and similar to the baseline rates reported in Chinese students by a systematic review published last year, where the mean prevalence of anxiety was 27.”
InfluentialSaddik, B., Hussein, A., Sharif-Askari, F., Kheder, W., Temsah, M., Koutaich, R., Haddad, E., Al-Roub, N., Marhoon, F. A., Hamid, Q., et al. (2020) · medRxiv · doi:10.2147/rmhp.s273333 · Cited by 214
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“Medical students have been shown to engage in even more stress exposure and display more mental health problems than non-medical students (Al-Dabal et al., 2010; Seedhom et al., 2019; Shad et al., 2015), and agematched individuals in the general population (Quek et al., 2019).”
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“Anxiety is most prevalent among medical students from the Middle East and Asian countries (19).”
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“Even before the COVID-19 pandemic, the global prevalence of anxiety among medical students was estimated to be 33.8%, and it was the most prevalent in those from the Middle East and Asia [21].”
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Impact of COVID-19 on medical students’ mental wellbeing in Jordan
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“Our findings compliment those of other reviews on the prevalence of common mental health problems in university students [14, 18, 25, 137].”
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“and anxiety among medical students are estimated to be 27% and 34%, respectively.(4,5) Data collected across several countries shows that suicidal ideation rates among medical students is an alarming 11%.”
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“Accumulating evidence indicates that medical students show high prevalence of different mental illnesses worldwide (Rotenstein et al., 2016; Tian-Ci Quek et al., 2019).”
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“33), considerably lower than the rates indicated in recent meta-analyses (Quek et al., 2019; Rotenstein et al., 2016).”
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“Indeed, research conducted worldwide has highlighted remarkable rates of severe psychological disease, in particular anxiety and depression, which were substantially higher than those reported among the general population (Eisenberg et al., 2007; Ibrahim et al., 2013; Quek et al., 2019; Mavrandrea and Giovazolias, 202…”
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“5%) among undergraduates were reported in American and European students [29].”
BackgroundPrevalence of Internet Gaming Disorder in Medical Students: A Meta-Analysis
Chiang, C. L. L., Zhang, M. W., & Ho, R. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.760911 · Cited by 45
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“Anxiety was most prevalent among medical students from the Middle East and Asia [10].”
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Factors affecting test anxiety: a qualitative analysis of medical students’ views
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“In a meta-analysis, Quek, Tam [7] reported that 33.”
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“Previous research has been inconsistent when gender is compared to depression, anxiety, and stress which suggests that gender likely has no significant role as a risk factor for psychological distress [1, 3, 8, 31, 32].”
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“Another meta-analysis estimated that the prevalence of anxiety among medical students was 33.8% [9].”
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“…also shown that the area of training (i.e., a student ’ s major) in fl uenced reported levels of mental distress (e.g., anxiety and depression), where the prevalence rate of anxiety in medical students was substantially higher than in the general population [25, 26] or non-medical students [27].”
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“8% of medical students were showing symptoms of anxiety and the majority of which were in the Middle East and Asia [6].”
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“8% [6], and depression in 62,728 medical students globally was determined as 28% [7].”
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“It should be noted that studying in Medical University in general is regarded as emotionally challenging, and the students more often suffer from anxiety or depression [55,56].”
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“Thus, it seemed reasonable to conclude that the prevalence of anxiety was higher among older students than among younger students [37].”
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“8%, showing a higher prevalence than in the general population, which may substantially impact QoL(26).”
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“This is concerning given the existing evidence on the alarming prevalence of burnout and psychiatric morbidities in learners, as COVID-19 may amplify these pre-existing issues (Puthran et al. 2016; Frajerman et al. 2019; Quek et al. 2019; Hartzband & Groopman 2020).”
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The association of vitamin D deficiency, age and depression in US adults: a cross-sectional analysis
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“Moreover, female students displayed a higher fear of COVID-19 than male students during the lockdown among undergraduates from Ecuador (Rodríguez-Hidalgo et al., 2020).”
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“Of the meta-analyses that provided a pooled prevalence rate, the highest anxiety prevalence rate was 33.8% and was conducted globally (Quek et al., 2019); however, when anxiety prevalence rates were grouped by continent, the prevalence was highest in the Middle East at 42.4%, followed by Asia at…”
InfluentialMental health and burnout during medical school: Longitudinal evolution and covariates
Carrard, V., Berney, S., Bourquin, C., Ranjbar, S., Castelao, E., Schlegel, K., Gaume, J., Bart, P., Mast, M. S., Preisig, M., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0295100 · Cited by 43
Students Anxiety Experiences in Higher Education Institutions
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Metadata
- Authors
- Tian-Ci Quek, T., Wai-San Tam, W., X. Tran, B., Zhang, M., Zhang, Z., Su-Hui Ho, C., & Chun-Man Ho, R.
- Affiliations
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119007, Singapore
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 119007, Singapore
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
- Huaibei Normal University (CN)
- Department of Psychological Medicine, National University Health System, Singapore 119007, Singapore
- Corresponding author
- Zhang, Zhisong
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-07-31
- Volume
- 16
- Issue
- 15
- Pages
- 2735
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6696211
- OpenAlex
- W2965255255
- Cited by
- 990
- References
- 136
- Citations by year
- 2026: 141 · 2025: 130 · 2024: 186 · 2023: 165 · 2022: 174 · 2021: 124 · 2020: 66 · 2019: 3
- FWCI
- 16.82
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- National University of Singapore (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- This study received funding from the National Social Science Fund (General Project of Education) (BBA170063)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- anxiety, medical students, prevalence, risk factors, mental health, medical education, help-seeking, stigma, gender differences, year of study
- MeSH terms
- Anxiety, Humans, Risk Factors, Students, Medical, Global Health, Models, Statistical, Prevalence, Odds Ratio
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