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Cited by 1,587Mental Health Treatment and AccessStudent Stress and CopingHigher Education Research Studies

Mental disorders among college students in the World Health Organization World Mental Health Surveys

Open access
Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C. +28 more·2016·Psychological Medicine
DOI 10.1017/s0033291716001665PMC PMC5129654
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Abstract

Background: Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Method: The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students ( n = 1572) and non-students in the same age range (18–22 years; n = 4178), including non-students who recently left college without graduating ( n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). Results: One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions: Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

Integrity signals

Registry

Crossref · 10.1017/s0033291716001665

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 12 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    The most prevalent individual disorders were phobias and major depressive disorder.

    “The most prevalent individual disorders were phobias (9.0–11.1%) and MDD (4.5–7.7%).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Among college students, 20.3% had a 12-month DSM-IV/CIDI disorder.

    “One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders.”
    • Also stated in: § What is the 12-month prevalence of DSM-IV/CIDI disorders among college students? · plain
      “Twelve-month prevalence of any DSM-IV/CIDI disorder was 20.3% among college students compared to 25.0% among attriters and 21.4% among other nonstudents.”
    Quote in the paperSubstantial claim
  • Findingown data

    Pre-matriculation onset disorders were more important than post-matriculation onset disorders in predicting subsequent college attrition.

    “Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among women, major depression was among the most important pre-matriculation disorders predicting college attrition.

    “with substance disorders and, among women, major depression the most important such disorders”
    • Also stated in: § Do pre- and post-matriculation onset DSM-IV/CIDI disorders predict college attrition? · plain
      “MDD, alcohol abuse, and drug dependence were significant among females (with ORs of 0.2–0.6).”
    Quote in the paperSubstantial claim
  • Findingown data

    Among students with 12-month disorders, 16.4% received minimally adequate treatment in the 12 months before interview.

    “Roughly one-sixth (16.4%) of students with 12-month DSM-IV/CIDI disorders received minimally adequate treatment for these disorders in the 12 months before interview.”
    Quote in the paperSubstantial claim
  • May combine two claims. 20
  • Classified as probably not a substantial claim. 22
  • Not yet classified. 1

  • May combine two claims.

    Findingnone given

    Anxiety disorders were the most prevalent class of disorders across all groups, followed by mood, substance, and behavioral disorders.

    “Anxiety disorders were the most prevalent class of disorders across all groups in the full sample (11.7–14.7%) followed by mood disorders (6.0–9.9%), substance disorders (4.5–6.7%), and behavioral disorders (2.8–5.3%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    MDD, alcohol abuse, and drug dependence were significant among females.

    “while MDD, alcohol abuse, and drug dependence were significant among females (with ORs of 0.2–0.6).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Phobia was by far the most prevalent individual disorder, followed by major depressive disorder.

    “Phobia was by far the most prevalent individual disorder (11.6–13.9%) followed by major depressive disorder (5.8–6.2%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Students had significantly lower prevalence than other nonstudents of GAD, PTSD, any mood disorder, ADHD, oppositional-defiant disorder, drug dependence, and number of disorders.

    “while students had significantly lower prevalence than other nonstudents of quite a few disorders (GAD, PTSD, any mood disorder, ADHD, oppositional-defiant disorder, drug dependence) as well as of number of disorders.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In logistic models controlling age-sex and survey, students had significantly higher prevalence than attriters of panic disorder and lower prevalence of behavioral disorders.

    “Logistic models controlling age-sex and survey found that students had significantly higher prevalence than attriters of panic disorder and lower prevalence of behavioral disorders, while students had significantly lower prevalence than other nonstudents of quite a few disorders (GAD, PTSD, any mood disorder, ADHD, oppositional-defiant disorder, drug dependence) as well as of number of disorders.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Twelve-month prevalence of any DSM-IV/CIDI disorder was 20.3% among college students, 25.0% among attriters, and 21.4% among other nonstudents.

    “Twelve-month prevalence of any DSM-IV/CIDI disorder was 20.3% among college students compared to 25.0% among attriters and 21.4% among other nonstudents.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Panic disorder was the only individual disorder with significantly different odds of post-matriculation onset, with higher odds among students than attriters.

