Effect of Citrus aurantium essential oil on anxiety in nursing students during exams

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DEYSEN KERLLA FERNANDES BEZERRA GIRAO
Sheyla Morais Maciel Rocha
Iara Pereira de Menezes
José Eduardo Ribeiro Honório Junior
Francisco Rafael Oliveira da Silva

Abstract

Anxiety is an emotional state characterized by feelings of apprehension, insecurity, and fear, and is a common reaction to stressful situations. This condition is often observed among nursing students, especially during exam periods, and can compromise academic performance. Given this, complementary therapies, such as the use of essential oils, have been explored for their possible anxiolytic effects. Citrus aurantium essential oil has stood outforits calming properties, making it a promising alternative for managing anxiety in academic settings. OBJECTIVE: to investigate the anxiolytic potential of Citrus aurantium (bitter orange) essential oil in reducing anxiety levels in nursing students during exam periods. MATERIALS AND METHODS: the research was conducted as double-blind randomized clinical trial. Participants were divided into two groups: one group used Citrus aurantium essential oil by inhalation, while the other used vegetable oil as a placebo. Anxiety was measured after the exams using the Zung Self-Rating Anxiety Scale (SAS). RESULTS: the sample consisted of 42 nursing students, aged between 19 and 53 years, with 50% of the sample concentrated in the 21 to 23 age group. Most participants were female. Regarding anxiety history, they reported anxiety, but many reported that they had no previous diagnosis. Although the experimental group had a slightly higher mean score than the placebo group (53.63 vs. 49.82), there was no statistically significant difference (p=0.273). CONCLUSION: the study indicated that Citrus aurantium essential oil did not reduce anxiety in nursing students during exam periods.

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Original Research

How to Cite

FERNANDES BEZERRA GIRAO, D. K., Maciel Rocha , S. M. ., de Menezes , I. P., Honório Junior, J. E. R., & Oliveira da Silva, F. R. (2026). Effect of Citrus aurantium essential oil on anxiety in nursing students during exams. Brazilian Journal of Health Aromatherapy and Essential Oil, 3(1), 62. https://doi.org/10.62435/2965-7253.bjhae.2026.62

References

References

1. SILVA R, Andrade R, Santos M, et al. Ansiedade: mecanismos fisiológicos, diagnóstico e intervenções terapêuticas. Revista Eletrônica Acervo Saúde. 2023;15(3):e10445. Disponível em: https://acervomais.com.br/index.php/saude/article/view/10445. Acesso em: 4 mai. 2025.

2. CASTILLO, Ana Regina GL; RECONDO, Rogéria; Asbahr, Fernando R; MANFRO, Gisele G. Transtornos de ansiedade. Rev. Bras Psiquiatr, 2000;22(Supl II):20-3.Disponívelem: https://www.scielo.br/j/rbp/a/dz9nS7gtB9pZFY6rkh48CLt/?lang=pt. Acesso em: 28 maio de 2023.. DOI: https://doi.org/10.1590/S1516-44462000000600006

3. ORGANIZAÇÃO PAN-AMERICANA DA SAÚDE. A OMS destaca a necessidade urgente de transformar saúde mental e atenção.2022.Disponívelem:https://www.paho.org/pt/noticias/ 17-6-2022- oms-destaca-necessidade-urgente-transformar-saude-mental-e-atencao. Acesso em: 17 mar. 2025.

4. Gomes de Souza QM, Ribeiro de Souza R, Silva Santos S, de Oliveira D. A ansiedade e o graduando de enfermagem. Revista Foco. 2023;27(123).

5. Karaca A, Yıldırım N, Cangür S, Acıkgoz F, Akkuş D. Relationship between mental health of nursing students and coping, self-esteem and social support. Nurse Educ Today. 2019 Feb;76:44–50. doi:10.1016/j.dent.2019.01.029. DOI: https://doi.org/10.1016/j.nedt.2019.01.029

6. Firmino, R. F. B., et al. Impactos de medicamentos benzodiazepínicos na qualidade de vida de pessoas portadoras de trans-tornodeansiedadegeneralizada. Research, Society and Development. 2021;10(15):e523101523202. doi:10.33448/rsd-v10i15.23202. DOI: https://doi.org/10.33448/rsd-v10i15.23202

7. Tesser CD, Sousa IMC, Nascimento MC. Práticas Integrativas e Complementares na Atenção Primária à Saúde brasileira. SaúdeDebate.2023;42(especial1set):174-188.Disponívelem: https://revista.saudeemdebate.org.br/sed/article/view/567. DOI: https://doi.org/10.1590/0103-11042018s112

