Mendelian randomization underscores the importance of clinical nursing in mitigating anxiety and panic attack risks among low-educated populations.

Abstract

Considering the complex and underexplored interplay between educational attainment (EA) and the prevalence of anxiety and panic attacks, which carries significant societal implications, we have designed a two-sample Mendelian randomization (MR) study. The primary objective of this research is to elucidate the causal relationship between education level and the risk of anxiety and panic attacks, thereby providing novel insights for clinical and nursing strategies. Our study adheres to the STROBE-MR guidelines and employs a classical two-sample MR analysis to investigate the causal relationship between EA (exposure) and the occurrence of anxiety/panic attacks (outcome). The data for 8 education-related phenotypes, along with anxiety and panic attack outcomes, were sourced from European population-based Genome-wide association studies databases. To ensure robustness, we applied 5 distinct MR analytical methods, supplemented by comprehensive sensitivity analyses, heterogeneity assessments, and evaluations of reverse causality bias to uphold rigorous quality control standards. Our findings, robust across various MR methods and consistent after inverse variance-weighted and false discovery rate (FDR) corrections, indicate a significant association between lower EA and an increased risk of anxiety or panic attacks. Specifically, individuals with no formal qualifications exhibited a higher risk (P-value&#x2005;=&#x2005;.005, OR&#x2005;=&#x2005;1.017, 95% CI&#x2005;=&#x2005;1.005-1.029, FDR&#x2005;=&#x2005;0.011). In contrast, higher levels of education were associated with a reduced risk: College or University degree (P-value&#x2005;<&#x2005;.01, OR&#x2005;=&#x2005;0.989, 95% CI&#x2005;=&#x2005;0.984-0.995, FDR&#x2005;=&#x2005;0.0007), EA (P-value&#x2005;<&#x2005;.01, OR&#x2005;=&#x2005;0.999, 95% CI&#x2005;=&#x2005;0.998-0.9995, FDR&#x2005;=&#x2005;0.0009), and A levels/AS levels or equivalent (P-value&#x2005;=&#x2005;.011, OR&#x2005;=&#x2005;0.988, 95% CI&#x2005;=&#x2005;0.978-0.997, FDR&#x2005;=&#x2005;0.019). These conclusions were consistently supported by at least 4 MR methods and successfully passed all quality control checks. Our study demonstrates a negative correlation between years of education and the risk of anxiety and panic attacks, suggesting that clinical nursing and patient education efforts should prioritize tailored psychological support and patient communication for individuals with lower EA. This population warrants enhanced attention and more compassionate care to mitigate their elevated risk of anxiety-related disorders.