When Minds Race and Bodies Ache: Investigating the Dual Burden of Generalized Anxiety and Somatic Symptoms on Nursing Students’ Well-Being During Exams at Qassim University

Nasiru Mohammed Abdullahi,1 Mohamed Goda Elbqry,2 Fatma Mohamed Elmansy,2 Saddam Ahmed Al-Ahdal,2 Shereen Ahmed A Qalawa,2 Ibrahim Alasqah,1 Patience Osose Nasir3 1Department of Psychiatric, Mental Health, and Community Health, College of Nursing, Qassim University, Buraydah City, Saudi Arabia; 2Department of Medical and Surgical, College of Nursing, Qassim University, Buraydah City, Saudi Arabia; 3Accident and Emergency Department, King Fahad Specialist Hospital, Buraydah City, Saudi ArabiaCorrespondence: Fatma Mohamed Elmansy, Department of Medical and Surgical, College of Nursing, Qassim University, P.O. Box: 52571, Buraydah City, Saudi Arabia, Tel +966542235580, Email [email protected]: Nursing students often experience high levels of stress during exams, which may be exacerbated by generalized anxiety disorder and associated somatic symptoms. This dual burden can adversely affect their physical health, mental well-being, and academic achievements.Aim: This study aimed to investigate the combined impact of generalized anxiety disorder and co-occurring somatic symptoms on the well-being of nursing students during exam periods at Qassim University.Methods: A cross-sectional correlational study was conducted among 706 nursing students at Qassim University during the exam period in May 2025. Using a standardized self-administered questionnaire to assess generalized anxiety disorder (GAD), patient health questionnaire-15 (PHQ-15) and world health organization’s 5 -item (WHO-5) well-being index. Statistical analysis was performed to examine correlations and identify significant associations.Results: Most students were female aged 18– 20 years. Over half (56%) reported moderate anxiety, and (52.7%) experienced minimal somatic symptoms. In contrast, the Well-Being Index showed over half of the respondents (52.7%) scoring the high well-being category. A significant positive correlation was found between GAD and PHQ-15 scores (r=0.480, p< 0.001). In contrast, both GAD and PHQ-15 were negatively correlated with WHO-5 scores (r=− 0.238 and r=− 0.346 respectively; p< 0.001).Conclusion: The findings indicate that generalized anxiety disorder and co-occurring somatic symptoms are prevalent among nursing students during exam periods, particularly affecting younger, female, and early-year students, and are significantly associated with reduced mental well-being. These results provide novel insight into the interplay between anxiety, somatic symptoms, and demographic factors in this population. To mitigate the negative impact of stress and enhance both academic achievements and overall health among nursing students, it is essential to implement mental health support strategies through early screening and intervention, as well as programs to promote student well-being during exams.Keywords: anxiety, burden, mind, somatic, nursing students, well-being