Prevalence and associated factors of anxiety and depression symptoms among basic education teachers in Espírito Santo, Brazil: a cross-sectional study

Mazzini, Yohan Cancilheri; Antonucci, Bruna Lopes; Ferreira, Beatriz Nicoli; Maia, Maria Carolina Magalhães de Castro Doyle; Tiguman, Gustavo Magno Baldin; Rocha, Kérilin Stancine Santos; Araújo, Dyego Carlos Souza Anacleto de

doi:10.1590/2317-6369/09425pt2026v51e4

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Research article • Rev. bras. saúde ocup. 51 • 2026 • https://doi.org/10.1590/2317-6369/09425en2026v51e4 linkcopy

Prevalence and associated factors of anxiety and depression symptoms among basic education teachers in Espírito Santo, Brazil: a cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To assess the prevalence and factors associated with symptoms of anxiety and depression among teachers from a regional education department in Espírito Santo, Brazil.

Methods A cross-sectional study was conducted with teachers from state schools, with schools selected through random sampling. A semi-structured questionnaire was applied, containing sociodemographic and occupational data and scales to screen for symptoms of anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). Poisson regression with robust variance was used.

Results 453 teachers participated, 65.3% of whom were cisgender women. The prevalence of anxiety symptoms was 32.7% (95%CI 28.4; 37.1) and depression 35.1% (95%CI 31.3%; 39.3). The prevalence of anxiety was higher in cisgender women (PR = 2.43; 95%CI 1.20; 4.89) and people with clinical insomnia symptoms (PR = 3.18; 95%CI 1.76; 5.72) and emotional exhaustion (PR = 2.51; 95%CI 1.36; 4.64). The prevalence of depression was also higher among cisgender women (PR = 1.70; 95%CI 1.15; 2.52), people with insomnia (PR = 1.88; 95%CI 1.29; 2.74), and emotional exhaustion (PR = 1.61; 95%CI 1.06; 2.47).

Conclusion Approximately one third of the teachers presented symptoms of anxiety as well as depression. The presence of these symptoms was associated with gender, insomnia, and emotional exhaustion.

Keywords:
School Teachers; Mental Health; Anxiety; Depression; Cross-Sectional Studies; Occupational Health

	n	%
Gender identity
Cisgender male	146	32.2
Cisgender Woman	286	63.2
Gender minorities	6	1.3
No answer	15	3.3
Sexual orientation
Heterosexual	395	87.2
Homosexual	29	6.4
Bisexual	16	3.5
Pansexual/Asexual	8	1.8
No answer	5	1.1
Age group
18-24 years old	6	1.3
25-34 years	112	24.7
35-44 years	152	33.6
45-59 years	148	32.7
≥ 60 years	22	4.9
No answer	13	2.8
Race/ethnicity
White	211	46.7
Brown	160	35.3
Black	72	15.9
Asian/indigenous	6	1.3
Don’t know or prefer not to answer	3	0.7
No answer	1	0.1
Family income
Up to 3 minimum wages	72	15.9
>3-5 minimum wages	229	50.5
>5 minimum wages	148	32.7
No answer	4	0.9
Has a partner
No	200	44.1
Yes	250	55.2
No answer	3	0.7
Has children
Yes	251	55.4
No	199	43.9
No answer	3	0.7
Number of children
None	199	43.9
1	126	27.8
2	93	20.5
3 or more	35	7.8
Higher academic degree
Degree	44	9.7
Specialization	299	66.0
Master’s/PhD	109	24.1
No answer	1	0.2
Employment relationship
Permanent	159	35.1
Temporary	290	64.0
No answer	4	0.9
School location
Vitória	109	24.1
Serra	259	57.2
Fundão	26	5.7
Santa Teresa	59	13.0
Job satisfaction
Dissatisfied	84	18.5
Neutral	43	9.5
Satisfied	322	71.1
No answer	4	0.9
Has another occupation
Yes	105	23.2
No	339	74.8
No answer	9	2.0
Length of experience in teaching
Up to 5 years	102	22.5
6-10 years	101	22.3
11-15 years	99	21.9
16-20 years	53	11.7
> 20 years	93	20.5
No answer	5	1.1
Weekly workload
Up to 25 hours	103	22.7
26-40 hours	167	36.9
41-50 hours	133	29.4
> 50 hours	23	5.1
No answer	27	5.9
Work shift
Daytime	331	73.1
Night	121	26.7
No answer	1	0.2
Health insurance
Yes	243	53.6
No	210	46.4
Symptoms of insomnia
Yes	97	21.4
No	349	77.0
No answer	7	1.6
Symptoms of emotional exhaustion
Yes	58	12.8
No	395	87.2

