Anxiety and depressive symptoms among medical students—A scoping review of systematic reviews and meta-analyses
Nadine Agyapong-Opoku, Felix Agyapong-Opoku, Belinda Agyapong, Andrew J. Greenshaw
Abstract
Background: Medical schools are globally recognized as higher education institutions requiring extreme dedication from students. The intensive nature of physician training demands heavy workloads, inconsistent sleep, and study-leisure imbalances. Such stressors are linked to poor student mental health, with anxiety and depression symptoms among the most documented disorders. These burdens negatively affect academic performance and are associated with dropout intentions, misconduct, burnout, and suicidal ideation. Objective: This scoping review summarizes recent evidence on the prevalence of anxiety and depression symptoms among medical students and identifies correlated factors. Methods: The review followed PRISMA guidelines and Arksey and O'Malley's five-stage methodological framework. Searches were conducted on July 5, 2025, in PubMed, MEDLINE, Web of Science, Scopus, and PsycINFO. Boolean operators combined terms related to prevalence, and correlates of depressive and anxiety symptoms, and medical students, limited to systematic reviews and meta-analyses published in English between January 2021 and July 2025. Sixteen studies met the inclusion criteria after screening. Data were charted for study characteristics, prevalence estimates, contributing factors, and methodological approaches. Results: The studies included in this review reported wide-ranging prevalence estimates, with the prevalence of depression symptoms in the included meta-analysis ranging from lowest of 18.1% to highest of 50.0% and anxiety symptoms from 17 to 54% although there was high heterogeneity in the screening instruments or measurement scales Biological sex differences in prevalence were frequently noted, with most studies reporting a higher prevalence among females; however, findings varied by region. Regional disparities were additionally observed, with some continents and countries reporting significantly higher prevalence rates than others. Factors associated with increased risk included early years of study, poor sleep quality, and academic stress. During COVID-19, most studies reported a higher prevalence of depression and anxiety symptoms than pre-pandemic levels. Conclusions: Anxiety and depressive symptoms remain widespread among medical students, driven by individual and contextual factors. Targeted interventions and early preventive strategies are urgently needed to address mental health challenges and protect student wellbeing.