Anxiety symptoms and perceived discrimination among university students in Ukraine, Switzerland, and the Basque Country: a cross-sectional study

Anxiety symptoms among university students are increasingly recognized as both a psychological and institutional concern in higher education. However, less is known about how anxiety symptoms are patterned across recruited student samples in different national and higher-education settings and how they relate to students’ perceived experiences within university environments. This study examined anxiety symptoms among university students in Ukraine, Spain (the Basque Country), and Switzerland, and explored whether perceived discrimination at university was associated with anxiety symptoms. A cross-sectional online survey was conducted between December 2024 and February 2025 among 1,437 university students from Ukraine, Switzerland, and Spain (the Basque Country). Anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 scale (GAD-7). Perceived discrimination was measured using a single binary self-report item asking whether participants had experienced discrimination at university due to belonging to a vulnerable or non-normative group. Descriptive statistics, chi-square tests, Kruskal–Wallis tests with Bonferroni-adjusted pairwise comparisons, Mann–Whitney U tests, and sequential ordinary least-squares regression models were used. Elevated anxiety symptoms (GAD-7 ≥ 10) were most frequent among students from Ukraine (35.2%), followed by Spain (the Basque Country) (30.4%) and Switzerland (21%). Differences in GAD-7 scores across study contexts were statistically significant but small (Kruskal–Wallis H(2) = 21.99, p < 0.001, epsilon-squared = 0.014). Overall, 6.5% of students reported perceived discrimination at university. In the fully adjusted sequential model ( n = 1,393), perceived discrimination was associated with a 1.78-point higher GAD-7 score (B = 1.78, SE = 0.67, 95% CI [0.47, 3.08], p = 0.008) after adjustment for study context, gender, and age. The estimate was similar when HC3 heteroscedasticity-robust standard errors were used. In the Swiss sensitivity sample, where perceived discrimination was reported more frequently, the adjusted coefficient was 2.45 points (95% CI [1.10, 3.80], p < 0.001). Anxiety symptoms were common and differed modestly across the three recruited higher-education samples. Self-reported perceived discrimination was positively associated with anxiety symptoms after adjustment for study context, gender, and age, although the highly uneven distribution of reported discrimination across samples limits cross-context inference. These findings suggest that student mental-health support should be considered alongside institutional efforts to strengthen inclusion, belonging, psychological safety, and discrimination prevention.