    “Logistic regression found only one individual disorder, panic disorder, with significantly different odds of post-matriculation onset among attriters compared to students, but in this case the odds were significantly higher, not lower, among students than attriters (OR 5.0; 95% CI 1.1–22.1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among students, post-matriculation onsets were more common than pre-matriculation onsets for 12-month panic disorder and alcohol abuse-dependence.

    “The only disorder-specific exceptions were that post-matriculation onsets were more common than pre-matriculation onsets among students for 12-month panic disorder (51.8%) and alcohol abuse-dependence (70.0−67.6%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The vast majority of these disorders have pre-matriculation onsets, which if anything were under-estimated.

    “that the vast majority of these disorders have pre-matriculation onsets (which, if anything, were under-estimated by our lack of precision in the dating of matriculation)”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    A similar reciprocal influence might account for post-matriculation onset disorders not being more common among attriters than students.

    “A similar kind of reciprocal influence might account for the fact that disorders with post-matriculation onsets were not more common among attriters than students.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The interview schedule was translated into other languages using a standardized WHO protocol.

    “The interview schedule was developed in English and translated into other languages using a standardized WHO protocol (Harkness et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harkness et al., 2008

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All analyses were also carried out in separate samples of men and women.

    “However, all analyses were also carried out in separate samples of men and women (detailed results are available on request) and important differences in results are noted throughout the text.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    If pre-matriculation lifetime disorders were causal risk factors rather than risk markers, 12-month presence of these disorders would predict subsequent attrition; failure to find higher 12-month prevalence among attriters than students might be evidence that these disorders were risk markers rather than causal risk factors.

    “If pre-matriculation lifetime disorders were causal risk factors rather than risk markers for subsequent attrition, we would expect that 12-month presence of these same disorders would predict subsequent attrition, in which case our failure to find higher 12-month prevalence among attriters than students might be taken as evidence that these pre-matriculation disorders were risk markers rather”
    Quote in the paperSubstantial claim

  • Not yet classified.

    Interpretation

    It is plausible that associations between pre-matriculation mental disorders and college attrition are non-causal because risk factors for adolescent substance and mood disorders overlap with risk factors for college attrition, none of which were controlled.

    “It is plausible to think that the associations are non-causal because risk factors for adolescent substance (Kilpatrick et al., 2000) and mood (Lewinsohn et al., 1998; Costello et al., 2002) disorders have many similarities with risk factors for college attrition (Ishitani & DesJardins, 2002; Stratton et al., 2006; Hartley, 2010), such as high stress, interpersonal discord, and diminished social”
    Quote in the paperNot yet classified0 of 3 sources checked
    • cites Kilpatrick et al., 2000

      Not checked in the free run.

    • cites Lewinsohn et al., 1998

      Not checked in the free run.

    • cites Costello et al., 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Response rates across surveys ranged from 50.4% to 97.2%, with a weighted mean of 71.4%.

    “Response rates ranged between 50.4% (Poland) and 97.2% (Colombia) with a weighted mean of 71.4% across surveys.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Only a small minority of college students with mental disorders receive even minimally adequate treatment, and the treatment rate is even lower in low-income countries.

    “We also found that only a small minority of college students with mental disorders receive even minimally adequate treatment and that the treatment rate is even lower in low-income countries.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Pre-matriculation mental disorders are associated both with failure to enter college and with attrition.

    “and that pre-matriculation mental disorders are associated both with failure to enter college and with attrition.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Interviews were administered face-to-face after informed consent using procedures approved by local Institutional Review Boards.

    “Interviews were administered face-to-face in respondent homes (or, in the case of students living in campus group housing, in their student residences) after obtaining informed consent using procedures approved by local Institutional Review Boards.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Joint age-sex distributions of students and nonstudents within each country were standardized to equal the pooled student distribution across all countries.