8. Domingos TS, Braga EM. Significado da massagem com aromaterapia em saúde mental. Acta Paul Enferm. 2014;27(6):579–84. doi:10.1590/1982-0194201400094 . DOI: https://doi.org/10.1590/1982-0194201400094

9. Chaves Neto G. Efeito do óleo essencial de Citrus aurantium L. nos níveis de ansiedade em usuários de crack internos em abstinência submetidos ao Teste de Simulação de Falar em Público. [Dissertação de Mestrado]. Universidade Federal da Pa-raíba; 2021. Disponível em: https://repositorio.Ufpb.br/jspui/ bitstream/tede/8244/2/arquivototal.pdf.

10. Gölücü M, Toker R, Tokgöz H, Yıldız Turgut D. Bitter orange (Citrus aurantium L.) peel essential oil compositions obtained with different methods. DOAJ. 2019.

11. Maksoud M, Silva R, Oliveira A, Santos L, Costa J, Souza M, et al. Uso da aromaterapia como tratamento adjuvante na redução desintomasdeansiedade:umarevisãointegrativa. Research, Society and Development. 2021;10(5):e19210515397. doi:10.33448/rsd-v10i5.15397. DOI: https://doi.org/10.33448/rsd-v10i10.19210

12. Friedman, L. M., Furberg, C., & DeMets, D. L. (2010). Fundamentals of Clinical Trials (4th ed.). Springer. DOI: https://doi.org/10.1007/978-1-4419-1586-3

13. Clifton L, Clifton DA. Como manter o nível máximo de cegamento na randomização para um ensaio clínico controlado por placebo. Contemp Clin Trials Commun. 2019 Jun; 14 :100356. [ Artigo gratuito do PMC ] [ PubMed ]

14. LopesAM, Musak RF,daCostaMR. Effects of Citrus aurantium essential oil on anxiety in hospital patients awaiting procedures: a randomized controlled trial. Complement Ther Med. 2021;58:102682. doi:10.1016/j.ctim.2021.102682. . DOI: https://doi.org/10.1016/j.ctim.2021.102682

15. Borges TLS. Aromaterapia inalatória com Lavandula x intermedia para redução da ansiedade: estudo de fase I e ensaio clínico controlado randomizado duplo-cego de fase II [dissertação]. João Pessoa (PB): Universidade Federal da Paraíba; 2023

16. Zung WWK.A rating instrument for anxiety disorders. Psychosomatics. 1971;12(6):371–379. doi:10.1016/S0033-3182(71)71479-0. DOI: https://doi.org/10.1016/S0033-3182(71)71479-0

17. Dunstan DA, Scott N. Norms for Zung's Self-rating Anxiety Scale. BMC Psychiatry. 2020 Feb 29;20(1):90. DOI: https://doi.org/10.1186/s12888-019-2427-6

18. Yu H,GeY,LiS,WangC,ZhuX,ZhangC,et al. Linalool as a natural anxiolytic agent: A review of the current evidence. Fitoterapia. 2022 Mar;157:104930.

19. SOUZA, Lívia Maria Trindade de. Efeito do óleo essencial de Citrus aurantium var. dulcis no Teste de Simulação de Falar em Público: um ensaio clínico randomizado. 2021. 100 f. Dissertação (Mestrado em Produtos Naturais e Sintéticos Bioativos) – UniversidadeFederaldaParaíba,JoãoPessoa,2021.Disponívelem:https://repositorio.ufpb.br/jspui/handle/123456789/22422. Acesso em: 5 jun. 2025.

20. Lis-Balchin M. Essential oils and aromatherapy: a review of issues in contemporary research. J R Soc Promot Health. 2003 Jun;123(2):107-12.

21. Ghalem,B.R.,etal.(2022). Neuropsychological effects of Citrus aurantium L. essential oil on anxiety and depression in an animal model. Journal of Integrative Medicine.

22. SunD, Zhu X, Bao Z. The relationship between physical activity and anxiety in college students: The mediating role of dietary nutrition and lifestyle habits. Front Psychol. 2024;15:1296154. doi:10.3389/fpsyg.2024.1296154. DOI: https://doi.org/10.3389/fpsyg.2024.1296154

23. Walker MP. Why We Sleep: Unlocking the Power of Sleep and Dreams. New York, NY: Scribner; 2017.

24. Mahajan K, Kaur M, Kalia M, Singh A. Academic Stress and Anxiety among University Students: A Systematic Review. Int J Ment Health Promot. 2023 Feb 1;25(1):1-16.