Health anxiety (HA) is increasingly recognized among medical students due to ongoing exposure to illness-related content and academic stress. This study examined the prevalence of HA in Chinese medical students and its association with health-oriented behaviors. A total of 2283 participants completed self-report measures of BMI, smoking status, diet, physical activity, and HA (Chinese Short Health Anxiety Inventory). The average HA score was 14.56 ± 6.34, and 33.2% scored above the clinical cut-off. Physical activity levels were significantly lower in students with HA (863.06 ± 737.12) compared to those without HA (945.34 ± 715.5; p = 0.012). Physical activity was the only significant predictor of HA (β = –0.344, p < 0.001), explaining 13.3% of the variance. However, results should be interpreted in light of limitations, including self-reported data and the single-university sample. Promoting physical activity may be a promising strategy to reduce HA in medical students.
AbbottRLavretskyH (2013) Tai Chi and Qigong for the treatment and prevention of mental disorders. Psychiatric Clinics of North America36(1): 109–119.
2.
AbramowitzJSOlatunjiBODeaconBJ (2007) Health anxiety, hypochondriasis, and the anxiety disorders. Behavior Therapy38(1): 86–94.
3.
AlthubaitiA (2023) Sample size determination: A practical guide for health researchers. Journal of General and Family Medicine24(2): 72–78.
4.
AminiHIsanejadAChamaniN, et al. (2020) Physical activity during COVID-19 pandemic in the Iranian population: A brief report. Heliyon6(11): e05411.
5.
BalajiNKMurthyPSKumarDN, et al. (2019) Perceived stress, anxiety, and coping states in medical and engineering students during examinations. Industrial Psychiatry Journal28(1): 86–97.
6.
BuechnerBMTraylorMKFeldmanRI, et al. (2023) Examining relationships between cognitive flexibility, exercise perceptions, and cardiovascular disease risk factors. European Journal of Investigation in Health, Psychology and Education13(10): 2276–2289.
7.
CraigCMarshallASjostromM, et al. (2017) International physical activity questionnaire-short form. Journal of American College Health65(7): 492–501.
8.
de SouzaKCMendesTBGomesTH, et al. (2021) Medical students show lower physical activity levels and higher anxiety than physical education students: A cross-sectional study during the COVID-19 pandemic. Frontiers in Psychiatry12: 804967.
9.
Ghayour BaghbaniSMArabshahiMSaatchianV (2023) The impact of exercise interventions on perceived self-efficacy and other psychological outcomes in adults: A systematic review and meta-analysis. European Journal of Integrative Medicine62: 102281.
10.
Gil-CalderónJAlonso-MoleroJDierssen-SotosT, et al. (2021) Burnout syndrome in Spanish medical students. BMC Medical Education21(1): 231.
11.
GouYLeiHZengY, et al. (2021) The effect of Pilates exercise training for scoliosis on improving spinal deformity and quality of life: Meta-analysis of randomized controlled trials. Medicine100(39): e27254.
12.
GreenECMurphyEMGryboskiK (2020) The health belief model. In: SweenyKRobbinsMLCohenLM (eds) The Wiley Encyclopedia of Health Psychology. pp.211–214. John Wiley & Sons.
13.
HaddadCSacreHHajjA, et al. (2020) Comparing cigarette smoking knowledge and attitudes among smokers and non-smokers. Environmental Science and Pollution Research27(16): 19352–19362.
14.
HorensteinAPotterCMHeimbergRG (2018) How does anxiety sensitivity increase risk of chronic medical conditions?Clinical Psychology Science and Practice25(3): e12248.
15.
JungmannSMWitthöftM (2020) Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety?Journal of Anxiety Disorders73: 102239.
16.
KhanZSubhanK (2023) Exploring the link between physical activity and mental well-being: Implications for health promotion. Journal of Psychology, Health and Social Challenges1(02): 117–131.
17.
KibbeyMMFedorenkoEJFarrisSG (2021) Anxiety, depression, and health anxiety in undergraduate students living in initial US outbreak “hotspot” during COVID-19 pandemic. Cognitive Behaviour Therapy50(5): 409–421.
18.
LajoieSPZhengJLiS, et al. (2021) Examining the interplay of affect and self regulation in the context of clinical reasoning. Learning and Instruction72: 101219.
19.
LanuzaFMoralesGHidalgo-RasmussenC, et al. (2022) Association between eating habits and quality of life among Chilean university students. Journal of American College Health70(1): 280–286.
20.
LeiHPengBTangM, et al. (2025) A study on the relationship between college students’ physical exercise and feelings of inferiority: The mediating effect of social support. PLoS One20(5): e0321685.
21.
LiuP (2025) Stress buffering effects of physical activity in adolescents: The moderating role of physical activity attitudes. BMC Public Health25: 463.
22.
LuoJWangPLiZ, et al. (2021) Health anxiety and its correlates in the general Chinese population during the COVID-19 epidemic. Frontiers in Psychiatry12: 743409.
23.
MengJGaoCTangC, et al. (2019) Prevalence of hypochondriac symptoms among health science students in China: A systematic review and meta-analysis. PLoS One14(9): e0222663.
24.
MochcovitchMDDeslandesACFreireRC, et al. (2016) The effects of regular physical activity on anxiety symptoms in healthy older adults: A systematic review. Revista Brasileira de Psiquiatria38(3): 255–261.
25.
MohsenabadiHPirmoradiMZahedi TajrishiK, et al. (2025) A transdiagnostic approach to investigate of the relationships between anxiety sensitivity and health anxiety: The mediated roles of distress tolerance and emotion regulation. Frontiers in Psychiatry16: 1478442.
