Mental health problems in college freshmen: Prevalence and academic functioning
Open accessAbstract
Background Mental health problems in college and their associations with academic performance are not well understood. The main aim of this study was to investigate to what extent mental health problems are associated with academic functioning.Methods As part of the World Mental Health Surveys International College Student project, 12-month mental health problems among freshmen (N = 4921) was assessed in an e-survey of students at KU Leuven University in Leuven, Belgium. The associations of mental health problems with academic functioning (expressed in terms of academic year percentage [or AYP] and grade point average [GPA]) were examined across academic departments.Results Approximately one in three freshman reports mental health problems in the past year, with internalizing and externalizing problems both associated with reduced academic functioning (2.9-4.7% AYP reduction, corresponding to 0.2-0.3 GPA reduction). The association of externalizing problems with individual-level academic functioning was significantly higher in academic departments with comparatively low average academic functioning.Limitations Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance.Conclusions Mental health problems are common in college freshman, and clearly associated with lower academic functioning. Additional research is needed to examine the potentially causal nature of this association, and, if so, whether interventions aimed at treating mental health problems might improve academic performance.
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Depression and anxiety among college students have a deleterious impact on overall functioning and academic performance.
“Research has also shown its deleterious impact on overall functioning and, in particular, academic performance [2, 7].”
From An internet-delivered acceptance and commitment therapy program for anxious affect, depression, and wellbeing: A randomized, parallel, two-group, waitlist-controlled trial in a Middle Eastern sample of college students (2024) · cites this paper as [7]
The Measures section includes depression and anxiety among the internalizing problems studied, and Results §3.3 associates internalizing problems with lower academic functioning in college freshmen. The paper does not assess overall functioning or isolate the effects of depression and anxiety; its academic findings are associations, not evidence of a causal impact. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAbout one in three university students report symptoms of depression and anxiety.
“About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health.”
From Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial (2024) · cites this paper as [4]
The Results (§3.2; page not available in our copy) report that 34.9% of college freshmen had a mental health problem in the past year. That figure includes problems beyond depression and anxiety; internalizing problems, a broader category that includes both, were reported by 23.7%. The claim also generalizes from freshmen to university students overall. (LLM, conf=0.91)
Experimental — accuracy not yet measuredSymptoms of depression and anxiety in university students can negatively affect their developmental trajectory concerning work, intimate relationships, and health.
“About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health.”
From Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial (2024) · cites this paper as [4]
The Introduction (page unavailable) links mental disorders in early adulthood to later health problems, relationship dysfunction, and labor-market marginalization, and suggests that problems during college may mediate those outcomes. It does not establish those long-term outcomes specifically for depression and anxiety symptoms in university students. The Discussion (page unavailable) reports that about one-third of freshmen endorsed mental-health problems, not specifically depression and anxiety. (LLM, conf=0.84)
Experimental — accuracy not yet measuredProlonged psychological stress has consequences for academic performance, campus engagement, and college drop-out.
“and also has consequences for academic performance (Bruffaerts et al., 2018), campus engagement (Salzer, 2012), and college drop-out (Eisenberg et al., 2009).”
From Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis (2022) · cites this paper as Bruffaerts et al., 2018
Bruffaerts et al. report in Results §3.3 that internalizing and externalizing mental health problems in college freshmen were associated with lower academic functioning. This supports the academic-performance part to which the citation is attached, but the study does not establish that prolonged psychological stress caused the decline. Campus engagement and dropout have separate citations in the citing sentence and are not assessed here. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMental disorders are highly prevalent among university students, with 12-month prevalence rates ranging from 20% to 45%.
“Mental disorders are highly prevalent among university students, with 12 -month prevalence rates ranging from 20% to 45% (Auerbach et al., 2016; Blanco et al., 2008; Bruffaerts et al., 2018).”
