The first study of its kind has been published in the open access journal BMJ Open and suggests that around a third of first-year university students have or develop moderate to severe anxiety and/or depression.
Depression and anxiety are mental health conditions that can affect the way a person feels and behaves. One in four adults including university students and one in 10 children experience mental illnesses.
The researchers wanted to find out which factors might predict recovery in students who start university with moderate to severe anxiety and/or depressive symptoms, and which factors might predict the emergence of these symptoms in first-year students without pre-existing anxiety and depression.
The causes of depression and anxiety in university students
The study highlighted how the increased use of prescription drugs (but not prescribed) and illicit drug use amongst those without mental health issues at the start of their university course is associated with greater odds of developing significant levels of anxiety and depression by the end of the first year.
However, socialising and getting involved in student clubs, societies, and sports teams is linked to lower odds of developing significant symptoms as well as boosting the recovery of university students who already have symptoms of depression and anxiety when they start their course.
Additionally, the researchers noted that the transition to university life coincides with the peak period for the emergence of mental illnesses, most (75%) of which start in young adulthood.
The most common of these disorders are anxiety and depression, known as ‘internalising disorders’ because they are directed or experienced inwardly and often include sadness and loneliness.
A large study of first-year students
The researchers used the survey responses of a representative sample of first-year students enrolled at a large, research-based, public university in Kingston, Ontario, Canada in 2018.
The survey explored factors previously associated with academic performance and mental health in students and was offered two weeks into the first term in September 2018 and two weeks before the start of the exam period in March 2019.
Students also provided information on potentially influential factors including:
- Parental education.
- Early life adversity such as divorce and sexual/physical/emotional abuse.
- Lifetime occurrence of mood and anxiety disorders.
The College Student Wellbeing scale was used to assess university students’ sense of belonging both within the campus and with their peers, whilst the Social Support Subscale of the Resilience Scale for Adolescents was used to measure levels of social support.
The amount and frequency of alcohol, sleeping pills and stimulants that had not been prescribed, cannabis, painkillers, opiates, psychedelics, and other recreational drugs the university students had used were formally assessed at both time points.
58% of eligible students completed the first round of questionnaires and assessments (3029 out of 5245) and 37% (1952) completed both sets.
The prevalence of clinically significant anxiety and depressive symptoms among the respondents was 32% and 27%, respectively, at the start of the academic year in 2018. These figures had risen to 37% and 33%, respectively, by March 2019.
As to the factors that were associated with the emergence of anxiety/depression over the first year, every one-point increase in the connectedness scale was associated with 10% and 6% lower odds of developing depression and anxiety symptoms, respectively. But increased drug use was strongly associated with heightened risk, every one-point increase in the score which ranges from 0-24, was associated with 16% higher odds of developing clinically significant levels of depressive symptoms.
The findings have important implications for university mental health policies
Due to the study being observational, it cannot establish a cause. The researchers also highlighted how the findings may not be more widely applicable to other universities in different countries.
Many interrelated factors influence the emergence and maintenance of mental health problems, including biological, psychological, and social factors, they added.
Nevertheless, the findings have important implications for university mental health policies, programmes, and practices, with the availability of clubs, societies and sporting activities likely to be key in promoting student mental health and wellbeing, the researchers suggested.
They concluded: “Moderate to severe levels of anxiety and depressive symptoms are common among students at entry to university and persist over the first year. University connectedness may mitigate the risk of persistent or emergent symptoms, whereas drug use appears to increase these risks.”