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Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis
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 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
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“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]
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“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]
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“Depression is prevalent among university students (Guo et al., 2020; Sheldon et al., 2021), where it leads to poor academic performance (Andrews and Wilding, 2004; Hysenbegasi et al., 2005), unhealthy interpersonal relationships (Lee et al., 2021), and low quality of life (Zhong et al., 2019).”
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Metadata
- 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)
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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