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Cited by 2,522Mental Health Treatment and AccessStudent Stress and CopingChild and Adolescent Psychosocial and Emotional Development

WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders.

Open access
Auerbach, Randy P., WHO WMH-ICS Collaborators, Mortier, Philippe, Bruffaerts, Ronny, Alonso, Jordi, Benjet, Corina, Cuijpers, Pim, Demyttenaere, Koen +11 more·2018·Journal of Abnormal Psychology
DOI 10.1037/abn0000362PMC PMC6193834
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Abstract

Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources.

Integrity signals

Registry

Crossref · 10.1037/abn0000362

Cites

76 of 76 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

13 of 49 cited sources checked · 4 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    Research studies have repeatedly found that these disorders are common among college students.

    “epidemiological studies consistently find high prevalence of these disorders among college students (Hunt & Eisenberg, 2010; Ibrahim, Kelly, Adams, & Glazebrook, 2013; Pedrelli, Nyer, Yeung, Zulauf, & Wilens, 2015).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Hunt & Eisenberg, 2010 source
    • cites Ibrahim, Kelly, Adams, & Glazebrook, 2013 source
    • cites Pedrelli, Nyer, Yeung, Zulauf, & Wilens, 2015 source
  • Premisecitation

    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.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Auerbach, et al., 2016 source

      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
  • Interpretationcitation

    The high prevalence finding is broadly consistent with earlier college student surveys.

    “This finding is broadly consistent with earlier college student surveys in documenting high recent prevalence of common mental disorders (Blanco et al., 2008; Cho et al., 2015; Eisenberg et al., 2007; Kendler et al., 2015); although most earlier surveys were carried out in the U.S. and assessed only current disorders (Merikangas et al., 2010).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Blanco et al., 2008 source
    • cites Cho et al., 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Eisenberg et al., 2007 source
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.
  • Premisecitation

    Internet-based CBT has effects equivalent to face-to-face CBT.

    “Internet-based cognitive behavior therapy (CBT), which has been shown to have effects equivalent to those of face-to-face CBT (Andersson, Cuijpers, Carlbring, Riper, & Hedman, 2014)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Andersson, Cuijpers, Carlbring, Riper, & Hedman, 2014 source

      The Abstract reports equivalent overall post-treatment effects for guided Internet-based CBT and face-to-face CBT in the trials reviewed. The citing sentence omits the therapist-guidance qualifier; the Methods specify that unguided Internet-based CBT was not included. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Findingown data

    Among those full-time respondents, 31% met screening criteria for at least one 12-month disorder.

    “We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder.”
    Quote in the paperSubstantial claim
  • May combine two claims. 36
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 6

  • May combine two claims.

    Premisecitation

    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”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Auerbach et al 2016 source

      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

  • May combine two claims.

    Premisecitation

    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,”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Auerbach, et al., 2016 source

      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
    • cites Beiter et al., 2015 source

      The Discussion (4; page not provided) says the prevalence of symptoms indicates a need to increase the number and scope of treatment programs. It does not establish that students needing treatment far outnumber the resources of most counseling centers or quantify unmet treatment need. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Storrie, Ahern, & Tuckett, 2010

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    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).”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Auerbach et al., 2016 source

      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
    • cites Bruffaerts et al., 2018 source
    • cites Mortier et al., in press

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    In the larger WMH surveys, about 20% of college students met criteria for a 12-month DSM-IV/CIDI disorder, and anxiety and mood disorders were the most common class.

    “One-fifth of college students in those surveys had 12-month DSM-IV/CIDI disorders, with anxiety and mood disorders the most common class of disorders.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Auerbach, et al., 2016 source

  • May combine two claims.

    Interpretationreasoning

    It is unlikely that college campuses will have sufficient resources to support student needs for mental health services, exacerbating existing problems of escalating financial expenses and long waitlists.

