ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
Increased anxiety symptoms in adolescents led by school phobia: a community-based study
Provisionally accepted
Mengye Cao1,2
Wenwen Shen1*
Fang Cheng1Wenwu Zhang1Suxian Tan3Xiulian Qian3Song Yuan4Shaohua Wang5Guoling Zhou5Deborah Baofeng Wang6Minjie Ye6Zhenyu Hu1*
Haihang Yu1*- 1Ningbo Kangning Hospital, Ningbo, China
- 2Ningbo University, Ningbo, China
- 3Third Hospital of Quzhou, Quzhou, China
- 4Zhoushan Second People's Hospital, zhejiang, China
- 5Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
- 6The Affiliated Wenzhou Kangning Hospital, Wenzhou, China
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Background. Increasing number of outpatient visits has been related to mental health crisis in adolescents. However, little is known for the chronological changes in adolescent anxiety symptoms in community samples, especially in China. Methods. Students from the 4th to the 11th grade were recruited from representative local schools in Zhejiang province. Screen for Child Anxiety-Related Emotional Disorders (SCARED) were used to collect the scores of panic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia, and were compared with the records of 2001. Results. Data from 8287 students showed that the anxiety symptoms were more frequent in girls and in higher grades. Chronological comparison suggested that all sub-types of anxiety have increased in girls, and symptoms of school phobia have increased in boys in middle schools. Largest size-effect of increase was seen for school anxiety. Conclusion. This study demonstrates a substantial increase in anxiety symptoms among Chinese adolescents over time, particularly among girls, with school-related anxiety showing the most pronounced rise. These findings indicate a growing mental health burden in community-based adolescent populations and underscore the importance of early identification and school-based preventive strategies.
Keywords: Adolescent, Anxiety, Primary schools, School phobia, Secondary schools, sex difference
Received: 22 Dec 2025; Accepted: 04 Feb 2026.
Copyright: © 2026 Cao, Shen, Cheng, Zhang, Tan, Qian, Yuan, Wang, Zhou, Wang, Ye, Hu and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenwen Shen
Zhenyu Hu
Haihang Yu
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