{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T13:36:42Z","timestamp":1793799402001,"version":"4.6.1"},"reference-count":58,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2014,9,26]],"date-time":"2014-09-26T00:00:00Z","timestamp":1411689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms\/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively).  A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug\/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21  self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory\/breathing; gastrointestinal; and, pains\/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness\/anxiety,  and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported \u22654 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation was for psychological symptoms. After controlling for sex, age country, and other symptom groups, stress was highly and significantly associated with psychological symptoms and also with pain &amp; aches symptoms in both countries. UK students were generally less stressed than their counterparts in Egypt. Age and female gender were also associated with stress; the younger the student was the more likely to suffer from stress. Interactions were not significant. Across both countries, the levels of stress among students and the associations between perceived stress and health complaints suggest the need for a multiple approaches in order to understand the sources of stress; how college students experience stress; and, the coping mechanisms that different students employ to mitigate stress. Interventions aimed at both preventing, treating and caring for students\u2019 distress, and also preventive strategies to help minimize the impact of stressful situations are required. Strategies that address both physical and psychological complaints may be beneficial for this population.<\/jats:p>","DOI":"10.3390\/ijerph111009981","type":"journal-article","created":{"date-parts":[[2014,9,26]],"date-time":"2014-09-26T11:27:58Z","timestamp":1411730878000},"page":"9981-10002","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Are Students\u2019 Symptoms and Health Complaints Associated with Perceived Stress at University? Perspectives from the United Kingdom and Egypt"],"prefix":"10.3390","volume":"11","author":[{"given":"Walid","family":"Ansari","sequence":"first","affiliation":[{"name":"Faculty of Applied Sciences, University of Gloucestershire, Gloucester GL2 9HW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Oskrochi","sequence":"additional","affiliation":[{"name":"Faculty of Technology, Design and Environment, Oxford Brookes University, Oxford OX33 1 HX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghollamreza","family":"Haghgoo","sequence":"additional","affiliation":[{"name":"Faculty of Technology, Design and Environment, Oxford Brookes University, Oxford OX33 1 HX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2014,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.7899\/1042-5055-22.1.12","article-title":"Student mental health in a chiropractic university setting","volume":"22","author":"Rubin","year":"2008","journal-title":"J. Chiropr. Educ."},{"key":"ref_2","first-page":"20","article-title":"The mental health crisis: What colleges must do","volume":"10","author":"Kadison","year":"2004","journal-title":"Chron. Higher Educ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1590\/S0034-89102006000700011","article-title":"Prevalence and risk factors of common mental disorders among medical students","volume":"40","author":"Lima","year":"2006","journal-title":"Rev. Saude Publica"},{"key":"ref_4","first-page":"166","article-title":"Understanding the psychosocial and physical work environment in a Singapore medical school","volume":"48","author":"Chan","year":"2007","journal-title":"Singapore Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/BF00893161","article-title":"Student physical symptoms and the social climate of college living groups","volume":"7","author":"Moos","year":"1979","journal-title":"Am. J. Community Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1556\/OH.2012.29431","article-title":"Study of stress, coping and psychosomatic health among baccalaureate nurses-to-be","volume":"153","author":"Piczil","year":"2012","journal-title":"Orv. Hetil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2188\/jea.10.241","article-title":"The characteristics of fatigue symptoms and their association with the life style and the health status in school children","volume":"10","author":"Okamoto","year":"2000","journal-title":"J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1097\/00001888-200604000-00009","article-title":"Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students","volume":"81","author":"Dyrbye","year":"2006","journal-title":"Acad. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2478\/v10001-008-0028-6","article-title":"Adverse effects of excessive mobile phone use","volume":"21","author":"Khan","year":"2008","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_10","first-page":"438","article-title":"The origin of stress, its causes, symptoms and frequency of appearance among the students of Medical University of Lublin","volume":"59","author":"Chrzanowska","year":"2004","journal-title":"Ann. Univ. Mariae Curie Sklodowska Med."},{"key":"ref_11","first-page":"425","article-title":"Trends in the prevalence of asthma and dyspnoea in first year university students, 1972\u201389","volume":"86","author":"Bruce","year":"1993","journal-title":"Q. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bruls, V.E., Bastiaenen, C.H., and de Bie, R.A. (2013). Non-traumatic arm, neck and shoulder complaints: Prevalence, course and prognosis in a Dutch university population. BMC Musculoskelet. Disord., 4.","DOI":"10.1186\/1471-2474-14-8"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3233\/BMR-130397","article-title":"Musculoskeletal pain among undergraduate laptop users in a Nigerian University","volume":"26","author":"Obembe","year":"2013","journal-title":"J. Back Musculoskelet Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/j.1601-5037.2009.00370.x","article-title":"Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students","volume":"7","author":"Hayes","year":"2009","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.jmpt.2010.06.003","article-title":"The association of self-reported backpack use and backpack weight with low back pain among college students","volume":"33","author":"Heuscher","year":"2010","journal-title":"J. Manipulative Physiol. Ther."