Prevalence of Probable Generalised Anxiety Disorder Among Master of Public Health Students at the University of Ibadan, Nigeria

Introduction

Generalised anxiety disorder (GAD) is a prevalent and debilitating mental health condition marked by are with University of Ibadan, Nigeria. persistent, excessive worry that interferes with daily functioning [1]. It presents with both psychological and physical symptoms such as restlessness, impaired concentration, muscle tension, and sleep disturbances [2]. The aetiology of GAD is multifactorial, involving genetic, neurobiological, environmental, and psychological contributors [3]. Despite effective pharmacological and psychotherapeutic treatments, GAD remains under-diagnosed and poorly understood among student populations, particularly in postgraduate public health programmes. Master of Public Health (MPH) students face academic, personal, and professional pressures that may predispose them to anxiety-related disorders. Emerging evidence links GAD to significant academic impairment, reduced concentration, poor sleep, social isolation, and physical health consequences such as high blood pressure and gastrointestinal 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 interventions. Findings from this research will provide evidence for the development of mental health support strategies, inform policy, and enhance the academic success and well-being of future public health leaders. By focusing on this specialised group, the study contributes to the broader discourse 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.

Nigeria

Methodology

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 university. 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, available to participate in the study, and voluntarily willing to participate in the study. Those who did not complete the survey after enrolling were excluded. The minimum sample size (N=140) was determined using the Leslie Kish formula with prevalence 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 questionnaire was used to collect data. The questionnaire 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 administered. 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 thoroughly for completeness and errors. Before distributing the questionnaire to study respondents, the researcher ensured that it resonated with the themes of the specific research objectives as well as the information collected from the literature 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 conducting the main study. Cronbach’s alpha was measured, revealing an acceptable coefficient of 0.762.

The copies of the questionnaire were assigned sequential numbers to facilitate easy identification, entry, and retrieval. Before commencing data entry, the questionnaire was thoroughly reviewed to ensure 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 respondents was assessed using an adapted generalised anxiety disorder assessment (GAD-7). A score of 0-4 was categorised as minimal anxiety and assigned code 1; 5-9 was categorised as mild anxiety (code 2); 10-14 was categorised as moderate anxiety (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, respondents who scored >9 were categorised as positive for GAD, while those who scored ≤9 were categorised as negative for GAD. Findings regarding risk factors for GAD among MPH students were summarised in prose, highlighting the percentage of respondents who mentioned 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 “Normal” for the Chi-square test to determine significant association between the prevalence of probable GAD and respondents’ workload. This was done to ensure that the Chi-square test was valid.

Results

Out of the 189 copies of the questionnaire distributed to the eligible respondents in the Faculty of Public Health, 170 were correctly completed, leading 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 constituted 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).

Variable Categories Prevalence of probable GAD

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. Additionally, mental health stigma could have influenced students' willingness to participate or to honestly disclose their GAD symptoms. Some of the other

Total Df X 2 p-value

Positive Freq.(%) limitations to this study included the single-institution setting which limits generalisability, self-reported data which is subject to recall and social desirability bias, and the lack of assessment of concurrent mental health conditions.