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Introduction : Generalised anxiety disorder (GAD) is a common and debilitating mental health condition characterised by excessive and persistent worry over various aspects of life. GAD poses significant challenges for university students, affecting their physical health, academic performance, and overall well-being. Investigating the prevalence of probable GAD among students of the University of Ibadan allows for targeted interventions tailored to their unique needs.
Aim : This study aimed to investigate the prevalence of probable GAD among Master of Public Health (MPH) students at the University of Ibadan in Nigeria.
Methods : This was a cross-sectional study involving a total of 170 MPH students, who were selected using a multi-stage sampling technique. A pre-tested, self-administered questionnaire was used to obtain data from the respondents. The GAD-7 scale was adapted to measure anxiety levels, categorising respondents as GAD negative (≤9) or GAD positive (>9). The Chi-square test was used to determine associations between variables at α= 0.05.
Results : The mean age of the respondents was 27.5 ±4.7 years, and the prevalence of probable GAD among them was 37.6%. Academic stress (70.6%) was the most reported risk factor for GAD, with a significant association between the prevalence of probable GAD and the respondents’ workload (p=0.006).
Conclusion : Prevalence of probable GAD was observed among the respondents, indicating the need to enhance the academic well-being of future public health leaders.
Keywords: Generalized Anxiety Disorder, Mental Health, Public Health
Generalised anxiety disorder (GAD) is a prevalent and debilitating mental health condition marked by Ayobami Joseph Osho (oshoayobami48@gmail.com) and Oyediran Emmanuel Oyewole (diranoyewole@gmail.com) are with University of Ibadan, Nigeria. DOI: 10.52609/jmlph.v6i1.240
persistent, excessive worry that interferes with daily functioning [1]. It presents with both psycho- logical and physical symptoms such as restlessness, impaired concentration, muscle tension, and sleep disturbances [2]. The aetiology of GAD is multi- factorial, involving genetic, neurobiological, envi- ronmental, and psychological contributors [3]. De- spite effective pharmacological and psychothera- peutic treatments, GAD remains under-diagnosed and poorly understood among student populations, particularly in postgraduate public health pro- grammes. Master of Public Health (MPH) students face aca- demic, personal, and professional pressures that may predispose them to anxiety-related disorders. Emerging evidence links GAD to significant aca- demic impairment, reduced concentration, poor sleep, social isolation, and physical health conse- quences such as high blood pressure and gastroin- testinal distress [4]. These challenges may lead to academic underperformance, dropout, and limited career progression [5]. Nonetheless, data on GAD prevalence among MPH students remain scarce, with most studies focusing on undergraduates or general student populations. This study addresses a critical knowledge gap by investigating the prevalence of probable GAD among MPH students at the University of Ibadan. Given the elevated mental health risks associated with postgraduate training in public health, targeted data are necessary to inform context-specific inter- ventions. Findings from this research will provide evidence for the development of mental health sup- port strategies, inform policy, and enhance the aca- demic success and well-being of future public health leaders. By focusing on this specialised group, the study contributes to the broader dis- course on mental health in higher education and strengthens advocacy for institutional mental health frameworks. The broad objective of this study was to investigate the prevalence of probable GAD among Master of Public Health Students attending the University of Ibadan in Ibadan, Nigeria. The specific objectives were to determine the prevalence of probable GAD
as well as the risk factors for GAD among the above-mentioned student population.