    “In order to increase precision of prevalence comparisons, the joint age-sex distributions of students and nonstudents within each country were standardized to equal the pooled student distribution across all countries combined.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    If pre-matriculation disorders associated with college attrition represent common causal pathways for traditional predictors of attrition, interventions focused on college entrants with these pre-existing disorders might reduce attrition.

    “On the other hand, to the extent that the pre-matriculation disorders associated with college attrition represent common causal pathways for many of the more traditional predictors of attrition documented by educational researchers, interventions focused on college entrants with these pre-existing disorders might be of great value in reducing attrition.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Part II respondents were weighted to adjust for differential probabilities of selection into Part II, making prevalence estimates in the weighted Part II sample identical to those in the Part I sample.

    “Part II respondents were weighted to adjust for differential probabilities of selection into Part II, making estimates of prevalence in the weighted Part II sample identical to those in the Part I sample.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The design-based Taylor series method implemented in SAS was used to adjust significance tests for weighting and clustering of observations.

    “The design-based Taylor series method (Wolter, 1985) implemented in the SAS software system (SAS Institute Inc., 2010) was used to adjust significance tests for the weighting and clustering of observations.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Wolter, 1985

      Not checked in the free run.

    • cites SAS Institute Inc., 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The definition of pre-matriculation disorders was conservative: virtually all classified pre-matriculation started before college entry, while some unknown number of disorders with onsets after age 17 started before college entry.

    “noting that the definition of pre-matriculation disorders was conservative in that virtually of those classified pre-matriculation did, in fact, start before college entry while some unknown number of disorders with onsets after age 17 started before the respondent’s college entry.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    There are likely downward biases in reports of lifetime prevalence and possibly in dating age-of-onset due to recall errors.

    “Although the WMH assessment used procedures shown experimentally to improve accuracy of recall (Scott et al., 2014), there are likely to be downward biases in reports of lifetime prevalence and possibly also in dating age-of-onset of disorders due to recall errors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Scott et al., 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    It is unclear whether recall biases would differ for students, attriters, and respondents who never entered college.

    “It is unclear whether these biases would be different for students, attriters, and respondents who never entered college.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Logistic models included dummy control variables for surveys.

    “Logistic models included dummy control variables for surveys.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    DSM-IV organic exclusion rules and diagnostic hierarchy rules were used other than for substance abuse.

    “DSM-IV organic exclusion rules and diagnostic hierarchy rules were used other than for substance abuse, which was defined with or without dependence.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Lifetime mental disorders and ages-of-onset were assessed retrospectively.

    “Lifetime mental disorders and ages-of-onset were assessed retrospectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Diagnoses were based on fully-structured lay-administered interviews rather than semi-structured clinical interviews, although WMH clinical appraisal data are reassuring.

    “In addition, diagnoses were based on fully-structured lay-administered interviews rather than semi-structured clinical interviews, although the WMH clinical appraisal data are reassuring (Haro et al., 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haro et al., 2006

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Statistical significance was consistently evaluated using .05-level two-tailed tests.

    “Statistical significance was consistently evaluated using .05-level two-tailed tests.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Small sample sizes resulted in wide confidence intervals, with many significant odds-ratios having confidence intervals where one bound was close to 1.0 or rounded to 1.0.

    “The small sample sizes also resulted in wide confidence intervals of estimates, with many of the odds-ratios considered significant having confidence intervals where one bound was very close to 1.0 and in a number of cases rounded to 1.0 with a single decimal of precision.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Not all WMH surveys included group housing in their sample frames, under-representing students living in campus dormitories or fraternity-sorority houses.

    “Another sampling-related limitation is that not all WMH surveys included group housing in their sample frames. This means that these surveys under-represented students living in campus dormitories or fraternity-sorority houses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Other research has shown that educational attainment is associated not only with prevalence but also severity of mental disorders.

    “This omission could be important given that other research has shown that educational attainment is associated not only with prevalence but also severity of mental disorders (Ten Have et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ten Have et al., 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Age-of-onset was assessed using special probing techniques shown experimentally to improve recall accuracy.