},{"key":"ref_16","first-page":"387","article-title":"The prevalence of computer-related musculoskeletal complaints in female college students","volume":"24","author":"Hamilton","year":"2005","journal-title":"Work"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1111\/j.1440-1746.2009.05943.x","article-title":"Prevalence of irritable bowel syndrome and its relationship with psychological stress status in Chinese university students","volume":"24","author":"Shen","year":"2009","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ijnurstu.2004.06.015","article-title":"Prevalence of irritable bowel syndrome, influence of lifestyle factors and bowel habits in Korean college students","volume":"42","author":"Kim","year":"2005","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0022-3999(99)00032-X","article-title":"Neurotic butterflies in my stomach: The role of anxiety, anxiety sensitivity and depression in functional gastrointestinal disorders","volume":"47","author":"Norton","year":"1999","journal-title":"J. Psychosom. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S0022-3999(03)00019-9","article-title":"Prevalence of irritable bowel syndrome among university students: The roles of worry, neuroticism, anxiety sensitivity and visceral anxiety","volume":"55","author":"Craske","year":"2003","journal-title":"J. Psychosom. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1046\/j.1440-1746.2003.03212.x","article-title":"Prevalence of irritable bowel syndrome in young adult Malaysians: A survey among medical students","volume":"18","author":"Tan","year":"2003","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"344","DOI":"10.2519\/jospt.2003.33.6.344","article-title":"The association between psychological distress and musculoskeletal symptoms experienced by Chinese high school students","volume":"33","author":"Cho","year":"2003","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/07448481.1995.9939100","article-title":"Do somatic complaints mask negative affect in youth?","volume":"44","author":"Terre","year":"1995","journal-title":"J. Am. Coll. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.ypmed.2003.07.001","article-title":"Differences in health complaints among university students from three European countries","volume":"37","author":"Stock","year":"2003","journal-title":"Prev. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"516","DOI":"10.3329\/jhpn.v29i5.8906","article-title":"Stress and its effects on medical students: A cross-sectional study at a college of medicine in Saudi Arabia","volume":"29","author":"Abdulghani","year":"2011","journal-title":"J. Health Popul. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.healthpol.2009.08.003","article-title":"Welfare state regimes and population health: Integrating the East Asian welfare states","volume":"94","author":"Eikemo","year":"2010","journal-title":"Health Policy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"58","DOI":"10.21101\/cejph.a3418","article-title":"Promoting public health: Benefits and challenges of a Europeanwide research consortium on student health","volume":"15","author":"Maxwell","year":"2007","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"583","DOI":"10.3390\/ijerph7020583","article-title":"How do I look? Body image perceptions among university students from England and Denmark","volume":"7","author":"Clausen","year":"2010","journal-title":"Int. J. Environ. Res. Publ. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"281","DOI":"10.3390\/ijerph8020281","article-title":"Does the association between depressive symptomatology and physical activity depend on body image perception? A survey of students from seven universities in the UK","volume":"8","author":"Stock","year":"2011","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2547","DOI":"10.7314\/APJCP.2012.13.6.2547","article-title":"Correlates of smoking, quit attempts and attitudes towards total smoking bans at university: Findings from eleven faculties in Egypt","volume":"13","author":"Labeeb","year":"2012","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_31","first-page":"293","article-title":"Physical and psychological well-being of university students: Survey of eleven faculties in Egypt","volume":"4","author":"Labeeb","year":"2013","journal-title":"Int. J. Prev. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"El Ansari, W., Sebena, R., and Stock, C. (2013). Socio-demographic correlates of six indicators of alcohol consumption: Survey findings of students across seven universities in England, Wales and Northern Ireland. Arch. Public Health, 71.","DOI":"10.1186\/2049-3258-71-29"},{"key":"ref_33","first-page":"1175","article-title":"Is alcohol consumption associated with poor academic achievement in university students?","volume":"4","author":"Stock","year":"2013","journal-title":"Int. J. Prev. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"211","DOI":"10.3109\/10826084.2013.824476","article-title":"Do importance of religious faith and healthy lifestyle modify the relationships between depressive symptoms and four indicators of alcohol consumption? A survey of students across seven universities in England, wales, and Northern Ireland","volume":"49","author":"Sebena","year":"2014","journal-title":"Subst. Use Misuse"},{"key":"ref_35","first-page":"105","article-title":"Body image concern and its correlates among male and female undergraduate students at Assuit University in Egypt","volume":"6","author":"Dibba","year":"2014","journal-title":"Glob. J. Health Sci."