A Cross-sectional design was utilised for this study, which was carried out from July 2024 to March 2025 at the University of Ibadan. The target population was MPH students attending the univer- sity. As a leading Nigerian university, it attracts a diverse range of students from different regions and backgrounds, making the findings relevant to other universities in Nigeria and similar developing countries. Participants who met the inclusion criteria were MPH students at the University of Ibadan, availa- ble to participate in the study, and voluntarily will- ing to participate in the study. Those who did not complete the survey after enrolling were excluded. The minimum sample size (N=140) was deter- mined using the Leslie Kish formula with preva- lence set at 10.1% in accordance with a study by Victor Mbanuzuru et al. [6]. Respondents were selected using a multi-stage sampling technique, and a self-administered ques- tionnaire was used to collect data. The question- naire was serially numbered before commencing the data collection process. The researcher and his assistants visited the University of Ibadan’s Faculty of Public Health to select the eligible respondents, and informed consent forms (detailing the purpose of the research and requesting the respondents’ consent) were attached to the questionnaire for completion before the questionnaire was adminis- tered. A total of 189 copies of the questionnaire were administered to the eligible respondents. Upon collecting the completed questionnaires, the researcher and his assistants checked them thor- oughly for completeness and errors. Before distributing the questionnaire to study re- spondents, the researcher ensured that it resonated with the themes of the specific research objectives as well as the information collected from the liter- ature review that was conducted for the study. It was also reviewed and validated by public health professionals. A pre-test was conducted on 15 MPH students (>10% of the minimum sample size) at the Obafemi Awolowo University (OAU), Ile-Ife, to evaluate the effectiveness, consistency of results, and reliability of the questionnaire before conduct- ing the main study. Cronbach’s alpha was meas- ured, revealing an acceptable coefficient of 0.762.
The copies of the questionnaire were assigned se- quential numbers to facilitate easy identification, entry, and retrieval. Before commencing data entry, the questionnaire was thoroughly reviewed to en- sure the accuracy, completeness, and proper data coding, using a coding guide. The collected data was then entered using IBM SPSS Statistics 29.0.1.0. Prevalence of probable GAD among the respond- ents was assessed using an adapted generalised anxiety disorder assessment (GAD-7). A score of 0-4 was categorised as minimal anxiety and as- signed code 1; 5-9 was categorised as mild anxiety (code 2); 10-14 was categorised as moderate anxi- ety (code 3); and 15−30 was categorised as severe anxiety (code 4). In this study, the scale was adapted rather than adopted, with three additional items added to the original seven, resulting in a 10- item instrument with a maximum total score of 30. Using the adapted GAD-7 as a screening tool, re- spondents who scored >9 were categorised as pos- itive for GAD, while those who scored ≤9 were cat- egorised as negative for GAD. Findings regarding risk factors for GAD among MPH students were summarised in prose, high- lighting the percentage of respondents who men- tioned the common risk factors. Descriptive statistics such as frequencies, mean and standard deviation, along with inferential statistics such as the Chi-square test, were employed for data analysis. It is worth noting that the categories “Light” and “Moderate” were collapsed into “Nor- mal” for the Chi-square test to determine signifi- cant association between the prevalence of proba- ble GAD and respondents’ workload. This was done to ensure that the Chi-square test was valid.