    “Age-of-onset of each disorder was assessed using special probing techniques shown experimentally to improve recall accuracy (Knäuper et al., 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Knäuper et al., 1999

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    There is no definitive way to adjudicate between causal and non-causal possibilities with the data presented.

    “There is no definitive way to adjudicate between these competing possibilities with the data presented here.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Cross-national analyses comparing high, upper-middle, and lower-middle/low income countries were less complete than preferred.

    “We carried out some cross-national analyses comparing results in high, upper-middle, and lower-middle/low income countries, but this level of disaggregation was less complete than we would have been preferred.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Overall fit of the logistic models was assessed by calculating area under the receiver operating characteristic curve.

    “Overall fit of the logistic models was assessed by calculating area under the receiver operating characteristic curve (AUC).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All analyses used weighted data.

    “All analyses used weighted data.”
    Quote in the paperSubstantial claim
38 of 38

  • The authors state this as an assumption.

    Replication will support the finding that pre-matriculation mental disorders are associated with college attrition.

    “Assuming that this replication supports our finding that pre-matriculation mental disorders are associated with attrition”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • An earlier WMH report on college students in 21 countries found somewhat lower lifetime (29.3%) and 12-month (25.2%) prevalence estimates of any disorder in mostly high-income countries, but used a wider range of DSM-IV disorders and more in-depth assessments.

    “An earlier WMH report based on face-to-face interviews with the subset of WMH household survey respondents in 21 countries who were college students found somewhat lower lifetime (29.3%) and 12-month (25.2%) prevalence estimates of any disorder in mostly high-income countries, but this result was based on a wider range of DSM-IV disorders and on most in-depth assessments of these disorders than in”

    From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Auerbach et al 2016

    Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Only 16.4% of all 12-month cases in those WMH surveys received any treatment for these disorders.

    “Only 16.4% of all 12-month cases received any treatment for these disorders.”

    From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Auerbach, et al., 2016

    The Abstract’s Results report 16.4% receiving treatment, but specify students with 12-month disorders, not all cases in the surveys. The detailed Results section describes the 16.4% figure as receipt of minimally adequate treatment, a narrower measure than any treatment. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The demand for mental health treatment among college students is much greater than most counseling centers can supply, leaving substantial unmet need.

    “the number of students in need of treatment for these disorders far exceeds the resources of most counseling centers, resulting in substantial unmet need for treatment of mental disorders among college students (Auerbach, et al., 2016; Beiter et al., 2015; Storrie, Ahern, & Tuckett,”

    From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Auerbach, et al., 2016

    The Results section reports that only 16.4% of college students with 12-month disorders received minimally adequate treatment, supporting substantial unmet treatment need. The Discussion also notes limited outpatient provider availability in lower-income countries, but the paper does not establish that demand exceeds the capacity of most college counseling centers or that counseling-center capacity causes the treatment gap. No page numbers were provided in our copy. (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 Auerbach et al., 2016

    Auerbach et al. is cited for the academic-performance part of the sentence; the separate citation to Mortier et al. accompanies the suicidal-thoughts-and-behaviors part. The Abstract Results and the Results section on college attrition associate pre-matriculation disorders with leaving college, an adverse educational outcome, but do not establish impairment in academic performance such as grades or coursework. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Only six common mental disorders were assessed, and the omission of ADHD, eating disorders, phobias, PTSD, conduct disorder, ODD, and IED is especially noteworthy because of their comparatively high prevalence in the WMH surveys.

    “Second, only six common mental disorders were assessed in the surveys. The omission of attention-deficit/hyperactivity disorder, eating disorders, phobias, post-traumatic stress disorder, conduct disorder, oppositional-defiant disorder, and intermittent explosive disorder are especially noteworthy because of their comparatively high prevalence in the WMH surveys (Auerbach et al., 2016)”

