ABSTRACT Background: Anxiety can be a general feeling of worry, a sudden attack of panicky feelings, or a fear of a certain situation or object. Children and teens have anxiety in their lives and like adults, they can suffer from anxiety disorders too. Aim: To assess the degree of Anxiety levels in young female adolescents by using a self-administered anxiety questionnaire. Methods: This study was conducted in the department of Physiology, Sri Ramachandra Medical College & Research Institute, Chennai among 50 healthy young female students. Males were excluded in this study. Their age group ranged between 17 to 19. Anxiety status was assessed by using Hamilton Anxiety (HAM-A) Rating Scale questionaire and it was scored. Results: Results showed that 64 % students scored moderate anxiety levels and 36% students scored mild anxiety levels. Conclusion: Based on the results, we have found that mild to moderate anxiety is seen among the young medical students. This could be due to psychophysiological factors like stress that may lead into anxiety and also due to new environmental study.
Key words: Anxiety, stress, young students
Stress is a normal part of life but too much of stress is harmful. Persistant and unrelenting stress often leads to anxiety and unhealthy behaviors. Stressful events such as starting to school, moving to college or hostel, or the loss of a parent can trigger the onset of an anxiety disorder include panic disorder, agoraphobia, specific phobias, generalised anxiety disorder, social phobia, obsessive–compulsive disorder, and acute and post-traumatic stress disorders. Anxiety is a basic human emotion consisting of fear and uncertainty that typically appears when an individual perceives an event as being a threat to the ego or self-esteem(1) . In some instances such as avoiding dangerous situations, anxiety can be helpful. However when taken to extremes, it may produce unwarranted results. Under normal conditions, anxiety improves a person’s productivity and capacity for adaptation. However, anxiety can also be maladaptive, provoking fears, inhibitions, and somatic changes, all of which interfere with a person’s capacity to overcome difficulties.
The emotional status of students affect the over all performance of students and lead to a cascade of consequences at both personal and professional levels (2). Anxiety can be accompanied by a variety of physical symptoms. Most commonly, these symptoms are related to the cardiovascular, respiratory, nervous and gastrointestinal systems. The physiological manifestations of any situation-specific anxiety generally include increased blood pressure, rapid heart rate with palpitations and tachycardia, sweating, dryness of the mouth, nausea, dizziness, hyperventilation, restlessness, tremors, insomnia, poor concentration and feelings of weakness (3). Students in extreme stress or depression need serious attention (4). Research has shown that if left untreated are at high risk to perform poorly in school, to have less developed social skills and to be more vulnerable to substance abuse (5). Anxiety is more common among the female gender (6). Hence, this study was undertaken to assess the degree of anxiety levels in young female adolescents.
MATERIAL AND METHODS
This cross-sectional study was conducted in the Department of Physiology, Sri Ramachandra Medical College and Research Institute, Chennai among 50 healthy female IST year medical students. Since anxiety is more common among the female gender (6) , males were excluded from this study (7,8). Their age group ranged between 17 to 19. Anxiety status was assessed by using Hamilton anxiety rating scale (HAM-A) questionnaire (9). After obtaining the informed consent, Hamilton anxiety rating scale questionnaire was given and explained to the students. The Hamilton Anxiety Scale is a 14-item test to measure the severity of anxiety symptoms including both psychic and somatic. HAMA scale is scored as follows: mild anxiety (14-17), moderate anxiety (18-25) and severe anxiety (26-30).
In our study, 64% (95% CI: 50.1% – 76.35%) of subjects scored moderate anxiety levels and 36% (95% CI: 20.2% – 45.8 %) of subjects scored mild anxiety levels
Anxiety is a normal reaction to stress. It is a universal experience which has an important protective function in the face of danger (10). If anxiety persists or excessive anxiety causes general poor health as well as specific physical or psychological illnesses like infection, heart disease or depression that impairs the quality of life in future. Anxiety and depression can be taken as a reliable indicator for assessment of mental illness in the community (6). While there is ample documentation that learning period is stressful, less is known about predictive variables that might identify students who have the most difficulty in managing stress during that period (11). In our study, 64% of subjects scored moderate anxiety levels and 36% of subjects scored mild anxiety levels. In the more competitive world, there is a widespread increase in stress-related mental disorders. It is estimated that by the year 2020, anxiety and depression will be the second most common cause of disability worldwide (12). Environmental and social circumstances play a major role in the onset of stress-related diseases. Developing countries share the heavy burden of social and economic challenges.
Among medical students, academic stressors include the volume of material to be learned, academic performance and evaluation like examination and continuous assessment (13). Studies shown that academic pursuits take a heavy toll on the mental capacities of all students are more prone to anxiety that leads to depression also (14). Ahmadi J et al studies reported that female students can be particularly vulnerable to stress and women were reported to be more anxious, phobic and depressed than men (5) .
In this study we have found that mild to moderate anxiety is seen among the adolescents. This could be due to more stress in the present day today modern life (11,15). This could be reduced or prevented by life style modifications like eating balanced healthy diet, doing regular muscular activity (16), learning relaxation skills, breathing exercises, participation in stress reduction programs(17), having more social activities, spending more time with books in the library, spending good time with family and friends (18). So that they can perform better in both curricular and extracurricular activities and they can lead good quality life. Students should be identified early in their first year and it is very important to educate or counsel students about environment and personal ability to manage the academic load might make the problem less overwhelming.
LACUNAE OF THIS STUDY
Anxiety is more common in some females in the premenstrual period (premenstrual syndrome). We have not done our study in the premenstrual period. In future, we will study the level of anxiety in the premenstrual period and anxiety levels in both genders to be compared with a larger sample size.
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