Around one-third of first-year university students suffer from or develop moderate to severe anxiety and/or depression, according to the first study of its sort published in the open-access journal BMJ Open.

Increased prescription (but not prescribed) and illicit drug use at the start of a course is correlated with an increased risk of developing severe levels of anxiety and depression by the ending of the first year, the data indicate.

However, socializing and involvement in student groups, societies, and sports teams have been attributed to a decreased danger of developing major symptoms and a boost in recovery for individuals who begin their course with depression or anxiety symptoms.

The transition to university life occurs during the peak period for the emergence of mental diseases, most of which (75 percent) begin in early adulthood, the researchers add.

The most prevalent of these disorders are anxiety and depression, which are referred to be ‘internalising disorders’ due to the fact that they are directed or experienced inwardly and frequently accompany feelings of melancholy and loneliness.

The scientists wanted to identify which factors are associated with recovery in students who begin university with moderate to severe anxiety and/or depressive symptoms, as well as which factors are associated with the emergence of these symptoms in first-year students who do not have pre-existing anxiety or depression.

The researchers analyzed survey responses from a representative sample of first-year students at a huge, research-intensive public institution in Kingston, Ontario, Canada in 2018.

The survey examined previously related factors with academic achievement and mental health in students and was administered two weeks into the first term in September 2018 and again two weeks before the exam season began in March 2019.

Additionally, respondents disclosed the following potentially important factors: parental education; early life adversity, such as divorce and sexual/physical/emotional abuse; and lifetime presence of mood and anxiety disorders.

The College Student Wellbeing scale was used to measure students’ sense of belonging on campus and with their peers, while the Social Support Subscale of the Resilience Scale for Adolescents was utilized to examine social support levels.

At both time points, the amount and frequency of alcohol, sleeping pills, and non-prescribed stimulants, cannabis, painkillers, opioids, psychedelics, and other recreational drugs used by the students were systematically assessed.

Approximately 58 percent of eligible students (3029 out of 5245) completed the initial round of surveys and exams, and 37 percent (1952) completed both sets.

At the start of the academic year in 2018, the prevalence of clinically significant anxiety and depressive symptoms was 32 percent and 27 percent, respectively. By March 2019, these figures had grown to 37 percent and 33 percent, respectively.

The analysis of characteristics linked with recovery revealed that students who began their course with a history of internalising disorders were nearly four times as likely to fail to recover from severe levels of anxiety/depressive symptoms as those who did not have this background.

However, students who felt linked to university life and their classmates had a stronger chance of recovering from depression and anxiety, with each point rise equivalent to an increase in probabilities of 18 percent and 14 percent, respectively.

Concerning the parameters linked with the appearance of anxiety/depression symptoms during the first year, each one-point increase in connection was associated with a 10 percent and 6 percent reduction in the likelihood of acquiring depression and anxiety symptoms, respectively.

However, increasing drug use was strongly connected with increased risk: each one-point rise in the score, which runs from 0 to 24, was associated with a 16 percent increased likelihood of developing clinically significant levels of depressive symptoms.

As this is an observational study, it cannot establish the main cause. Additionally, the researchers warn that the findings may not be more broadly relevant to other colleges in other nations.

Multiple interacting elements, including biological, psychological, and social aspects, all contribute to the formation and maintenance of mental health issues, they say.

The findings, however, have significant implications for university mental health policies, programs, and practices, with the availability of clubs, societies, and sporting activities likely to be critical in supporting student mental health and wellbeing, the authors conclude.

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.”

Source: 10.1136/bmjopen-2020-047393

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