    “It is unlikely in light of this that college campuses will have sufficient resources to support student needs for mental health services, exacerbating the problems that already exist in the mental health treatment system of escalating financial expenses and long waitlists (Andersson & Titov, 2014; Webb, Rosso, & Rauch, 2017).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Andersson & Titov, 2014 source
    • cites Webb, Rosso, & Rauch, 2017 source

      The Introduction (page not provided) identifies treatment costs and long wait-lists as barriers to mental health care. It does not address whether college campuses will have sufficient resources to meet student needs, or say that costs and wait-lists are escalating. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In earlier surveys, links with socio-demographic factors were usually weak: women had more anxiety and mood disorders than men, men had more substance use disorders than women, and lower socio-economic background went with higher prevalence of all disorders.

    “These associations have typically been found to be small, but with women having higher rates of anxiety and mood disorders than men, men having higher rates of substance use disorders than women, and socio-economic background being inversely related to prevalence of all disorders (Chen & Jacobson, 2012; Eisenberg, Hunt, & Speer, 2013).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Chen & Jacobson, 2012 source

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

      Experimental — accuracy not yet measured
    • cites Eisenberg, Hunt, & Speer, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductcitation

    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)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Auerbach et al., 2016 source

      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

  • May combine two claims.

    Findingown data

    The assessed syndromes usually first appeared in early-to-middle adolescence and were still present in the survey year.

    “Syndromes typically had onsets in early-middle adolescence and persisted into the year of the survey.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    The correlates most strongly linked to a positive screen were older age, female sex, having unmarried or deceased parents, no religious affiliation, non-heterosexual identity and behavior, lower secondary school rank, and extrinsic motivation for attending college.

    “Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, non-heterosexual identification and behavior, low secondary school ranking, and”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Preliminary analyses found that most of the 50 transgender or 'other' students had multiple mental disorders and considerable impairment, so they were reported separately.

    “preliminary analyses reported below showed that the majority of the 50 remaining students who identified either as transgender or “other” rather than as male or female endorsed a number of mental disorders and experienced considerable impairment, leading us to focus on them in a separate report.”
    Quote in the paperSubstantial claim

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

    Findingown data

    Most excluded part-time students were from Australia, older, and full-time employed, expected to access mental health services through their employer rather than college.

    “Most of these students came from the Australian sample and were older, full-time employed people who would normally be expected to access mental health services, if they were needed, through their employer or employer-sponsored health insurance rather than through their college.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Extrinsically motivated students and students with lower high school rankings had elevated odds of mental disorders.

    “extrinsically motivated (as compared to intrinsically motivated) students and students with lower high school rankings (relative to students with higher high school rankings) had elevated odds of mental disorders.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Findingown data

    Lifetime prevalence of any disorder was similar for those excluded for missing gender/full-time status (35.9%) and part-time students (41.2%), but much higher for transgender/'other' students (76.5%).

    “Prevalence was similar for the additional respondents excluded because of missing information on gender or full-time student status (35.9%) and because of being part-time (41.2%), whereas the students who self-identified as either transgender or “other” had much higher lifetime prevalence of any disorder (76.5%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Findingown data

    Median age-of-onset was 14.2 years, with the highest at 14.6 in Spain and the lowest at 13.6 in the U.S.

    “Median age-of-onset was 14.2 years of age, from a high of 14.6 in Spain to a low of 13.6 in the U.S.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Retrospective recall errors do not substantially bias the estimated age-of-onset.

  • May combine two claims.

    Findingown data

    Several socio-demographic and college-related variables had statistically significant but substantively modest associations (OR=1.4-1.5) with overall disorder prevalence: female gender, unmarried or deceased parents, no religious affiliation, bottom 70% high school class, and extrinsic reasons for college.

    “We found a number of socio-demographic and college-related variables that had statistically significant but substantively modest associations (OR=1.4–1.5) with overall disorder prevalence: being female, having parents who were not married or deceased, having no religious affiliation, graduating in the bottom 70% of their high school class, and having primarily extrinsic reasons for going to”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Findingown data

    Among respondents with a lifetime disorder, 89.0% had 12-month prevalence, ranging from 94.2% in Northern Ireland to 83.3% in Spain.

