Health anxiety among medical and non-medical university students in Palestine: associations with intolerance of uncertainty, daily phone use, and field of study

BACKGROUND: Medical student syndrome (MSS) is commonly used to describe illness-related anxiety in academic settings, particularly anxiety linked to exposure to disease-related information. However, it remains unclear whether elevated health anxiety is actually more common among medical students than among students in other fields. This study examined SHAI-defined elevated health anxiety among university students in Palestine and assessed its associations with intolerance of uncertainty, daily phone use, and field of study. METHODS: A cross-sectional study was conducted among 484 university students in Palestine using an online self-administered questionnaire. Elevated health anxiety was assessed using the main section of the Short Health Anxiety Inventory (SHAI; items 1-14), with a score of ≥ 18 used as a screening threshold. MSS was treated as a conceptual framework rather than as a distinct clinical diagnosis. Intolerance of uncertainty was measured using the 12-item Intolerance of Uncertainty Scale (IUS-12). Bivariate associations were assessed using chi-square and Mann-Whitney U tests. Independent associations were examined using Poisson regression with robust variance, and results were reported as adjusted prevalence ratios (PRs) with 95% confidence intervals (CIs). RESULTS: Overall, 27.3% of students met the SHAI-based screening threshold for elevated health anxiety. The prevalence was lowest among human medicine students (19.7%) and was higher among non-health-related students (33.3%) and other health-related students (34.3%), indicating that SHAI-defined elevated health anxiety was more common among students outside human medicine. This pattern remained evident after adjustment: compared with human medicine students, prevalence was significantly higher among non-health-related students (adjusted PR = 1.597, 95% CI: 1.112-2.295, p = 0.011) and other health-related students (adjusted PR = 1.635, 95% CI: 1.129-2.369, p = 0.009). Intolerance of uncertainty remained the strongest independent correlate; each 5-point increase in IUS-12 score was associated with a 29% higher prevalence of elevated health anxiety (adjusted PR = 1.29, 95% CI: 1.19-1.40, p < 0.001), and greater daily phone use was also independently associated with higher prevalence (adjusted PR = 1.041, 95% CI: 1.003-1.080, p = 0.033). Camp residence was likewise associated with higher prevalence (adjusted PR = 1.838, 95% CI: 1.035-3.266, p = 0.038). CONCLUSIONS: SHAI-defined elevated health anxiety was common among Palestinian university students, but it was not highest among human medicine students. The prevalence was higher among students in non-health-related and other health-related disciplines. Because the SHAI measures general health anxiety rather than anxiety specifically triggered by exposure to medical knowledge, these findings should be interpreted as evidence that elevated health anxiety in university settings may extend beyond medical students rather than as a definitive test of Medical Student Syndrome as a distinct phenomenon.