This Canadian study is the first of its kind in which students have been assessed on prevalence or likelihood of developing anxiety or depression in their college life. The study has been published in the open access journal BMJ Open and clearly suggests that nearly one third of first year university students either have or develop moderate to severe anxiety and/or depression. The area of interest for the researchers was to find out the factors which might predict recovery in students who start the university with moderate to severe anxiety and/or depressive symptoms and also those factors which might predict the emergence of these symptoms in first year students without pre-existing depression or anxiety.
To carry out the study 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 the year 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. 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 classes is associated with greater odds of developing significant levels of depression and anxiety by the end of the first year.
Factors which lower the odds of developing significant symptoms and recovery of students who already have depression and anxiety symptoms are related to one’s level of socialisation and involvement in student societies, clubs and sports teams. A significant noting made by the research team was that the transition of university life coincides with the peak period for the emergence of mental illness, nearly75% of which starts in young adulthood. Students also spoke about other potentially influential factors like parental education, early life adversities like sexual/emotional/physical abuse and divorce. Social support, sense of belonging both within the campus and with their peers and the amount and frequency of alcohol, stimulants, sleeping pills that had not been prescribed was also assessed.
58% of eligible students completed the first round of questionnaires and assessments (3029 out of 5245) and 37% (1952) completed both sets. Resultantly, at the start of the year 2018, 27% students showed significant symptoms of depression and 32% students showed significant symptoms of anxiety. These figures had risen to 33% and37% respectively by March 2019.
The study was an observational one so it cannot establish a cause. The researchers thus highlighted how their findings may not be more widely applicable to other universities in different countries as many interrelated factors influence the emergence and maintenance of mental health problems including psychological, social and biological factors. The conclusion was that moderate to severe levels of depressive and anxiety symptoms are common among students at entry to university and persist during the first year. University connectedness may mitigate the risk of emergent or persistent symptoms, whereas drug use appears to increase these risks.