    “The vast majority (89.0%) of respondents with a lifetime disorder had 12-month prevalence, from a high of 94.2% in Northern Ireland to a low of 83.3% in Spain.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Findingown data

    Median proportional annual persistence was 65.0%, ranging from 72.2% in the U.S. to 50.3% in Mexico.

    “Median proportional annual persistence (i.e., the proportion of years in episode between age-of-onset and age at interview) was 65.0%, from a high of 72.2% in the U.S. to a low of 50.3% in Mexico.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Retrospective recall errors do not substantially bias the estimated age-of-onset.

  • May combine two claims.

    Findingown data

    Major depressive disorder was the most common disorder across all countries combined (21.2% lifetime; 18.5% 12-month), followed by generalized anxiety disorder (18.6-16.7%).

    “Major depressive disorder (MDD) was the most common of the disorders examined across all countries combined (21.2% lifetime prevalence; 18.5% 12-month prevalence) followed by generalized anxiety disorder (18.6–16.7%) (Table 3).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

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

    Study design and conductnone given

    Every institution in the study obtained ethics approval, and every participant gave informed consent.

    “Each institution received ethics approval to participate in the project and all participants provided consent.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    One-third of students have one or more of the 12-month disorders considered, and other disorders not considered are likely present among a substantial number of other students.

    “one-third of students have one or more of the 12-month disorders considered here and other disorders that we did not consider are likely to be present among a substantial number of other students.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

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

    Interpretationreasoning

    The observed female gender correlation may be driven by an imbalanced assessment of internalizing (4) versus externalizing (2) disorders and by assessment before peak onset periods.

    “it also may be that (a) our assessment reflects an imbalanced assessment of internalizing versus externalizing disorders but (b) perhaps more critically, the assessment of these disorders is conducted before their peak period of onset.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Premisecitation

    In NCS-R and NESARC, median age-of-onset for major depression and mood disorders was about 30 years, compared to about 14 years in the WMH-ICS sample.

    “in both NCS-R and NESEARC, median age-of-onset for major depression (Hasin et al., 2005) and mood disorders (Kessler et al., 2005) was ~30 years compared to ~14 years within the WMH-ICS sample.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Hasin et al., 2005 source
    • cites Kessler et al., 2005

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Missing item responses in completed questionnaires were filled in with multiple imputation using chained equations.

    “Item-level missing data in the completed surveys were imputed using the method of multiple imputation (MI) by chained equations (van Buuren, 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites van Buuren, 2012 source

  • May combine two claims.

    Study design and conductown data

    The pooled response rate across surveys, weighted by achieved sample size, was 45.5%, with country rates ranging from 7.0% to 79.3%.

    “The response rates were quite variable across countries, from a low of 7.0% in Australia to a high of 79.3% in Mexico. The weighted (by achieved sample size) mean response rate across all surveys was 45.5%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Both sets of surveys documented that most lifetime mental disorders among college students started before college entrance and that persistence was very high.

    “both sets of surveys documented that most lifetime mental disorders among college students started prior to college entrance and that persistence of these disorders was very high, suggesting that clinical interventions early in the college career might be warranted.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Retrospective recall errors do not substantially bias the estimated age-of-onset.

  • May combine two claims.

    Interpretationreasoning

    There is strong reason to believe that rates of externalizing disorders and serious mental illness will show higher prevalence during later college years.

    “There also is strong reason to believe that rates of disorders, particularly externalizing disorders (e.g., substance use disorder) and serious mental illness (e.g., bipolar disorder, thought disorders), will show higher prevalence during later college years.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Arnett, 2005 source
    • cites Sussman & Arnett, 2014 source

  • May combine two claims.

    Premisecitation

    Substance use disorders, bipolar disorder, and thought disorders typically emerge in the early-to-mid 20s, and the typical college lifestyle may confer increased risk of disorder onset.

    “Indeed, substance use disorders, bipolar disorder, and thought disorders typically emerge in the early-to-mid 20s, and the typical college lifestyle—irregular sleep, increased interpersonal stress, experimental substance use—may confer increased risk of disorder onset (Arnett, 2005; Sussman & Arnett, 2014).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Arnett, 2005 source
    • cites Sussman & Arnett, 2014 source

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

    Study design and conductreasoning

    The CIDI-SC had not yet been validated in college student samples.

