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Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis

Sheldon, Elena, Simmonds-Buckley, Melanie, Bone, Claire, Mascarenhas, Thomas, Chan, Natalie, Wincott, Megan, Gleeson, Hannah, Sow, Karmen +2 more·2021·Journal of Affective Disorders
DOI 10.1016/j.jad.2021.03.054
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Abstract

Background Effective targeting of services requires that we establish which undergraduates are at increased risk of mental health problems at university. We aimed to conduct a systematic review and meta-analysis of the prevalence and risk factors for mental health problems in undergraduates.Methods We searched MEDLINE, PsycInfo, EMBASE and the Cochrane Central Register. Eligible studies were assessed using the Quality of Prognostic Studies checklist and narratively synthesised. Pooled prevalence of depression and suicide-related outcomes, and associated risk factors (odds ratios) were estimated using random-effects meta-analyses.Results Sixty-six eligible studies of varying quality were included in a narrative synthesis. The pooled prevalence of depression (eight studies; 13,790 participants) was 25% (95% CI 17%, 35%) and the pooled prevalence of suicide-related outcomes (four studies; 2,586 participants) was 14% (95% CI 0%, 44%). Thirteen studies contributed to meta-analytic syntheses of 12 depression-related and four suicide-related risk factors. Presenting with a current mental health problem, negative rumination, parent separation, experiences of sexual harassment and parental depression significantly predicted depression outcomes. Childhood adversity, baseline mental health problems and financial difficulties significantly predicted suicide-related outcomes.Limitations Student mental health is a heterogeneous research area and is hampered by the use of imprecise terms, both for describing risk factors and mental health outcomes. These inconsistencies limit the extent to which datasets can be meaningfully synthesised.Conclusions This review evidences the importance of a range of risk factors for poor undergraduate mental health. Interventions should be developed to target modifiable risk factors and prevent poor mental health outcomes. Systematic review registration: PROSPERO registration CRD42019144927.

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  • Internationally, prevalence rates of depression and anxiety among students are high, ranging from 25% to 34% in meta-analytic reviews of undergraduate students, irrespective of the COVID-19 pandemic.

    “Internationally, prevalence rates of depression and anxiety are high among students, irrespective of the COVID-19 pandemic (Ibrahim et al. 2013), ranging from 25% to 34% in meta-analytic reviews of undergraduate students (Gao et al. 2020;Sheldon et al. 2021;Tung et al. 2018).”

    From Health-Promoting Learning Environments in Higher Education: A Scoping Review of Structural Interventions to Protect Student Mental Health (2024) · cites this paper as Sheldon et al. 2021

    The Prevalence of depression and suicide related outcomes section (p. 17) reports a pooled depression prevalence of 25% among undergraduates. It does not report a pooled anxiety prevalence or a 34% estimate, so Sheldon et al. supports only part of the range attributed to the cited reviews. The pandemic qualification is attached to Ibrahim et al. in the citing sentence, not Sheldon et al. (LLM, conf=0.89)

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  • The prevalence of mental health problems among university students is higher than in the general population.

    “Research has shown that the prevalence of mental health problems in this group is higher than in the general population [2, 3].”

    From Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder—study protocol for a randomized controlled trial (2023) · cites this paper as [2]

    The Introduction (p. 2) says university students report higher levels of depression than the general population. The Discussion (p. 18) likewise suggests higher depression prevalence, but says comparisons are inconclusive and difficult to make robustly. The claim extends that qualified finding about depression to mental health problems generally. (LLM, conf=0.88)

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  • The most common mental health problems among university students are anxiety, depression, and substance abuse disorder.

    “the most common ones being anxiety, depression, and substance abuse disorder [3,4,6]”

    From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [6]

    The Discussion (p. 18) reports that 25% of undergraduates experience depression, supporting its inclusion as a common problem. The paper discusses anxiety, but does not establish that anxiety and substance abuse disorder are among the most common problems; Lifestyle Factors (p. 15) instead treats substance and alcohol abuse as risk factors for suicide. (LLM, conf=0.85)

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Authors
Sheldon, E., Simmonds-Buckley, M., Bone, C., Mascarenhas, T., Chan, N., Wincott, M., Gleeson, H., Sow, K., Hind, D., & Barkham, M.
Affiliations
University of Sheffield (GB)
Corresponding author
Sheldon, Elena
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2021-05
Volume
287
Pages
282-292
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2021.03.054
OpenAlex
W3148997915
Cited by
644
References
88
Citations by year
2026: 151 · 2025: 174 · 2024: 153 · 2023: 98 · 2022: 61 · 2021: 7
FWCI
17.35
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
student mental health, undergraduate students, depression prevalence, suicide risk, risk factors, rumination, parental separation, sexual harassment, parental depression, childhood adversity, financial hardship
MeSH terms
Humans, Mental Health, Risk Factors, Students, Universities, Prevalence

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