Association between wealth status, behavioral factors, and anxiety symptoms among women in Nepal: A cross-sectional analysis of NDHS 2022 data

Background Anxiety is a natural response to some sorts of incidents; everybody experiences its symptoms in some form in their lifetime globally. This study assessed factors associated with anxiety symptoms among women in Nepal using data from the Nepal Demographic and Health Survey (NDHS) 2022. Methods A cross-sectional analysis was conducted using nationally representative data from the NDHS 2022, collected from January 2 to June 22, 2022. A total of 14,845 women aged 15–49 years were selected using a multistage probability-proportional-to-size sampling strategy. Anxiety symptoms were measured using the Generalized Anxiety Disorder 7-item (GAD-7) scale, with a cut-off score of ≥5 indicating mild to moderate anxiety symptoms. Weighted multivariate logistic regression was used to identify associated factors, adjusting for the complex survey design (clustering, stratification, and sampling weights). Results The weighted prevalence of anxiety symptoms among women was 21.9% (95% CI: 21.2–22.6). After adjusting for confounders, women who were heads of household (adjusted Odds Ratio (aOR) = 1.253; 95% Confidence Interval (CI): 1.064 to 1.477; p < 0.01 ), married (aOR = 1.458; 95% CI: 1.107 to 1.921; p < 0.01), with middle wealth index (aOR = 1.423; 95% CI: 1.096–1.846; p < 0.01 ), poorer wealth index (aOR = 1.491; 95% CI: 1.153–1.929; p < 0.01), and current smokers (aOR = 1.903; 95% CI: 1.435–2524; p < 0.001) had significantly higher odds of anxiety symptoms. Conclusion Nearly one in five women in Nepal reported anxiety symptoms. Socio-demographic, economic, and behavioral factors are significantly associated with anxiety symptoms. These findings highlight the need for targeted mental health interventions for high-risk groups, including married women, smokers, and women from poorer households.