    From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Auerbach et al., 2016

    The Method > Measures section lists ADHD, phobias, PTSD, conduct disorder, oppositional-defiant disorder, and intermittent explosive disorder among the disorders assessed in the WMH surveys. The Results section reports that phobias were among the most prevalent individual disorders, but our copy does not assess eating disorders or establish comparatively high prevalence for every disorder listed. The statement that only six disorders were assessed appears to concern the citing authors’ surveys, not the WMH surveys. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. First, 1994, Structured Clinical Interview for Axis I DSM-IV Disorders
  2. Harkness, 2008, The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders, 91
  3. 2015, Mental Health Atlas 2014
  4. 2010, SAS/STATR Software

Cited by

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Authors
Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Demyttenaere, K., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., Karam, E. G., Kiejna, A., Kovess-Masfety, V., Lee, S., McGrath, J. J., O'Neill, S., Pennell, B.-E., Scott, K., ten Have, M., Torres, Y., Zaslavsky, A. M., Zarkov, Z., & Bruffaerts, R.
Affiliations
  • Harvard University (US)
  • Universitat Pompeu Fabra (ES)
  • University of Michigan (US)
  • Amsterdam Public Health (NL)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Boston University (US)
  • KU Leuven (BE)
  • University of Al-Qadisiyah (IQ)
  • Universidade de São Paulo (BR)
  • Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
  • Universitair Ziekenhuis Leuven (BE)
  • National School of Public Health, Management and Professional Development (RO)
  • University College Hospital, Ibadan (NG)
  • Centro de Investigación Biomédica en Red de Salud Mental (ES)
  • University of Balamand (LB)
  • Wroclaw Medical University (PL)
  • Chinese University of Hong Kong (HK)
  • The University of Queensland (AU)
  • University of Otago (NZ)
  • Universidad CES (CO)
  • National Center of Public Health and Analyses (BG)
Corresponding author
Kessler, R. C.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2016-08-03
Volume
46
Issue
14
Pages
2955-2970
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291716001665
PMC
PMC5129654
OpenAlex
W2503814187
Cited by
1,587
References
43
Citations by year
2026: 155 · 2025: 219 · 2024: 208 · 2023: 210 · 2022: 228 · 2021: 234 · 2020: 157 · 2019: 94 · 2018: 58 · 2017: 22
FWCI
91.07
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (acceptedVersion)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (acceptedVersion)
  • Ulster University Research Portal (Ulster University) (submittedVersion, other-oa)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • Lirias (submittedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, public-domain)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Robert Wood Johnson Foundation (044708)
  • John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
  • John W. Alden Trust
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • World Health Organization
  • Australian Government
  • Universidad CES
  • European Commission (EAHC 20081308, 20081308, QLG5–1999-01042, SANCO2004123, 2004123)
  • Public Health Agency (STL/5184/15, RES/4792/13, COM/4027/08)
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (03/00204-3, 03/00204?)
  • Generalitat de Catalunya (01042)
  • Bundesministerium für Gesundheit
  • Shire
  • Universidade de Lisboa
  • Ministerio de Ciencia y Tecnología (SAF 2000 158-CE)
  • Regione Piemonte (00/0028)
  • Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu
  • Servier
  • H. Lundbeck A/S
  • Fundação Champalimaud (R01 MH070884)
  • Ministerio de Salud
  • Ministerstwo Zdrowia
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration
  • Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
  • Pan American Health Organization
  • Executive Agency for Health and Consumers
  • Fundação para a Ciência e a Tecnologia
  • Instituto de Salud Carlos III (CB06/02/0046, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
  • Departament de Salut, Generalitat de Catalunya
  • National Institute of Mental Health (R13-MH-066849, NIMH R01MH070884, R01‐MH070884, T32MH017119, U01-MH-60220, MH60220, MH070884, K23MH097786, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (FIRCA R03TW006481, R03TW006481)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD041028)
  • Cilag
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Education › Higher Education Research Studies
Keywords
mental illness, university students, college attrition, age of onset, major depressive disorder, anxiety disorders, mood disorders, behavioral disorders, prevalence of mental disorders, treatment of mental disorders, educational attainment, World Mental Health Surveys
MeSH terms
Adolescent, Adult, Mental Disorders, Female, Health Surveys, Humans, Male, Mental Health, Students, Universities, Global Health, World Health Organization, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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