Prevalence and severity of mental health problems in early-career researchers: a systematic review and meta-analysis

In the paper

“recent studies suggest that this population experiences a disproportionate degree of psychological distress, including clinically defined syndromes such as depression, generalized anxiety disorder (GAD) and burnout, or individual symptoms such as stress, poor sleep and suicidal ideation1,9–11.”

What the sources say

• ?Not checked — no full text of the sourcecites [1] Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T. & Vanderford, N. L. Evidence for a mental health crisis in graduate education. Nat. Biotechnol. 36, 282–284 (2018). source
• Partly supported

  The Introduction reports substantially higher anxiety among graduate students than in the general population, and the Discussion reports a high prevalence of anxiety and describes stress among postgraduates. But the paper studies graduate students rather than early-career researchers generally, and its Limitations say anxiety was usually measured by self-report rather than clinical diagnosis. It does not establish elevated rates of depression, burnout, poor sleep, or suicidal ideation in that population. Page numbers are not available in our copy. (LLM, conf=0.88)

  cites [9] Chi, T., Cheng, L. & Zhang, Z. Global prevalence and trend of anxiety among graduate students: a systematic review and meta-analysis. Brain Behav. 13, e2909 (2023). sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Check pendingcites [11] Satinsky, E. N. et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci. Rep. 11, 14370 (2021). source

In the paper

“yielding 148 studies and four primary databases (k = 228; N = 138,446).”

In the paper

“Depending on the measurement scale, the average symptom severity across syndromes ranged from mild to severe for depressive symptoms and from mild to borderline abnormal for anxiety symptoms, and fell below screening-based severity cut-offs for eating disorder symptoms, substance abuse (for example, alcohol abuse) and suicidal ideation.”

In the paper

“In terms of severity, ECRs reported mild levels of depression and anxiety, moderate stress and generally poor sleep quality, while levels of severity of suicidal ideation and eating disorders fell below clinical cut-offs.”

In the paper

“In addition, the prevalence of psychological distress increased during the COVID-19 pandemic and has remained elevated since.”

In the paper

“For symptoms, average sleep quality was poor (with a wide estimate range across studies), and stress was consistently reported as moderate, underscoring the wide range of stressors experienced by ECRs62.”

In the paper

“At the symptom level, moderate levels of stress and psychological distress were observed (scoring below clinical thresholds), with psychological distress defined here by broad screening tools (WHO-5, K-6 and K-10) rather than as an umbrella construct as in the rest of the present meta-analysis.”

In the paper

“Of 10,534 screened records, 148 records and four databases qualified for inclusion, yielding a total of 228 samples.”

In the paper

“Sleep quality ranged between unproblematic and poor, but few data were available.”

In the paper

“The final sample for meta-analysis consisted of 138,446 individuals (134,572 doctoral, 3,522 postdoctoral; pre- or postdoctoral status not reported for 352 ECRs).”

In the paper

“Severity was lowest for depersonalization (−7.5; 95% CI, −8.4 to −6.9), followed by emotional exhaustion (8.5; 95% CI, 1.6–15.3), while reduced personal accomplishment had the highest severity (26.7; 95% CI, 17.1–36.3).”

In the paper

“This was confirmed by Egger’s regression tests for the severity model but not the prevalence model (prevalence: F(1, 350) = 2.58, P = .109; severity: F(1, 534) = 22.96, P < .001).”

In the paper

“Age was associated with lower prevalence (by −0.01%; 95% CI, −0.03 to −0.00); thus, per ten-year increase in age, the overall prevalence for mental health syndromes and symptoms was 1% lower.”

In the paper

“Samples from the USA reported a lower prevalence of psychological distress (by 0.66%; 95% CI, −2.63 to 0.00) and severity (by 4.00 POMP score points; 95% CI, −8.32 to −0.32) than all other samples (R2 = 5.1% and 2.9%, respectively).”

In the paper

“Prevalence estimates varied strongly between syndromes and symptom domains (R2 = 21.2%), but all individual estimates deviated significantly from zero (Fig. 2).”

In the paper

“For the analysis, we differentiated the Healthy Minds Network into 15 unique datasets, yielding a total of 166 included records and datasets.”