Out of the 189 copies of the questionnaire distrib- uted to the eligible respondents in the Faculty of Public Health, 170 were correctly completed, lead- ing to a response rate of 89.95%. The mean age of the respondents was 27.5±4.7 years. In terms of gender distribution, females con- stituted the majority at 72.9% (n=124), while males accounted for 27.1% (n=46). The marital status of the majority of respondents was single, representing 78.2% (n=133) of the sample. Meanwhile, 20.6% (n=35) were married, and a few (0.6% each) (n=1) were either widowed or divorced. Early-life experiences played a role in respondents’ backgrounds, with 36.5% (n=62)
Variables Responses Frequency % Feeling nervous Not at all 78 45.9 Several days 59 34.7 More than half the days 19 11.2 Nearly every day 14 8.2 Unable to control worrying Not at all 90 52.9 Several days 48 28.2 More than half the days 18 10.6 Nearly every day 14 8.2 Worrying too much about different things Not at all 44 25.9 Several days 85 50.0 More than half the days 18 10.6 Nearly every day 23 13.5 Trouble Relaxing Not at all 96 56.5 Several days 47 27.6 More than half the days 15 8.8 Nearly every day 12 7.1 Being so restless that it is hard to sit still Not at all 125 73.5 Several days 32 18.8 More than half the days 7 4.1 Nearly every day 6 3.5 Becoming easily annoyed Not at all 93 54.7 Several days 54 31.8 More than half the days 12 7.1 Nearly every day 11 6.5 Afraid something awful might happen Not at all 94 55.3 Several days 51 30.0 More than half the days 16 9.4 Nearly every day 9 5.3 Overwhelmed by academic demands Not at all 32 18.8 Several days 69 40.6 More than half the days 33 19.4 Nearly every day 36 21.2 Easily irritated by academic responsibilities Not at all 77 45.3 Several days 58 34.1
34.7
27.6
23.5 24
14.1
Frequency Percentage
Minimal Anxiety Mild Anxiety
Moderate Anxiety Severe Anxiety
More than half the days 17 10.0 Nearly every day 18 10.6 Difficulty concentrating on studies due to feelings of worry
Several days 61 35.9 More than half the days 18 10.6 Nearly every day 12 7.1
Not at all 79 46.5
order and selected variables (traumatic experience, workload, sleeping pattern, and gender).
No 76 (70.4) 32 (29.6) 108 (100.0) 1 8.109 0.004
Yes 30 (48.4) 32 (51.6) 62 (100.0)
Total 106 (62.4) 64 (37.6) 170 (100.0)
Workload Normal* 58 (75.3) 19 (24.7) 77 (100.0) 2 10.113 0.006
Heavy 27 (50.9) 26 (49.1) 53 (100.0)
Overwhelming 21 (52.5) 19 (47.5) 40 (100.0)
Total 106 (62.4) 64 (37.6) 170 (100.0)
<5 hours 20 (45.5) 24 (54.5) 44 (100.0) 2 7.499 0.024
5-6 hours 65 (67.0) 32 (33.0) 97 (100.0)
>6 hours 21 (72.4) 8 (27.6) 29 (100.0)
Total 106 (62.4) 64 (37.6) 170 (100.0)
Yes 0 2 (100.0) 2 (100.0) - 6.094 0.025**
No 76(67.9) 36 (32.1) 112 (100.0)
Don’t Know 30 (53.6) 26 (46.4) 56 (100.0)
Total 106 (62.4) 64 (37.6) 170 (100.0)
Gender Male 30 (65.2) 16 (34.8) 46 (100.0) 1 0.220 0.639
Female 76 (61.3) 48 (38.7) 124 (100.0)
Total 106 (62.4) 64 (37.6) 170 (100.0)
* The categories “Light” and “Moderate” as seen in table 2 were recoded into “Normal” for the variable “workload” in this table ** Despite the statistically significant findings, no inferential remarks can be made given the low number of variables in this category. This was a cross‒sectional study; hence, inferences regarding causation could not be made. Addition- ally, mental health stigma could have influenced students' willingness to participate or to honestly disclose their GAD symptoms. Some of the other
Positive Freq.(%)
limitations to this study included the single-institu- tion setting which limits generalisability, self-re- ported data which is subject to recall and social de- sirability bias, and the lack of assessment of con- current mental health conditions.
