Anxiety and depressive symptoms among medical students at a private medical school in the interior of Brazil: a cross-sectional study using PHQ-9 and GAD-7

Abstract

Background: Depression is a prevalent mental disorder causing significant functional impairment worldwide, disproportionately affecting adolescents and young adults. University students are especially vulnerable due to academic pressure and social changes, with medical students showing even higher rates of anxiety and depression. Despite this, data from private medical schools in Brazil's interior remain scarce. Self-report tools such as Patient Health Questionnaire-9 PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) enable fast, low-cost screening and have been validated for the Brazilian population. Objective: This study aimed to assess the prevalence of depressive and anxious symptoms among medical students at a private institution in Minas Gerais, Brazil. Methods: Observational cross-sectional study conducted in December 2025 with students aged 18 years or older who completed an anonymous online questionnaire. Symptoms in the previous two weeks were assessed with the PHQ-9 and the GAD-7. Scores of 10 or higher were used as the cutoff for clinically relevant symptoms on both instruments. Categorical variables were summarized as absolute and relative frequencies, and combined categories were calculated to describe isolated versus concurrent symptom patterns Results: A total of 112 students participated; 67 (59.82%) were female, 42 (37.50%) male, and 3 (2.68%) did not report sex. Clinically relevant anxiety symptoms were present in 57 students (50.89%), and clinically relevant depressive symptoms in 48 (42.86%). Concurrent anxiety and depressive symptoms occurred in 38 students (33.93%). Isolated anxiety symptoms were observed in 19 (16.96%), and isolated depressive symptoms in 10 (8.93%). Forty-five students (40.18%) screened negative on both scales. Conclusion: Approximately one in two students screened positive for clinically relevant anxiety symptoms and more than two in five for depressive symptoms, with substantial co-occurrence. These findings support the implementation of continuous mental health promotion and early identification strategies in medical training, including periodic screening with validated tools and clear referral pathways for assessment and care.