    “However, these validation studies have not yet been carried out in samples of college students.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The AUDIT version used classified alcohol use disorder by a total score of at least 8 or a score of at least 4 on the dependence items, and it has shown agreement with clinical diagnoses at AUC 0.78-0.91.

    “The version of the AUDIT we used, which defined alcohol use disorder as either a total score of 8+ or a score of 4+ on the AUDIT dependence questions (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), has been shown to have concordance with clinical diagnoses in the range AUC = 0.78–0.91 (Reinert & Allen, 2002).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Babor, Higgins-Biddle, Saunders, & Monteiro, 2001
    • cites Reinert & Allen, 2002 source

  • May combine two claims.

    Interpretationown data

    The majority of WMH-ICS respondents were aged 18-19 years, which necessarily affects the interpretation of age-of-onset.

    “Of note, the majority of WMH-ICS respondents were aged 18–19 years, and this necessarily impacts the interpretation of age-of-onset.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Retrospective recall errors do not substantially bias the estimated age-of-onset.

  • May combine two claims.

    Study design and conductnone given

    Response rates in the college surveys were quite variable and lower overall than in the nationally representative face-to-face community household surveys in the WMH initiative.

    “the response rates in the college surveys were quite variable and were lower overall than in the nationally representative face-to-face community household surveys in the WMH initiative.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    It is likely that more than one-third of respondents suffered from significant distress and that fewer than one-third suffered from a serious mental disorder.

    “it is likely that more than one-third of our respondents suffered from significant distress and that fewer than the one-third suffered from a serious mental disorder.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

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

    Study design and conductnone given

    It is unknown whether calibration studies in separate countries would show that concordance of the structured questions in the diagnostic screens is equally valid in all countries.

    “Nor do we know if calibration studies in separate countries would show that concordance of the structured questions in our diagnostic screens are equally valid in all countries.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Study design and conductnone given

    The surveys used well-validated screening scales calibrated to yield unbiased prevalence estimates in general population samples, but calibration studies have not yet been carried out in college students.

    “although the surveys used well-validated screening scales calibrated to yield unbiased prevalence estimates in general population samples, calibration studies have not yet been carried out in samples of college students.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Premisecitation

    Internet-based interventions exist for a broad range of psychiatric disorders and associated problems and have been shown to be effective for prevention and treatment.

    “A number of internet-based interventions exist for a broad range of psychiatric disorders (e.g., depression, anxiety, eating disorders) and associated problems (e.g., sleep, stress) and have been shown to be effective for both prevention and treatment of these conditions (e.g., Ebert et al., 2015; Josephine, Josefine, Philipp, David, & Harald, 2017; Olthuis, Watt, Bailey, Hayden, & Stewart, 2015;”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Ebert et al., 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Josephine, Josefine, Philipp, David, & Harald, 2017 source
    • cites Olthuis, Watt, Bailey, Hayden, & Stewart, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductreasoning

    Lifetime prevalence and age-of-onset were assessed retrospectively, which may contribute to downward biases given recall errors.

    “Fourth, lifetime prevalence and age-of-onset were assessed retrospectively, which may contribute to downward biases given recall errors.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Retrospective recall errors do not substantially bias the estimated age-of-onset.

  • May combine two claims.

    Interpretationreasoning

    The true prevalence of mental disorders among college students is likely a good deal higher than reported, particularly because only first-year students not yet through high-risk periods were included.

    “therefore, the true prevalence of mental disorders among college students is likely to be a good deal higher than reported in the current study; particularly as we are only including first-years students who are not yet through the high-risk periods for many common disorders.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The diagnostic screening scales are equally valid across the countries studied and in college student samples.

  • May combine two claims.

    Premisecitation

    Sub-threshold cases are known to have substantial impairment and to benefit from internet-based interventions, potentially reducing the incidence of threshold cases.

