{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:22:53Z","timestamp":1760059373961,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"national funds through the Foundation for Science and Technology","award":["UID\/04923"],"award-info":[{"award-number":["UID\/04923"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Anxiety disorders are the most prevalent mental illnesses worldwide and in Portugal, often resulting in chronicity and disability. The objective of this study is to evaluate the sociodemographic and health-related factors associated with anxiety in the Portuguese adult population. Methods: This study included participants aged 18 to 65 years from the nationwide, population-based EpiDoC cohort, who were followed from 2011 to 2021 (n = 2927). Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). A mixed logistic regression analysis was performed using a prospective analytical approach. Two strategies were used to adjust the mixed models: (i) model with only complete observations (n = 1950) and (ii) model with imputation of the category \u201cNo\u201d in missing self-reported diseases (n = 2554). Results: The proportion of anxiety symptoms decreased from 2011\u20132013 to 2021 (12.5% vs. 8.5%). Experienced anxiety symptoms were positively associated (OR &gt; 1, p &lt; 0.05) with being female; having a high school, 2nd and 3rd cycle (6\u20139 years of studies), or primary\/no education; being unemployed; seeking the first job; and not working or being temporarily unable to work. Additionally, anxiety symptoms were positively associated (OR &gt; 1, p &lt; 0.05) with smoking daily, lack of physical exercise, and medication use. Digestive diseases, multimorbidity, and region were also positively associated (OR &gt; 1, p &lt; 0.05) with anxiety symptoms. Moreover, age was negatively associated (OR &lt; 1, p &lt; 0.05) with experiencing anxiety symptoms. Conclusions: Some determinants are modifiable and preventable through economic, social, and health policies. Measures to promote healthy lifestyles, like physical exercise, reduce substance abuse, prevent chronic diseases, increase employability, and increase schooling and health literacy, are necessary to reduce the anxiety rate in Portugal.<\/jats:p>","DOI":"10.3390\/jcm14124100","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T08:18:43Z","timestamp":1749543523000},"page":"4100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anxiety in Portugal: Associated Factors in Adult Population from 2011 to 2021"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8704-0480","authenticated-orcid":false,"given":"Ana","family":"Pedro Costa","sequence":"first","affiliation":[{"name":"University of \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Psychiatry Service of Mental Health Department, Health Unit of Baixo Alentejo (ULSBA), 7801-849 Beja, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5517-4855","authenticated-orcid":false,"given":"Anabela","family":"Afonso","sequence":"additional","affiliation":[{"name":"Department of Mathematics, School of Science and Technology, University of \u00c9vora, 7000-671 \u00c9vora, Portugal"},{"name":"Center for Research in Mathematics and Applications (CIMA), Institute for Advanced Studies and Research (IIFA), University of \u00c9vora, 7000-671 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8825-4923","authenticated-orcid":false,"given":"Irma","family":"da Silva Brito","sequence":"additional","affiliation":[{"name":"Nursing School of Coimbra, 3004-011 Coimbra, Portugal"},{"name":"Health Sciences Research Unit: Nursing, 3046-851 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3175-5708","authenticated-orcid":false,"given":"Teresa","family":"Dion\u00edsio Mestre","sequence":"additional","affiliation":[{"name":"University of \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Department of Health, Polytechnic Institute of Beja, 7800-295 Beja, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6395-1231","authenticated-orcid":false,"given":"Ana","family":"Matos Pires","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Psychiatry Service of Mental Health Department, Health Unit of Baixo Alentejo (ULSBA), 7801-849 Beja, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-8041","authenticated-orcid":false,"given":"Manuel Jos\u00e9","family":"Lopes","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"S\u00e3o Jo\u00e3o de Deus School of Nursing, University of \u00c9vora, 7000-811 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2023, April 22). 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