	n	%
Anxiety symptoms (GAD-7)
No anxiety	170	37.5
Mild non-pathological anxiety	133	29.4
Moderate anxiety	87	19.2
Severe anxiety	61	13.5
Symptoms of depression (PHQ-9)
No depression	165	36.4
Mild depression	127	28.0
Moderate depression	73	16.1
Moderately severe depression	54	11.9
Severe depression	32	7.1

Variable	Anxiety Symptoms				Depression Symptoms
Variable	Crude PR (95%CI)	p	Adjusted PR* (95%CI)	p	Crude PR (95%CI)	p	Adjusted PR* (95%CI)	p
Gender identity		0.14		0.04		0.09		0.02
Cisgender man	Ref.		Ref.		Ref.		Ref.
Cisgender woman	1.41 (0.97; 2. 06)		2.43 (1.20; 4.89)		1.47 (1.02; 2.12)		1.70 (1.15; 2.52)
Gender minority	1.96 (0.60; 6.36)		2.48 (0.58; 10.66)		1.87 (0.58; 6.06)		0.90 (0.26; 3.14)
Sexual orientation		0.16		0.43		0.02		0.10
Heterosexual	Ref.		Ref.		Ref.		Ref.
Homosexual	1.45 (0.82; 2.56)		1.80 (0.74 ; 4.40)		1.62 (0.97; 2.72)		1.88 (1.06; 3.34)
Bisexual	2.02 (1.06; 3.85)		-		1.47 (0.72; 3.00)		1.05 (0.46; 2.40)
Pan/Asexual	0.81 (0.20; 3.26)		-		-		-
Job satisfaction		0.01		0.91		<0.01		0.38
Dissatisfied	Ref.		Ref.		Ref.		Ref.
Neutral	0.95 ( 0.55; 1.65)		0.89 (0.40; 1.99)		0.92 (0.55; 1.55)		0.99 (0.58; 1.70)
Satisfied	0.59 ( 0.40; 0.86)		0.88 (0.46; 1.66)		0.54 (0.38; 0.77)		0.77 (0.51; 1.16)
Has another occupation		0.02		0.05		0.10		0.25
No	Ref.		Ref.		Ref.		Ref.
Yes	1.51 (1.06 ; 2.14)		1.74 (1.00; 3.01)		1.35 (0.95; 1.90)		1.24 (0.86; 1.78)
Symptoms of insomnia		<0.001		<0.001				<0.001
No	Ref.		Ref.		Ref.		Ref.
Yes	2.89 (2.09 ; 3.99)		3.18 (1.76; 5.72)		2.47 (1.80; 3.39)		1.88 (1.29; 2.74)
Emotional exhaustion symptoms		<0.001		<0.001		<0.001		0.03
No	Ref.		Ref.		Ref.		Ref.
Yes	3.06 (2.16 ; 4.34)		2.51 (1.36; 4.64)		2.66 (2.14; 3.32)		1.61 (1.06; 2.47)

