Anxiety and Depressive Symptoms among Undergraduate Health Sciences Students at a Rural South African University: Prevalence and Multivariable Correlates

Health sciences students may experience substantial anxiety and depressive symptoms, yet evidence from rural South African faculties remains limited. This study estimated the prevalence and severity of anxiety and depressive symptoms and examined associated sociodemographic, academic, and health-related characteristics.

A quantitative cross-sectional survey was conducted among undergraduate students enrolled in six programmes within the Faculty of Health Sciences at a rural South African university in 2024. Of 1,679 eligible students, 848 participated (50.5%). Anonymous questionnaires included the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Descriptive, non-parametric, linear, and logistic regression analyses were performed.

At least moderate anxiety symptoms (GAD-7 ≥10) were present in 34.0% of participants, while at least moderate depressive symptoms (PHQ-9 ≥10) were present in 55.9%. GAD-7 and PHQ-9 scores were strongly correlated (Pearson r=0.65, 95% CI 0.61–0.68; p < 0.001). In adjusted logistic models, lower household income, trauma history, and previous psychological support were associated (p≤0.05) with anxiety outcomes. Female sex, non-Medicine programme enrolment, and earlier study year were associated (p≤0.05) with depressive outcomes, while prior psychiatric history and psychological support showed inverse associations. Nagelkerke R² values were 0.12 for anxiety and 0.18 for depressive symptoms.

The findings indicate a substantial burden of screening-positive anxiety and depressive symptoms in this rural health sciences cohort. Associations should be interpreted as exploratory, cross-sectional correlates rather than causal determinants or individual-level risk estimates.

Faculty-wide service-linked screening, trauma-informed counselling, first-year support, and coordinated academic, financial aid, and mental health services may help address student needs. Future longitudinal research should assess causal pathways and intervention effectiveness.