| Variables | Frequency | % | |
|---|---|---|---|
| Description of current academic workload | Light | 7 | 4.1 |
| Moderate | 70 | 41.2 | |
| Heavy | 53 | 31.2 | |
| Overwhelming | 40 | 23.5 | |
| Typical number of hours’ sleep per night | Less than 5 hours | 44 | 25.9 |
| 5-6 hours | 97 | 57.1 | |
| 7-8 hours | 28 | 16.5 | |
| More than 8 hours | 1 | 0.6 | |
| Engagement in physical exercise in a week | Never | 27 | 15.9 |
| Once a week | 72 | 42.4 | |
| 2-3 times a week | 44 | 25.9 | |
| More than 3 times a | 27 | 15.9 | |
| week | |||
| Consumption of vegetables in a week | Once | 56 | 32.9 |
| Twice | 53 | 31.2 | |
| More than 3 times | 49 | 28.8 | |
| Not at all | 12 | 7.1 | |
| Family history of GAD | Yes | 2 | 1.2 |
| No | 112 | 65.9 | |
| Don’t Know | 56 | 32.9 | |
| Feelings of stress related to studies | Rarely | 19 | 11.2 |
| Occasionally | 67 | 39.4 | |
| Frequently | 58 | 34.1 | |
| Almost always | 23 | 13.5 | |
| Don’t know | 3 | 1.8 | |
| Receipt of peer support in managing stress lev- | No | 58 | 34.1 |
| els | |||
| Yes | 112 | 65.9 | |
| Receipt of professional help for issues related | No | 153 | 90.0 |
| to anxiety | |||
| Yes | 17 | 10.0 | |
| Confidence in ability to manage anxiety per- | Very confident | 70 | 41.2 |
| sonally | |||
| Somewhat confident | 63 | 37.1 | |
| Not very confident | 27 | 15.9 | |
| Not confident at all | 5 | 2.9 | |
| Not sure | 5 | 2.9 | |
| Academic environment contributes to anxiety | Yes | 120 | 70.6 |
| levels | |||
| No | 29 | 17.1 | |
| Not sure | 21 | 12.4 | |
| Journal of Medicine, Law & Public Health Vol 6, No 1. 2026 | p873 | ||
| indicated in Table 3, there was a significant association | between the prevalence | of probable | GAD and |
| selected variables: traumatic experience, workload, | and sleeping pattern (p=0.004, | p=0.006, | p=0.024, |
| There was no significant association between | the prevalence of probable | GAD | and the re- |
| gender (p=0.639). |
| order and selected v | ||
|---|---|---|
| Variable Categories | ||
| Traumatic No | ||
| experience | ||
| Yes | ||
| Total | ||
| Workload Normal* | ||
| Heavy | ||
| Overwhelm | ||
| Total | ||
| Sleeping <5 hours | ||
| pattern | ||
| 5-6 hours | ||
| >6 hours | ||
| Total | ||
| Family his- Yes | ||
| tory | ||
| No | ||
| Don’t Know | ||
| Total | ||
| Gender Male | ||
| Female | ||
| Total | ||
| * The categories “Light” and “Mod | ||
| ** Despite the statistically signifi | ||
| category. | ||
| This was a cross‒sectional st | ||
| regarding causation could no | ||
| ally, mental health stigma c | ||
| students' willingness to part | ||
| disclose their GAD symptom | ||
| The Journal of Medicine, Law & Public Health Vol 6, No 1. 2026 | p874 | |
| IV. DISCUSSION | several | key risk factors associated with GAD |
| The ents respondents highlight ety across al. ical found identified [7] and students, prevalence in in reported different this probable this the a study in study. variation probable a rate severe the of contexts. GAD was probable significantly Similarly, sample. anxiety 37.6%, in GAD among prevalence For GAD The Mbanuzuru prevalence in corresponding instance, student lower a study’s among few rates than populations Saudi Alatawi respond- et findings (10.1%) of the al. to med- anxi- one [6] 64 et | among The pressure, uting ronment. [10], icantly disorders et determinant al. most which [11] | their MPH contributes with This among identified significant GAD highlighted of students a aligns GAD, majority university symptoms to academic with indicating among the at that the of development a students. academic the study to University these workload the respondents that by academic was Similarly, students Graves stress of of as academic a Ibadan. anxiety signif- attrib- major envi- et who Liu al. |
| lower adolescents than that in Nigeria. found in These this study comparisons among in-school suggest | perceive heightened | their risk workload of experiencing as overwhelming anxiety symptoms. are at a |
| that tensive evated workload, postgraduate risk programmes and of GAD future students, due such career to as particularly academic uncertainties. MPH, may expectations, those face an in in- el- | The as load Sleep many present as | deprivation either of the study overwhelming respondents also further emerged supports or described heavy. as these a critical their findings, work- risk |