Variables	Anxiety Symptoms				Symptoms of Depression
	Crude PR (95%CI)		Adjusted PR* (95%CI)		Crude PR (95%CI)		Adjusted PR* (95%CI)
	PR (95%CI)	p	PR (95%CI)	p	PR (95%CI)	p	PR (95%CI)	p
Gender identity		0.14		0.04		0.09		0.02
Cisgender man	Ref.		Ref.		Ref.		Ref.
Cisgender woman	1.41 (0.97 - 2. 06)		2.43 (1.20 - 4.89)		1.47 (1.02 - 2.12)		1.70 (1.15 - 2.52)
Gender minority	1.96 (0.60 - 6.36)		2.48 (0.58 - 10.66)		1.87 (0.58 - 6.06)		0.90 (0.26 - 3.14)
Sexual orientation		0.16		0.43		0.02		0.10
Heterosexual	Ref.		Ref.		Ref.		Ref.
Homosexual	1.45 (0.82 - 2.56)		1.80 (0.74 - 4.40)		1.62 (0.97 - 2.72)		1.88 (1.06 - 3.34)
Bisexual	2.02 (1.06 - 3.85)		-		1.47 (0.72 - 3.00)		1.05 (0.46 - 2.40)
Pan/Asexual	0.81 (0.20 - 3.26)		-		-
Age group		0.30				0.53
18-24 years	Ref.				Ref.
25-34 years	2.41 (0.33 - 17.49)				0.80 (0.25 - 2.59)
35-44 years	2.11 (0.29 - 15.23)				0.75 (0.24 - 2.40)
45-59 years	1.74 (0.24 - 12.66)				0.62 (0.19 - 2.0)
≥ 60 years	1.09 (0.12 - 9.76)				0.46 (0.11 - 1.90)
Race/ethnicity		0.91				0.98
White	Ref.				Ref.
Brown	0.98 (0.68 - 1.41)				1.01 (0.71 - 1.43)
Black	1.08 (0.68 - 1.70)				1.00 (0.63 - 1.57)
Asian/indigenous	1.38 (0.50 - 3.78)				1.28 (0.47 - 3.50)
Family income		0.96				0.41
Up to 3 minimum wages	Ref.				Ref.
3-5 minimum wages	0.98 (0.62 - 1.55)				0.87 (0.57 - 1.32)
> 5 minimum wages	0.94 (0.58 - 1.54)				0.74 (0.46 - 1.17)
Marital status		0.89				0.43
No partner	Ref.				Ref.
With partner	0.98 (0.71 - 1.35)				0.88 (0.64 - 1.20)
Number of children		0.55				0.90
Without children	Ref.				Ref.
1 child	1.15 (0.79 - 1.68)				1.03 (0.71 - 1.50)
2 children	1.00 (0.65 - 1.54)				1.03 (0.69 - 1.56)
> 2 children	0.68 (0.31 - 1.48)				0.80 (0.40 - 1.59)
Higher academic degree		0.77				0.92
Bachelor’s degree	Ref.				Ref.
Specialization	0.84 (0.50 - 1.41)				0.98 (0.58 - 1.66)
Master’s or doctorate	0.81 (0.45 - 1.44)				0.91 (0.50 - 1.64)
Employment		0.51				0.52
Permanent	Ref.				Temporary
Temporary	0.89 (0.64 - 1.25)				0.90 (0.65 - 1.24)
School location		0.82				0.90
Vitória	Ref.				Ref.
Serra	1.15 (0.77 - 1.72)				0.98 (0.68 - 1.43)
Fundão	0.89 (0.39 - 2.01)				0.75 (0.33 - 1.67)
Santa Teresa	1.01 (0.57 - 1.79)				0.99 (0.58 - 1.68)
Job satisfaction		0.01		0.91		<0.01		0.38
Dissatisfied	Ref.		Ref.		Ref.		Ref.
Neutral	0.95 (0.55 - 1.65)		0.89 (0.40 - 1.99)		0.92 (0.55 - 1.55)		0.99 (0.58 - 1.70)
Satisfied	0.59 (0.40 - 0.86)		0.88 (0.46 - 1.66)		0.54 (0.38 - 0.77)		0.77 (0.51 - 1.16)
Has another occupation		0.02		0.05		0.10		0.25
No	Ref.		Ref.		Ref.		Ref.
Yes	1.51 (1.06 - 2.14)		1.74 (1.00 - 3.01)		1.35 (0.95 - 1.90)		1.24 (0.86 - 1.78)
Length of teaching experience		0.49				0.69
Up to 5 years	Ref.				Ref.
6-10 years	1.22 (0.75 - 1.99)				1.12 (0.71 - 1.78)
11-15 years	1.06 (0.64 - 1.76)				0.85 (0.52 - 1.40)
16-20 years	1.48 (0.86 - 2.54)				1.21 (0.71 - 2.06)
> 20 years	0.91 (0.54 - 1.55)				0.92 (0.56 - 1.50)
Weekly workload		0.75				0.89
Up to 25 hours	Ref.				Ref.
26-40 hours	1.11 (0.71 - 1.75)				0.99 (0.65 - 1.51)
41-50 hours	1.26 (0.79 - 1.99)				1.06 (0.69 - 1.64)
> 50 hours	0.93 (0.38 - 2.23)				0.77 (0.32 - 1.82)
Work shift		0.94				0.99
Daytime	Ref.				Ref.
Night	0.99 (0.68 - 1.42)				1.00 (0.70 - 1.42)
Health plan		0.84				0.74
No	Ref.				Ref.
Yes	0.97 (0.70 - 1.34)				0.95 (0.69 - 1.29)
Insomnia symptoms		<0.001		<0.001		<0.001		<0.001
No	Ref.		Ref.		Ref.		Ref.
Yes	2.89 (2.09 - 3.99)		3.18 (1.76 - 5.72)		2.47 (1.80 - 3.39)		1.88 (1.29 - 2.74)
Burnout symptoms		<0.001		<0.001		<0.001		0.03
No	Ref.		Ref.		Ref.		Ref.
Yes	3.06 (2.16 - 4.34)		2.51 (1.36 - 4.64)		2.66 (2.14 - 3.32)		1.61 (1.06 - 2.47)