From Increasing intentions to use mental health services among university students. Results of a pilot randomized controlled trial within the World Health Organization's World Mental Health International College Student Initiative (2019) · cites this paper as Bruffaerts et al., 2018
The Introduction reports that 12–50% of college students meet criteria for common mental disorders, supporting the claim that prevalence is high but not its stated 20–45% range. Results §3.2 reports past-year mental health problems in 34.9% of freshmen; Methods §2.2 clarifies that the screening instrument cannot assign disorder diagnoses. The paper therefore supports the general point, but not the precise range as a 12-month prevalence of diagnosed disorders. (LLM, conf=0.88)
Experimental — accuracy not yet measured
High prevalence of these disorders among college students is associated with substantial impairment in academic performance and with suicidal thoughts and behaviors.
“it is associated with substantial impairment in academic performance (Auerbach et al., 2016; Bruffaerts et al., 2018) as well as suicidal thoughts and behaviors (Mortier et al., in press).”
From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Bruffaerts et al., 2018
Mental health disorders among college students are related to poorer academic performance and higher college dropout rates.
“Mental health disorders among college students are related to various negative outcomes, such as poorer academic performance [9, 10] and higher college dropout rates [4, 11].”
An estimated 9% of all students have depressive symptoms.
“and an estimated 9% of all students have depressive symptoms [5].”
From Analysis of Mobile App-Based Mental Health Solutions for College Students: A Rapid Review (2023) · cites this paper as [5]
The Results (§3.2; page unavailable) estimate 23.7% prevalence for internalizing problems among college freshmen, not 9% for depressive symptoms. The Measures (§2.2; page unavailable) include depression within a broader internalizing screen, but the passages found when searching for depressive symptoms and 9% give no separate depression estimate or estimate for all students. (LLM, conf=0.76)
Experimental — accuracy not yet measuredMental health problems have been increasing among university students in recent years.
“mental health problems have already been on the rise among university students in recent years (Auerbach et al., 2016; Bruffaerts et al., 2018; Storrie et al., 2010).”
From Feasibility of a Brief Online Mindfulness and Compassion-Based Intervention to Promote Mental Health Among University Students During the COVID-19 Pandemic (2021) · cites this paper as Bruffaerts et al., 2018
College students are a vulnerable population.
“college students, who are known to be a vulnerable population [13].”
From Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study (2020) · cites this paper as [13]
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“This often exacerbates their vulnerability to develop mental health issues, posing adverse consequences for their well-being and academic performance (Auerbach et al., 2016; Bravo et al., 2018; Bruffaerts et al., 2018; Pedrelli et al., 2015).”
- Authors
- Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., Nock, M. K., & Kessler, R. C.
- Affiliations
- KU Leuven (BE)
- Harvard University (US)
- Vrije Universiteit Amsterdam (NL)
- Boston University (US)
- Corresponding author
- Bruffaerts, Ronny
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 225
- Pages
- 97-103
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC5846318
- OpenAlex
- W2739036953
- Cited by
- 1,047
- References
- 55
- Citations by year
- 2026: 98 · 2025: 137 · 2024: 173 · 2023: 159 · 2022: 143 · 2021: 188 · 2020: 82 · 2019: 41 · 2018: 24 · 2017: 1
- FWCI
- 81.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Lirias (KU Leuven) (submittedVersion, cc-by-nc-nd)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH070884)
- the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, R01 DA016558)
- Fogarty International Center (FIRCA R03-TW006481)
- Belgian Fund for Scientific Research (11N0514N/11N0516N)
- King Baudouin Foundation (2014-J2140150-102905)
- Eli Lilly (IIT-H6U-BX-I002)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Education › Higher Education Research Studies
- Keywords
- mental illness, first-year students, academic functioning, internalizing problems, externalizing problems, grade point average, prevalence, academic departments, university students
- MeSH terms
- Achievement, Belgium, Female, Humans, Male, Mental Health, Social Adjustment, Students, Universities, Prevalence, Young Adult
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