    “sub-threshold cases are known to have substantial impairment (Cuijpers, de Graaf, & van Dorsselaer, 2004; Fergusson, Horwood, Ridder, & Beautrais, 2005) and to benefit from internet-based interventions (Andersson & Cuijpers, 2009; Spek et al., 2008); potentially reducing the incidence of threshold cases (Buntrock et al., 2016).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Cuijpers, de Graaf, & van Dorsselaer, 2004

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Fergusson, Horwood, Ridder, & Beautrais, 2005 source
    • cites Andersson & Cuijpers, 2009 source

  • May combine two claims.

    Study design and conductreasoning

    The cross-national prevalence estimates are based on a convenience sample of colleges with relatively low and quite variable response rates, limiting generalizability.

    “First, the cross-national prevalence estimates are based on a convenience sample of colleges with relatively low and quite variable response rates, limiting generalizability of results.”
    Quote in the paperSubstantial claim
39 of 39

  • The paper relies on this without support.

    It is unclear which disorders would benefit most from internet-based CBT or how effective that treatment is in college students.

    “However, little is known about the disorders for which such interventions are most needed or the effectiveness of internet-based CBT among college students.”

  • The authors state this as an assumption.

    In Mexico, students who skipped the survey despite time being reserved during required activities were treated as definite non-respondents.

    “No follow-up of non-respondents was carried out in Mexico because it was assumed that students who failed to complete the survey even though time was set aside for it during mandatory activities were firm non-respondents.”

  • The paper relies on this without support.

    The diagnostic screening scales are equally valid across the countries studied and in college student samples.

    “although the surveys used well-validated screening scales calibrated to yield unbiased prevalence estimates in general population samples, calibration studies have not yet been carried out in samples of college students.”
    “Nor do we know if calibration studies in separate countries would show that concordance of the structured questions in our diagnostic screens are equally valid in all countries.”

  • The paper relies on this without support.

    Retrospective recall errors do not substantially bias the estimated age-of-onset.

    “Fourth, lifetime prevalence and age-of-onset were assessed retrospectively, which may contribute to downward biases given recall errors.”
4 of 4

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?

  • Depressive and anxiety difficulties are among the most frequently reported reasons for seeking psychological assistance amongst college-aged students.

    “They are also some of the most frequently reported reasons for seeking psychological assistance amongst college-aged students [2, 3].”

    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 [2]

    The Introduction identifies mood and anxiety disorders as common among college students, and the Discussion describes substantial unmet need for mental health services (pages unavailable). Neither section establishes that depressive and anxiety difficulties are among the most frequently reported reasons students seek psychological assistance; prevalence and reasons for seeking help are different measures. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Mental disorders are highly prevalent among emerging adults, and those suffering from a disorder at this age are more vulnerable to mental problems even 10 years later.

    “Indeed, various epidemiological studies have shown that mental disorders are highly prevalent among emerging adults, and those suffering from a disorder at this age are more vulnerable to mental problems even 10 years later [3,4].”

    From The Influence of Positive and Negative Aspects of Perfectionism on Psychological Distress in Emerging Adulthood: Exploring the Mediating Role of Self-Compassion (2023) · cites this paper as [3]

    The Results (Prevalence of Common Mental Disorders; page unavailable) report high prevalence among first-year college students, who fall within emerging adulthood. The Discussion (Trajectory of Mental Disorders and Associated Outcomes; page unavailable) describes future follow-up as a goal, but does not report that having a disorder at this age predicts mental health problems 10 years later. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In Western countries, one-third of university students have a 12-month mental disorder.

    “In Western countries, one-third of university students have a 12-month mental disorder (2).”

    From Mental health services for German university students: acceptance of intervention targets and preference for delivery modes (2024) · cites this paper as [2]

    The Results (Prevalence of Common Mental Disorders; page not supplied) report 31% 12-month prevalence among surveyed first-year students. But the Discussion (page not supplied) says the colleges were a nonrepresentative convenience sample across eight countries, including Mexico and South Africa. The finding therefore does not establish a prevalence for university students in Western countries generally; the survey screened for selected disorders rather than diagnosing all mental disorders. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Prolonged psychological stress is closely associated with mental disorders.

