Generalized Anxiety Disorder as a Precipitant to Perceived Stress and the Outcomes Associated With Academic Performance and Lifestyle: A Cross Sectional Study Among Medical Students in Sudan 2022

AIMS: To examine the prevalence of Generalized anxiety disorder (GAD), levels of anxiety and perceived stress in Sudanese medical students. Also measuring students’ academic performance, the satisfaction with the former, and lifestyle characteristics. Then investigating the different correlations between all these factors. METHODS: We conducted a cross-sectional study at University of Khartoum, among Sudanese medical students. A self-administered anonymous online questionnaire was filled by 340 medical students,which includes Generalized anxiety disorder-2 (GAD-2), and Perceived Stress Scale (PSS-10), beside academic performance and lifestyle characteristics questions. RESULTS: The data obtained from 340 medical students revealed 3.8% (n = 13) had a previous GAD diagnosis and 29.1% scored ≥ 3 in GAD-2, indicating the possibility of having GAD, 7 of them have a previous GAD diagnosis. Among participants 9.7% use addictive substance, with 42% of them having a high GAD-2 score. Higher anxiety levels were associated with high stress scores (p = 0.000). High GAD-2 scores were significantly associated with those spending less than 10,000 SDG (18$)/week, increased hours of smart devices usage for entertainment (p-value = 0.004), and unhealthy diet (p-value = 0.004). Low anxiety scores were associated with improved quality of sleep (p-value = 0.00), satisfaction with religious practices (p-value = 0.00) and increased leisure /hobbies time (p-value = 0.018). Elevated stress levels were higher in females (p-value 0.035), students with lower academic performance satisfaction levels, and increased hours of smart devices usage for entertainment (p-value = 0.001). Reduced stress levels were associated with age > 23, increased time spent on leisure/hobbies (p-value = 0.002) and eating a healthier diet (p-value = 0.006). Mean academic score was positively associated with academic performance satisfaction (p-value = 0.00), making the mean academic score an indirect modulator for anxiety and perceived stress. CONCLUSION: The study elaborates that GAD diagnosis is quite low; with almost third of participants having the probability of developing GAD, asserting the significance of implementing periodic mental health screening programs for medical students, early diagnosis of high-risk individuals, and early interventions through confidential access to mental health services to prevent further harm to the students' health. The impact of financial burden on medical students’ elevated the GAD-2 score; as well as poor lifestyle, i.e. habits such as unhealthy diet, increased hours of using smart devices, low sleep quality and low satisfaction with religious practices, which are all modifiable risk factors of GAD.