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Medical education is associated with high levels of stress that can intensify health-related anxiety, referred to as illness anxiety disorder, medical student syndrome, or nosophobia. This phenomenon often occurs when medical students, after studying a particular illness, start to feel they are having its symptoms and believe they may have the disease. We aimed to determine the prevalence of illness anxiety disorder and its relationship with generalized anxiety among medical students in Karachi.

This cross-sectional study was carried out from February 2025 to May 2025 among MBBS students in Karachi. A pre-validated structured questionnaire, comprising demographic details, the Short Health Anxiety Inventory (SHAI) scale, the Medical Students' Disease (MSD) Perception Scale, and the MSD Distress Scale, was distributed among 300 students from first to fifth year.

Out of 300 students, significant health-related anxiety (SHAI ≥ 18) was present in 16% (n = 48), and moderate to severe generalized anxiety (GAD-7 score ≥ 10) was present in 28% (n = 83) of the students. The highest mean SHAI score was shown by fifth-year students (12.31 ± 1.12), while the highest mean GAD-7 scores were shown by second-year students (7.25 ± 0.69). Gender and academic year did not have a statistically significant association with SHAI and GAD-7 scores (p > 0.05). Moreover, the Pearson correlation test revealed a low positive but statistically significant correlation between SHAI and GAD-7 scores (r = 0.462, p < 0.001). Linear regression analysis also revealed that the GAD-7 score was a significant predictor of the SHAI score, accounting for 21.4% of the variance in the SHAI score (β = 0.462, 95% CI: 0.425-0.663, p < 0.001*).

Health-related anxiety and generalized anxiety are prevalent and correlated among the medical students of Karachi. The results of this study emphasize that we must target our mental health interventions to alleviate anxiety-related distress in this population.