    “Prolonged psychological stress is closely associated with mental disorders (Auerbach et al., 2018; Beiter et al., 2015; Karyotaki et al., 2020; Mortier et al., 2018)”

    From Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis (2022) · cites this paper as Auerbach et al., 2018

    The Introduction says increased stress is a known contributor to mental disorders, and the Discussion suggests that increased interpersonal stress may raise the risk of disorder onset among college students. Neither passage addresses prolonged psychological stress or establishes how close the association is; the study’s reported correlates do not include a measure of stress. Page numbers were not available in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • 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 [4]

    The Introduction describes mood, anxiety, and substance-use disorders as common among college students. But the Results (Prevalence of Common Mental Disorders; page unavailable) identify major depression and generalized anxiety disorder as the most prevalent disorders studied, with the other disorders—including alcohol use disorder—at comparatively much lower prevalence. Thus the source supports including substance-use disorders among common problems, but not placing them alongside depression and anxiety as the most common. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Cites

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Authors
Auerbach, R. P., Collaborators, W. W.-I., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., Hasking, P., Murray, E., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Stein, D. J., Vilagut, G., Zaslavsky, A. M., & Kessler, R. C.
Affiliations
  • Columbia University (US)
  • KU Leuven (BE)
  • Municipal Institute for Medical Research (ES)
  • Amsterdam Public Health (NL)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Boston University (US)
  • University of Ulster (GB)
  • Harvard University (US)
  • University of Cape Town (ZA)
Corresponding author
Auerbach, Randy P.
ORCID
Venue
Journal of Abnormal Psychology
Publisher
American Psychological Association (APA)
Published
2018-10
Volume
127
Issue
7
Pages
623-638
ISSN
  • 0021-843X (ISSN-L)
  • 1939-1846
DOI
10.1037/abn0000362
PMC
PMC6193834
OpenAlex
W2891230948
Semantic Scholar
e4bb2ff549f8438750959e9e3e0c679bbd9381f7
Cited by
2,522
References
76
Citations by year
2026: 410 · 2025: 396 · 2024: 387 · 2023: 369 · 2022: 319 · 2021: 372 · 2020: 183 · 2019: 74 · 2018: 9
FWCI
216.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Abnormal Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Lirias (submittedVersion, other-oa)
  • eSpace (Curtin University) (submittedVersion)
  • Ulster University Research Portal (Ulster University) (submittedVersion, other-oa)
  • VU Research Portal (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • National Institute of Mental Health (R56MH109566, R01MH070884)
  • Belgian Fund for Scientific Research (11N0514N/11N0516N/1114717N)
  • King Baudouin Foundation (2014-J2140150-102905)
  • Eli Lilly (IIT-H6U-BX-I002)
  • BARMER
  • Netherlands Organisation for Health Research and Development (636110005)
  • Protestants Fonds voorde Geestelijke Volksgezondheid
  • South African Medical Research Council
  • Fondo de Investigación Sanitaria (PI13/00343)
  • Instituto de Salud Carlos III (CM14/00125, CD12/00440)
  • European Union Regional Development Fund
  • Ulster University
  • Ministerio de Sanidad, Servicios Sociales e Igualdad (2015I015)
  • DIUE Generalitat de Catalunya (2017 SGR 452; 2014 SGR 748)
  • FPU (0572805728)
  • WHO World Mental Health
  • John D. and Catherine T. MacArthur Foundation
  • Pfizer Foundation
  • U.S. Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558)
  • Fogarty International Center (R03-TW00648)
  • Pan American Health Organization
  • Eli Lilly and Company
  • Ortho-McNeil Pharmaceutical
  • GlaxoSmithKline
  • Bristol-Myers Squibb
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
university students, mental illness, prevalence, common mental disorders, major depressive disorder, generalized anxiety disorder, panic disorder, alcoholism, substance use disorders, sociodemographic correlates, mental health services, first-year students, religious affiliation
MeSH terms
Adolescent, Adult, Mental Disorders, Female, Health Surveys, Humans, Male, Mental Health, Mental Health Services, Students, World Health Organization, Prevalence, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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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 under definition version 3 (extract-v3) on 2026-09-28.

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

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