Background: Depression and anxiety are highly prevalent among medical students and may adversely affect academic functioning and professional development. Early identification of these symptoms and their associated factors is therefore essential. Religiosity has been suggested as a potential modifier of mental health outcomes, although existing evidence remains inconsistent. This study aimed to assess symptoms of depression and anxiety, levels of religiosity, and their associations among medical students. Methods: This cross-sectional study was conducted among medical students at the University of Osijek, Croatia, from 29 September to 5 October 2025. Anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale, depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and religiosity using the Duke University Religion Index (DUREL). Results: A total of 260 students (197 females, 63 males) completed the survey. At least mild depressive and anxiety symptoms were reported by 54.2% and 58.1%, respectively; 9.2% had moderately severe or severe depression, and 25% reported moderate to severe anxiety. Suicidal or self-harm ideation in the past two weeks occurred in 12.8%. Female students had higher median depression (p = 0.01) and anxiety scores (p = 0.005) than male students; however, these differences did not remain statistically significant after Bonferroni correction. Religiosity was not associated with PHQ-9 or GAD-7 scores after correction; however, categorical analyses indicated that students with moderate to high religiosity more frequently reported moderate to severe depressive symptoms (p = 0.037). Conclusions: The high prevalence of depression, anxiety, and suicidal ideation underscores the need for continuous mental health screening, early identification of risk factors, and implementation of preventive programs among the student population, particularly medical students as future healthcare professionals.
Keywords: anxiety; depression; medical student; mental disorders; mental health; religious and spiritual beliefs; student; suicidal ideation.