| The study’s most respondents common GAD were excessive symptoms worry, among nerv- this | factor, the recommended | with only a few 7–8 respondents hours of sleep managing per night. to get |
| ousness, mands. dicating ence paired ders [5]. difficulty academic These that and feeling university findings relaxing, performance overwhelmed align students excessive with due frequently past to by worry, anxiety academic research and experi- disor- im- de- in- | This et a disrupts tion. dents significant al. finding Similarly, [12], | experiencing cognitive who is predictor consistent established Eisenberg function chronic of with et anxiety that sleep and al. the inadequate [5] emotional deprivation work disorders, found of that sleep regula- Alvaro were as stu- is it |
| Additionally, significant ademic students, in Syrian performance mirroring medical correlation Barbosa-Camacho students. the among between findings Mexican GAD of et Jamil al. and [8] university et poor found al. ac- [9] a | more reinforcing mental Lifestyle poor dietary | likely health factors to the habits management. report importance such were persistent as also physical of prominent anxiety sleep inactivity hygiene symptoms, among and re- in |
| The present study revealed statistically significant | spondents. | Only a few engaged in regular exercise |
| evidence traumatic symptoms not dicating have had occurred such that that events of the experiences. GAD respondents by observed are chance. compared more The association likely who with p-value to have those exhibit is of experienced unlikely who 0.004, signs have in- or to | more centage roborates who associated reduced reported | than did endorphin findings three with not that increased times engage low from release per levels in Mammen week, anxiety exercise and of physical while increased symptoms & at Faulkner all. an activity equal This physio- due [13], cor- per- are to |
| There between workload value (p=0.006) was the reported also prevalence a providing statistically by the of respondents, strong probable significant evidence GAD association with and against the the p- | logical Social behaviours of respondents | stress support were responses. reported also and examined. professional feeling supported While help-seeking a majority by their |
| the that null increased hypothesis academic of no association workload may and contribute indicating | peers, such as | only counselling, a few had for ever anxiety-related sought professional issues. help, This |
| to study the population. prevalence of probable GAD among the | aligns despite | with the Hunt availability & Eisenberg of mental [14], health who found services, that |
| Likewise, observed and irregular respondents’ or between a disrupted statistically sleeping the sleep prevalence significant patterns potentially of (p=0.024), association probable contributing GAD with was | many assistance financial [15] perceptions | highlighted students constraints. due of to mental hesitate stigma, that Furthermore, health lack in to seek Nigeria, of often knowledge, Gureje professional discourage cultural et al. or |
| The Journal of Medicine, Law & Public Health Vol 6, No 1. 2026 | p875 | |
| behaviour among the respondents in this study. | al. Depression, anxiety, and academic per- | |
| The limitations of this study were acknowledged | formance in COVID-19: a cross-sectional | |
| and addressed to the extent possible in the study | study. BMC Psychiatry. 2022;22(1):443. | |
| design, data collection, and analysis processes to | 9. | Jamil H, Alakkari M, Al-Mahini MS, Al- |
| ensure the validity and reliability of the findings. | sayid M, Al Jandali O. The impact of anxi- | |
| V. CONCLUSION | ety and depression on academic perfor- | |
| mance: a cross-sectional study among med- | ||
| These study findings call for urgent interventions | ical students in Syria. Avicenna J Med. | |
| to improve mental health literacy, promote health- | 2022;12(3):111-9. | |
| ier coping strategies, and enhance institutional sup- | 10. | Graves BS, Hall ME, Dias-Karch C, |
| port systems. | Haischer MH, Apter C. Gender differences | |
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