Low sense of coherence is associated with anxiety among adults: Results based on data from all 47 prefectures of Japan

Anxiety disorder is a major societal, economic, and healthcare burden, so it is essential to identify underlying risk factors. Sense of coherence (SOC), defined as an individual's perceived ability to control events and cope with challenges, is strongly associated with healthcare outcomes. This study investigated the association between SOC and anxiety among adults in all 47 prefectures of Japan using a cross-sectional online panel survey. SOC was assessed using the University of Tokyo Health Sociology version of the SOC Scale and anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale. Among 2100 participants (1051 males and 1049 females), 475 (22.6%) were identified with anxiety (scoring 8 points or higher on the GAD-7 scale). Before adjustment for potential confounders, there was a significant negative association between SOC and presence of anxiety. Even after adjustment, the presence of anxiety was significantly higher among the lower SOC subgroup than the higher SOC subgroup. These results indicate that approximately one-fifth of adults in Japan suffer from anxiety and that low SOC is a significant risk factor. •This study examined the relationship between sense of coherence (SOC) and anxiety•2100 adults from all 47 prefectures of Japan completed the survey•Approximately one-fifth suffered from anxiety•Anxiety prevalence was significantly higher among the lower SOC subgroup