295 - Anxiety and Depression Symptom Severity Among University Students Seen in Primary Care Versus Psychiatry Clinics

Publication Number: 3284.295

Jessica N. Simmons, UVA Department of Student Health and Wellness, Charlottesville, VA, United States; Rita Farah, University of Virginia School of Medicine, CHARLOTTESVILLE, VA, United States; Rebecca L. Ferrara, University of Virginia, Charlottesville, VA, United States; Stephanie M. Hartman, University of Virginia, Charlottesville, VA, United States; Michael R. Patrizio, University of Virginia Student Health & Wellness, Charlottesville, VA, United States; Meredith Hayden, University of Virginia, Charlottesville, VA, United States

Background: Anxiety and depression visits are increasing at college health centers. According to the American College Health Association, 35.2% and 26.7% of college students reported a diagnosis of anxiety or depression in 2024. While most institutes of higher education provide both primary care and psychiatric services, researchers have not studied how anxiety or depression screening scores and symptom severity differ between these clinics.

Objective: The objective of this study was to determine if the presenting symptom severity for students with anxiety and depression differs between primary care and psychiatry clinics within a large, public university student health center.

Design/Methods: The Student Health Research Database, an IRB-approved database, was utilized to extract a data set consisting of all initial visits to the SHC for anxiety or depression from July 1, 2023 - June 30, 2025. Scores for the GAD-7 and PHQ-9 screening tests at initial visits with primary care versus psychiatry providers were compared using Pearson Chi Square test with Bonferroni correction. Students seen in primary care self-schedule while students seen in psychiatry were referred by a therapist.

Results: During the study period, there were 456 primary care and 432 psychiatry clinic initial visits for anxiety or depression. Initial GAD-7 scores were more likely to be in the minimal anxiety range in primary care versus psychiatry (GAD-7 0-4; p < 0.001). GAD-7 scores were comparable, regardless of site of care, for all other levels of anxiety, including severe anxiety (GAD-7 5-9, 10-14, 15-21). The distribution of PHQ-9 categories between primary care and psychiatry was statistically significant at the lowest range of PHQ-9 scores (PHQ-9 0-4; p< 0.001). However, as with the GAD-7 scores, there was no statistical difference in site of care when comparing mild, moderate, or severe scores (PHQ-9 5-9, 10-14, ≥15).

Conclusion(s): This study shows there is significant overlap in presenting symptom severity for anxiety and depression between student health primary care and psychiatry clinics. Indeed, this was true even at higher anxiety and depression screening scores. This has implications for ensuring primary care clinicians have the tools they need to provide up-to-date care, such as training, time, and therapist collaboration. In addition, student health centers should consider workflows that allow for escalating care to psychiatry from primary care when clinically indicated.

GAD-7 Score Distribution
GAD-7 Scores in Primary Care Versus Psychiatry

PHQ-9 Score Distribution
PHQ-9 Scores in Primary Care Versus Psychiatry

Scheduling to Primary Care Versus Psychiatry
Scheduling routes at student health center