26.
MoralesAEspadaJPCarballoJL, et al. (2015) Short health anxiety inventory: Factor structure and psychometric properties in Spanish adolescents. Journal of Health Psychology20(2): 123–131.
27.
MorcosGAwanOA (2023) Burnout in medical school: A medical student’s perspective. Academic Radiology30(6): 1223–1225.
28.
MoyersSAHaggerMS (2023) Physical activity and cortisol regulation: A meta-analysis. Biological Psychology179: 108548.
29.
NédóEPaulikE (2012) Association of smoking, physical activity, and dietary habits with socioeconomic variables: A cross-sectional study in adults on both sides of the Hungarian-Romanian border. BMC Public Health12(1): 10.
30.
NelsonVRAsifIM (2020) Exercise as a prescription for mental health. In: HongERaoAL (eds) Mental Health in the Athlete: Modern Perspectives and Novel Challenges for the Sports Medicine Provider. pp.269–276.
31.
NuttallFQ (2015) Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today50(3): 117–128.
32.
OttoMWEastmanALoS, et al. (2016) Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. Clinical Psychology Review49: 67–78.
33.
QuNLiK (2004) Study on the reliability and validity of international physical activity questionnaire (Chinese Vision, IPAQ). Zhonghua liu Xing Bing xue za zhi= Zhonghua Liuxingbingxue Zazhi25(3): 265–268.
34.
Robles-MariñosRAngelesAIAlvaradoGF (2022) Factors associated with health anxiety in medical students at a private university in Lima, Peru. Revista Colombiana de psiquiatria (English ed.)51(2): 89–98.
35.
RohillaJTakPJhanwarS, et al. (2020) Health anxiety among medical students: A comparison between preclinical and clinical years of training. Journal of Education and Health Promotion9(1): 356.
36.
ShiWShenZWangS, et al. (2020) Barriers to professional mental health help-seeking among Chinese adults: A systematic review. Frontiers in Psychiatry11: 442.
37.
SniehottaFFScholzUSchwarzerR (2005) Bridging the intention–behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychology and Health20(2): 143–160.
38.
SuaibS (2024) Dynamics of social interaction, social support, and psychological well-being in urban communities: Social support theory perspective. International Journal of Religion5(11): 4786–4803.
39.
TalapkoJPerićIVulićP, et al. (2021) Mental health and physical activity in health-related university students during the COVID-19 pandemic. Healthcare9: 801.
40.
TangMYSmithDMMc SharryJ, et al. (2019) Behavior change techniques associated with changes in postintervention and maintained changes in self-efficacy for physical activity: A systematic review with meta-analysis. Annals of Behavioral Medicine53(9): 801–815.
41.
TranVDDoVVPhamNM, et al. (2020) Validity of the international physical activity questionnaire–short form for application in Asian countries: A study in Vietnam. Evaluation & The Health Professions43(2): 105–109.
42.
WangHZhangQLinY, et al. (2023) Keep moving to retain the healthy self: The influence of physical exercise in health anxiety among Chinese menopausal women. Behavioral Sciences13(2): 140.
43.
WeckFRichtbergSNengJJ (2014) Epidemiology of hypochondriasis and health anxiety: Comparison of different diagnostic criteria. Current Psychiatry Reviews10(1): 14–23.
44.
WheatonMGBermanNCFranklinJC, et al. (2010) Health anxiety: Latent structure and associations with anxiety-related psychological processes in a student sample. Journal of Psychopathology and Behavioral Assessment32: 565–574.
45.
WhiteKKendrickTYardleyL (2009) Change in self-esteem, self-efficacy and the mood dimensions of depression as potential mediators of the physical activity and depression relationship: Exploring the temporal relation of change. Mental Health and Physical Activity2(1): 44–52.
46.
YangHFuCZhangX, et al. (2023) Association between physical activity levels and anxiety or depression among college students in China during the COVID-19 pandemic: A meta-analysis. Medicine102(49): e36524.
47.
YangXWangMWangJ, et al. (2024) Physical literacy and health of Chinese medical students: The chain mediating role of physical activity and subjective well-being. Frontiers in Public Health12: 1348743.
48.
YuanYZhangYLiuR, et al. (2015) The reliability and validity of a Chinese-version short health anxiety inventory: An investigation of university students. Neuropsychiatric Disease and Treatment16(11): 1739–1747.
49.
YuSKowittSDFisherEB, et al. (2018) Mental health in China: Stigma, family obligations, and the potential of peer support. Community Mental Health Journal54: 757–764.
50.
ZhangBLeiSMLeS, et al. (2022) Changes in health behaviors and conditions during COVID-19 pandemic strict campus lockdown among Chinese university students. Frontiers in Psychology13: 1022966.
51.
ZhangGFengWZhaoL, et al. (2024a) The association between physical activity, self-efficacy, stress self-management and mental health among adolescents. Scientific Reports14(1): 5488.
52.
ZhangJLiuYSunL (2017) Psychological strain and suicidal ideation: A comparison between Chinese and US college students. Psychiatry Research255: 256–262.
53.
ZhangRYinYZhangY, et al. (2024b) Physical activity, weight management, and mental health during COVID-19 lockdown: A cross-sectional study of healthcare students in China. PLoS One19(10): e0302894.
54.
ZhaoFYangXPanX, et al. (2018) Prevalence of anxiety symptoms and its correlates among medical students in China: A national survey in 33 universities. Value in Health21: S182–S183.
55.
ZhengGLanXLiM, et al. (2015) Effectiveness of tai chi on physical and psychological health of college students: Results of a randomized controlled trial. PLoS One10(7): e0132605.