Variáveis	Sintomas de Ansiedade				Sintomas de Depressão
	Regressão não ajustada		Regressão ajustada*		Regressão não ajustada		Regressão ajustada*
	RP (IC95%)	p	RP (IC95%)	p	RP (IC95%)	p	RP (IC95%)	p
Identidade de gênero		0,14		0,04		0,09		0,02
Homem cisgênero	Ref.		Ref.		Ref.		Ref.
Mulher cisgênero	1,41 (0,97 – 2, 06)		2,43 (1,20 - 4,89)		1,47 (1,02 - 2,12)		1,70 (1,15 - 2,52)
Minoria de gênero	1,96 (0,60 – 6,36)		2,48 (0,58 - 10,66)		1,87 (0,58 - 6,06)		0,90 (0,26 - 3,14)
Orientação sexual		0,16		0,43		0,02		0,10
Heterossexual	Ref.		Ref.		Ref.		Ref.
Homossexual	1,45 (0,82 - 2,56)		1,80 (0,74 - 4,40)		1,62 (0,97 - 2,72)		1,88 (1,06 - 3,34)
Bissexual	2,02 (1,06 - 3,85)		-		1,47 (0,72 - 3,00)		1,05 (0,46 - 2,40)
Pan/Assexual	0,81 (0,20 - 3,26)		-		-
Faixa etária		0,30				0,53
18-24 anos	Ref.				Ref.
25-34 anos	2,41 (0,33 - 17,49)				0,80 ( 0,25 - 2,59)
35-44 anos	2,11 (0,29 - 15,23)				0,75 (0,24 - 2,40)
45-59 anos	1,74 (0,24 - 12,66)				0,62 (0,19 - 2,0)
≥ 60 anos	1,09 ( 0,12 - 9,76)				0,46 (0,11 - 1,90)
Cor/etnia		0,91				0,98
Branca	Ref.				Ref.
Parda	0,98 (0,68 - 1,41)				1,01 (0,71 - 1,43)
Preta	1,08 (0,68 - 1,70)				1,00 (0,63 - 1,57)
Asiática/indígena	1,38 (0,50 - 3,78)				1,28 (0,47 - 3,50)
Renda familiar		0,96				0,41
Até 3 salários-mínimos	Ref.				Ref.
3-5 salários-mínimos	0,98 (0,62 - 1,55)				0,87 (0,57 - 1,32)
> 5 salários-mínimos	0,94 (0,58 - 1,54)				0,74 (0,46 - 1,17)
Estado civil		0,89				0,43
Sem parceiro	Ref.				Ref.
Com parceiro	0,98 (0,71 - 1,35)				0,88 (0,64 - 1,20)
Número de filhos		0,55				0,90
Sem filhos	Ref.				Ref.
1 filho	1,15 (0,79 - 1,68)				1,03 (0,71 - 1,50)
2 filhos	1,00 (0,65 - 1,54)				1,03 (0,69 - 1,56)
> 2 filhos	0,68 (0,31 - 1,48)				0,80 (0,40 - 1,59)
Maior titulação acadêmica		0,77				0,92
Graduação	Ref.				Ref.
Especialização	0,84 (0,50 - 1,41)				0,98 (0,58 - 1,66)
Mestrado ou doutorado	0,81 (0,45 - 1,44)				0,91 (0,50 - 1,64)