In the paper

“The severity model indicated that psychological distress was higher during the COVID-19 period (POMP score, 34.63 (31.48, 37.77)) than during the period after (POMP score, 31.89 (26.23, 37.55)), but these estimates were not significantly different from the pre-pandemic period (POMP score, 33.81 (30.62, 36.99); R2 = 0.25%).”

In the paper

“Overall severity estimates for depression ranged from mild to severe, and for GAD from mild to borderline abnormal, whereas assessments of eating disorders and substance abuse were consistently below clinical thresholds.”

In the paper

“Heterogeneity was high (amounts of heterogeneity within and between samples were roughly equal for severity estimates; for prevalences, heterogeneity was higher between than within samples; Supplementary Tables 14 and 15), with 95% prediction intervals ranging from 0.2% to 71.1% for prevalence and 0.8% to 66.9% for severity estimates.”

In the paper

“With references retrieved through backward and forward citation search, this systematic review and meta-analysis synthesized data from 228 samples and 138,446 individuals, representing the largest quantitative synthesis of psychological distress among ECRs to date.”

In the paper

“Overall, 32 non-peer-reviewed records were included52,54,107,111,118,125,132,135,138,148,177,178,191,196,202,206–222.”

What the sources say

• Not checked yetcites [52] Healthy Minds Study among Colleges and Universities 2007–2024 (Healthy Minds Network, Univ. Michigan, Univ. California Los Angeles, Boston Univ. & Wayne State Univ., 2024).
• ?Not matched

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

  cites [54] Panger, G., Tyron, J. & Smith, A. Graduate Student Happiness & Well-Being Report (University of California, Berkeley, 2014).
• ?Not matched

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

  cites [107] Andrade, D. M. B. The Effect of Burnout Syndrome on Graduate Students During the COVID-19 Pandemic (Univ. Pécs, 2023).
• ?Not matched

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

  cites [111] Barreira, P., Basilicoz, M. & Bolotnyy, V. Graduate Student Mental Health: Lessons from American Economics Departments (Harvard University, 2018).
• ?Not checked — no full text of the sourcecites [118] Byrom, N. & Metcalfe, J. Impact of COVID 19 on doctoral and early career researchers. figshare https://doi.org/10.6084/M9.FIGSHARE.12361493 (2021). source
• ?Not matched

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

  cites [125] Dumitrescu, G. A. Self-Efficacy, Locus of Control, Perceived Stress and Student Satisfaction as Correlates of Dissertation Completion (Andrews Univ., 2016).
• ?Not matched

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

  cites [132] Gakhal, S. Enhancing the Mental Wellbeing of PhD Students (Coventry Univ., 2024).
• ?Not matched

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

  cites [135] Giménez Dasí, M. et al. La Salud Mental en Nuestras Manos: Una Acción para los Estudiantes de Doctorado Desde la Facultad de Psicología (Univ. Complutense Madrid, 2024).
• Check pendingcites [138] Hazell, C. M. et al. Nationwide assessment of the mental health of UK doctoral researchers. Humanit. Soc. Sci. Commun. 8, 305 (2021). source
• ?Not matched

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

  cites [148] Jing, J. The Association Between Stress, Coping Strategies, Individual Characteristics and Well-Being among Mainland Chinese PhD students in Hong Kong: A Mixed-Methods Study (Chinese Univ. Hong Kong, 2021).

In the paper

“No striking differences were found in the overall prevalence and severity estimates, and neither was reduced heterogeneity when excluding outliers (Supplementary Table 38), which is why they were kept in all analyses.”

In the paper

“This meta-analysis found that nearly one in three ECRs reported elevated psychological distress across all outcomes, with mild average symptom severity for depressive and anxiety symptoms, moderate stress and poor sleep quality.”

In the paper

“These patterns were consistent across academic disciplines, genders and career stages.”

In the paper

“The identification of studies via databases and the other described methods yielded a total of 10,534 articles published up to 28 October 2025.”

In the paper

“Because primary studies employed a wide range of instruments to assess psychological distress and related syndromes and symptoms, the summary statistics were not directly comparable across studies.”

In the paper

“Four databases14,52,118,208 were included.”

