Frequently Asked Questions

Anxiety symptoms were very common in this sample: 94.0% of participants had at least mild anxiety on the HAM-A. Of the 440 adults included, 50.0% (n=220) had mild anxiety, 44.0% (n=194) had moderate-to-severe anxiety, and 6.0% (n=26) had mild-to-moderate anxiety.

The study included 440 adults who attended the Pronto Socorro primary care outpatient clinic in Higuerote, Miranda State, Venezuela, between October and December 2023. Eligible participants were age 18 years or older, were not currently receiving psychiatric pharmacotherapy, and had no prior diagnosis of generalized anxiety disorder. The mean age was 33.75b115.307 years (range, 181386), and 70.21% (n=308) were female.

Yes. Psychosocial stress was reported by 67.9% of participants (n=299) and showed the strongest association with anxiety severity in the analysis, with an OR of 124.6 (99% CI, 29.3529.6; P<.001). Among participants who reported stress, 64.0% (n=192) had moderate-to-severe anxiety, 28.09% (n=84) had mild anxiety, and 8.0% (n=24) had mild-to-moderate anxiety.

Yes. A lifetime history of anxiety episodes was reported by 50.9% of the sample (n=224), and 49.1% (n=216) reported at least 1 lifetime panic attack. Among patients with moderate-to-severe anxiety, 85.7% (n=192) reported anxiety episodes and 90.0% (n=180) reported panic attacks; these variables were statistically associated with anxiety severity (OR=641.0; 99% CI, 138.52,966.8; P<.001 and OR=74.9; 99% CI, 30.2185.7; P<.001, respectively).

The authors cautioned that these very large odds ratios likely reflect strong co-occurrence and conceptual overlap with anxiety severity rather than independent risk.

Yes. Alcohol consumption was reported by 77.8% of participants (n=316) and was significantly associated with anxiety severity, with an OR of 3.4 (99% CI, 1.86.2; P<.001). Alcohol use was reported in 78.30% (n=148) of those with moderate-to-severe anxiety, 63.63% (n=140) of those with mild anxiety, and 100% (n=28) of those with mild-to-moderate anxiety.

Yes. A family history of anxiety was reported by 60.0% of participants (n=264) and was significantly associated with anxiety severity (OR=2.9; 99% CI, 1.65.2; P<.01). A family history of depression was reported by 51.8% (n=228) and was also significantly associated with anxiety severity (OR=2.1; 99% CI, 1.23.8; P<.01).

Yes. A history of SARS-CoV-2 infection was reported by 47.27% of participants (n=208) and was significantly associated with anxiety severity, with an OR of 1.9 (99% CI, 1.23.1; P<.001). Among those with prior infection, 55.3% (n=115) had moderate-to-severe anxiety, 32.2% (n=67) had mild anxiety, and 12.5% (n=26) had mild-to-moderate anxiety.

Yes. More than half of the sample, 53.6% (n=236), reported unbalanced eating habits, including skipping 1 or more daily meals, and these habits were significantly more frequent among patients with moderate-to-severe anxiety. In addition, 85.7% (n=376) reported consuming sweets, fast food, or ultraprocessed foods; the study states that unbalanced eating habits were associated with higher anxiety severity (P<.01).

The study did not find statistically significant associations between anxiety severity and several variables, including smoking habits, illicit substance use, personal history of depression, traumatic childhood event, and the presence of medical comorbidities. Smoking was reported by 14.5% of participants (n=64), illicit substance use by 2.0% (n=9), personal history of depression by 13.2% (n=58), traumatic childhood event by 47.9% (n=211), and at least 1 medical comorbidity by 22.7% (n=100).

Only 10% of the sample (n=44) reported a history of traumatic brain injury, and no participants in that subgroup had moderate-to-severe anxiety. Within the traumatic brain injury subgroup, 84.1% (n=37) had mild anxiety and 15.9% (n=7) had mild-to-moderate anxiety.

The authors did not perform bivariate or logistic analyses for traumatic brain injury because the subgroup was small and likely unrepresentative, and they noted that most injuries were remote and may have been affected by recall bias. The paper therefore does not support a firm conclusion about the relationship between traumatic brain injury and anxiety severity in this sample.

No statistically significant association was observed between sex and anxiety severity after adjustment. Although women made up most of the sample (70.21%, n=308) and predominated across anxiety categories, the adjusted analysis showed an OR of 1.32 (99% CI, 0.762.27; P=.018), which did not meet the study's predefined significance threshold of P<.01.

This was a descriptive, cross-sectional, quantitative, population-based study conducted in a single underserved primary care clinic in Higuerote, Venezuela, from October to December 2023. Participants completed an anonymous 49-item survey that included the Hamilton Anxiety Rating Scale for anxiety symptoms, the 10-item Perceived Stress Scale for psychosocial stress, and author-developed yes/no questions on possible correlates such as family history, substance use, eating habits, SARS-CoV-2 infection, and traumatic brain injury.

Because the study was cross-sectional, the reported odds ratios should be interpreted as measures of association rather than risk or causation. The authors also noted that odds ratios may overestimate effect sizes when outcomes are highly prevalent and cells are sparse.

The main limitation was the cross-sectional design, which prevents causal inference and means the odds ratios represent associations rather than risk. The authors also cautioned that some odds ratios, especially for anxiety episodes and panic attacks, may be inflated by sparse cell effects and conceptual overlap with anxiety severity.

For traumatic brain injury, the subgroup was small and likely unrepresentative, most injuries were remote, and recall bias may have affected results. These limitations mean the findings are most useful for identifying patterns of co-occurrence and clinically relevant correlates within this specific underserved primary care population.