Prevalence and Correlates of Anxiety and Depression Symptoms Among Medical Students: The Role of Student Debt Burden

Authors

• Foroozan Afsharchi, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Joshua F. Edwards, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Kailash S. Ram, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Jingru Huang, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Valicia Hale, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Ismail El Moudden, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow

ORCID

0009-0001-0510-1148 (Afsharchi), 0000-0003-4187-0793 (Edwards), 0009-0006-7998-7064 (Ram), 0000-0001-7702-2564 (El Moudden)

Document Type

Article

Publication Date

2026

DOI

10.1177/23821205261449382

Publication Title

Journal of Medical Education and Curricular Development

Volume

13

Pages

23821205261449382

Abstract

Background

This cross-sectional study examined whether anxiety and depression symptoms decrease as medical students progress through training (suggesting adjustment disorder) or persist (suggesting chronic conditions), while identifying associated risk factors, including student debt burden and treatment effectiveness.

Methods

We surveyed medical students (years 1-4) at VHS-ODU using a sociodemographic questionnaire and validated screening instruments (GAD-7 for anxiety and PHQ-9 for depression) via RedCap from September to November 2024.

Results

Among 126 students, Scores were higher in Years 2-3 than in Years 1 and 4, but differences by year were not significant (GAD-7 p=0.055; PHQ-9 p=0.352). Students with a prior mental-health diagnosis had higher symptoms (GAD-7 8.09 vs 4.31; PHQ-9 10.18 vs 4.72; p≤0.001). Among those with a prior diagnosis, scores did not differ by current treatment category (GAD-7, p = 0.900; PHQ-9, p = 0.263). Higher student-loan balances were associated with higher scores (descriptive only; group Ns were unavailable for testing).

Conclusion

Medical schools should prioritize proactive screening and timely access to care, bolster support during clinical training, and address financial stressors; longitudinal studies are needed to test whether such changes reduce symptom burden.

Rights

© 2026 The Authors

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Original Publication Citation

Afsharchi, F., Edwards, J. F., Ram, K. S., Huang, J., Hale, V., & El Moudden, I. (2026). Prevalence and correlates of anxiety and depression symptoms among medical students: The role of student debt burden. Journal of Medical Education and Curricular Development, 13, Article 23821205261449382. https://doi.org/10.1177/23821205261449382

Repository Citation

Afsharchi, F., Edwards, J. F., Ram, K. S., Huang, J., Hale, V., & El Moudden, I. (2026). Prevalence and correlates of anxiety and depression symptoms among medical students: The role of student debt burden. Journal of Medical Education and Curricular Development, 13, Article 23821205261449382. https://doi.org/10.1177/23821205261449382