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"El Ansari, W., Khalil, K., Crone, D., and Stock, C. (2014). Physical activity and gender differences: Correlates of compliance with recommended levels of five forms of physical activity among students at nine universities in Libya. Cent. Eur. J. Public Health, 22, (In press).","DOI":"10.21101\/cejph.a4011"},{"key":"ref_37","first-page":"705","article-title":"Factors associated with smoking, quit attempts and attitudes towards total smoking bans at university: A survey of seven universities in England, Wales and Northern Ireland","volume":"3","author":"Stock","year":"2012","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Cohen, S., Kamarck, T., and Mermelstein, R. (1983). A global measure of perceived stress. J. Health Soc. Behav., 24.","DOI":"10.1037\/t02889-000"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s10389-007-0173-6","article-title":"Gender differences in health complaints among students: Results from a survey in seven countries","volume":"16","author":"Stock","year":"2008","journal-title":"J. Public Health"},{"key":"ref_40","first-page":"S62","article-title":"Process and results of field work concerning the Federal Health Survey","volume":"61","author":"Potthoff","year":"1999","journal-title":"Gesundheitswesen"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"American College Health Association (2006). American College Health Association-National College Health Assessment (ACHA-NCHA) spring 2005 reference group data report (Abridged). J. Am. Coll. Health, 55, 15\u201316.","DOI":"10.3200\/JACH.55.1.5-16"},{"key":"ref_42","unstructured":"World Health Organization (WHO) (2000). Obesity: Preventing and Managing the Global Epidemic, WHO."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1093\/fampra\/10.2.212","article-title":"Measuring functional status in a population survey. The Dartmouth COOP\/WONCA functional health assessment charts used in an epidemiological study","volume":"10","author":"Bruusgard","year":"1993","journal-title":"Fam. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1055\/s-2001-12116","article-title":"Health of students during their course of studies","volume":"63","author":"Stock","year":"2001","journal-title":"Das Gesundheitswesen"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s10389-013-0571-x","article-title":"Symptoms and health complaints and their association with perceived stress: Students from seven universities in England, Wales and Northern Ireland","volume":"21","author":"Oskrochi","year":"2013","journal-title":"J. Public Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1891\/1541-6577.23.4.259","article-title":"Cultural determinants of help seeking: A model for research and practice","volume":"23","year":"2009","journal-title":"Res. Theory Nurs. Pract."},{"key":"ref_47","first-page":"10","article-title":"Perceived stress and gastrointestinal symptoms in nursing students in Korea: A cross-sectional survey","volume":"8","author":"Lee","year":"2011","journal-title":"BMC Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.ypmed.2010.04.005","article-title":"Lifestyle risk factors of students: A cluster analytical approach","volume":"51","author":"Dodd","year":"2010","journal-title":"Prev. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"197","DOI":"10.21101\/cejph.a3684","article-title":"Health promoting behaviours and lifestyle characteristics of students at seven universities in the UK","volume":"19","author":"Stock","year":"2011","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.3390\/ijerph8051308","article-title":"Feeling healthy? A survey of physical and psychological wellbeing of students from seven universities in the UK","volume":"8","author":"Stock","year":"2011","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1002\/j.0022-0337.2013.77.6.tb05532.x","article-title":"Stress and health-promoting attributes in Australian, New Zealand, and Chilean dental students","volume":"77","author":"Morgan","year":"2013","journal-title":"J. Dent. Educ."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/j.socscimed.2009.11.012","article-title":"School differences in adolescent health and wellbeing: Findings from the Canadian Health Behaviour in School-Aged Children Study","volume":"70","author":"Saab","year":"2010","journal-title":"Soc. Sci. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1016\/j.socscimed.2008.01.022","article-title":"Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis","volume":"66","author":"Eikemo","year":"2008","journal-title":"Soc. Sci. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/eurpub\/11.1.4","article-title":"Subjective health complaints in adolescence: A cross-national comparison of prevalence and dimensionality","volume":"11","author":"Haugland","year":"2001","journal-title":"Eur. J. Public Health"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Song, Y., and Lindquist, R. (2014). Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. Nurse Educ. Today, 7.","DOI":"10.1016\/j.nedt.2014.06.010"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1177\/1524839913510316","article-title":"An examination of stress in college students over the course of a semester","volume":"15","author":"Baghurst","year":"2014","journal-title":"Health Promot. Pract."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Yarnal, C., Qian, X., Hustad, J., and Sims, D. (2013). Intervention for positive use of leisure time among college students. J. Coll. Character, 14.","DOI":"10.1515\/jcc-2013-0022"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1176\/appi.ap.12010003","article-title":"A systematic review of stress-management programs for medical students","volume":"37","author":"Shiralkar","year":"2013","journal-title":"Acad. Psychiatry"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/11\/10\/9981\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:16:22Z","timestamp":1760217382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/11\/10\/9981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,26]]},"references-count":58,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2014,10]]}},"alternative-id":["ijerph111009981"],"URL":"https:\/\/doi.org\/10.3390\/ijerph111009981","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,26]]}}}