Vínculo empregatício		0,51				0,52
Efetivo	Ref.				Ref.
Temporário	0,89 (0,64 - 1,25)				0,90 (0,65 - 1,24)
Localização da escola		0,82				0,90
Vitória	Ref.				Ref.
Serra	1,15 ( 0,77 - 1,72)				0,98 (0,68 - 1,43)
Fundão	0,89 ( 0,39 - 2,01)				0,75 (0,33 - 1,67)
Santa Teresa	1,01 (0,57 - 1,79)				0,99 (0,58 - 1,68)
Satisfação com o trabalho		0,01		0,91		<0,01		0,38
Insatisfeito	Ref.		Ref.		Ref.		Ref.
Neutro	0,95 ( 0,55 - 1,65)		0,89 (0,40 - 1,99)		0,92 (0,55 - 1,55)		0,99 (0,58 - 1,70)
Satisfeito	0,59 ( 0,40 - 0,86)		0,88 (0,46 - 1,66)		0,54 (0,38 - 0,77)		0,77 (0,51 - 1,16)
Possui outra ocupação		0,02		0,05		0,10		0,25
Não	Ref.		Ref.		Ref.		Ref.
Sim	1,51 (1,06 - 2,14)		1,74 (1,00 - 3,01)		1,35 (0,95 - 1,90)		1,24 (0,86 - 1,78)
Tempo de experiência no ensino		0,49				0,69
Até 5 anos	Ref.				Ref.
6-10 anos	1,22 (0,75 - 1,99)				1,12 (0,71 - 1,78)
11-15 anos	1,06 ( 0,64 - 1,76)				0,85 (0,52 - 1,40)
16-20 anos	1,48 (0,86 - 2,54)				1,21 (0,71 - 2,06)
> 20 anos	0,91 (0,54 - 1,55)				0,92 (0,56 - 1,50)
Carga horária semanal		0,75				0,89
Até 25 horas	Ref.				Ref.
26-40 horas	1,11 (0,71 - 1,75)				0,99 (0,65 - 1,51)
41-50 horas	1,26 (0,79 - 1,99)				1,06 (0,69 - 1,64)
> 50 horas	0,93 (0,38 - 2,23)				0,77 (0,32 - 1,82)
Turno de trabalho		0,94				0,99
Diurno	Ref.				Ref.
Noturno	0,99 (0,68 - 1,42)				1,00 (0,70 - 1,42)
Plano de saúde		0,84				0,74
Não	Ref.				Ref.
Sim	0,97 ( 0,70 - 1,34)				0,95 (0,69 - 1,29)
Sintomas de Insônia		<0,001		<0,001		<0,001		<0,001
Não	Ref.		Ref.		Ref.		Ref.
Sim	2,89 ( 2,09 - 3,99)		3,18 (1,76 - 5,72)		2,47 (1,80 - 3,39)		1,88 (1,29 - 2,74)
Sintomas de Burnout		<0,001		<0,001		<0,001		0,03
Não	Ref.		Ref.		Ref.		Ref.
Sim	3,06 (2,16 - 4,34)		2,51 (1,36 - 4,64)		2,66 (2,14 - 3,32)		1,61 (1,06 - 2,47)

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[TFN1001] GAD-7: Generalized Anxiety Disorder-7

[TFN2001] PHQ-9: Patient Health Questionnaire-9