What the sources say

• Check pendingcites [14] Hazell, C. M. et al. Understanding the mental health of doctoral researchers: a mixed methods systematic review with meta-analysis and meta-synthesis. Syst. Rev. 9, 197 (2020). source
• Not checked yetcites [52] Healthy Minds Study among Colleges and Universities 2007–2024 (Healthy Minds Network, Univ. Michigan, Univ. California Los Angeles, Boston Univ. & Wayne State Univ., 2024).
• ?Not checked — no full text of the sourcecites [118] Byrom, N. & Metcalfe, J. Impact of COVID 19 on doctoral and early career researchers. figshare https://doi.org/10.6084/M9.FIGSHARE.12361493 (2021). source
• ?Not checked — no full text of the sourcecites [208] Buffel, V. & Velde, S. V. de. Cross-country dataset C19 ISWS. Zenodo https://doi.org/10.5281/zenodo.5946964 (2022). source

In the paper

“Thresholds identifying a clinically relevant amount or severity of symptoms varied depending on the utilized scale (for an overview of the varying thresholds across the different utilized scales, their scoring methods, ranges and thresholds, see Supplementary Tables 20–29).”

In the paper

“Seven outliers were found in the prevalence model36,96,161,195,221,230, and 13 in the POMP-score model55,105,107,121,128,186,189,209,211,216,230,241,242.”

In the paper

“Third, for some syndromes and symptoms, the available evidence was drawn exclusively from studies conducted in the USA (for example, eating disorders, non-suicidal self-injury and alcohol abuse), and for syndromes or symptoms, it was limited overall (for example, sleep quality and personality disorders).”

In the paper

“Of the 464 authors contacted, we received 188 responses (40.5% response rate; not counting authors that could not be contacted due to missing contact information).”

In the paper

“Population-based studies report lower prevalence in comparable age groups (4–5%)25–27, suggesting that suicidal ideation among doctoral students is roughly two times higher than in the general population.”

What the sources say

• ?Not matched

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

  cites [25] Piscopo, K. D. Suicidality and Death by Suicide among Middle-Aged Adults in the United States CBHSQ Report (Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 2017).
• ?Not matched

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

  cites [26] National Study of Mental Health and Wellbeing (Australian Bureau of Statistics, 2020).
• Not checked yetcites [27] Léon, C., du Roscoät, E. & Beck, F. Prévalence des pensées suicidaires et tentatives de suicide chez les 18–85 ans en France: résultats du Baromètre santé 2021. Bull. Épidémiol. Hebd. 3, 42–56 (2024).

In the paper

“For example, the most recent estimates on depression include data up to November 201911.”

What the sources say

• Check pendingcites [11] Satinsky, E. N. et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci. Rep. 11, 14370 (2021). source

In the paper

“Here we conducted a preregistered systematic review and multilevel meta-analysis (PROSPERO: CRD42024596813) to quantify psychological distress among ECRs.”

In the paper

“Scopus, Web of Science, ERIC and PubMed were searched through 28 October 2025, yielding 148 studies and four primary databases (k = 228; N = 138,446).”

In the paper

“These studies identified several study-level moderators. Prevalence estimates were generally lower in studies with random sampling and higher study quality, and both prevalence and severity estimates varied depending on which type of measurement scale was used.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Not checked yetcites [9] Chi, T., Cheng, L. & Zhang, Z. Global prevalence and trend of anxiety among graduate students: a systematic review and meta-analysis. Brain Behav. 13, e2909 (2023). source

In the paper

“Mental health concerns among early-career researchers (ECRs), including predoctoral (PhD students) and early postdoctoral researchers, have been gaining attention and point towards a potential mental health crisis in academia1–7.”

What the sources say

• ?Not checked — no full text of the sourcecites [1] Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T. & Vanderford, N. L. Evidence for a mental health crisis in graduate education. Nat. Biotechnol. 36, 282–284 (2018). source
• ?Not checked — no full text of the sourcecites [2] Woolston, C. PhDs: the tortuous truth. Nature 575, 403–406 (2019). source
• ?Not checked — no full text of the sourcecites [3] Busch, C. A., Wiesenthal, N. J., Gin, L. E. & Cooper, K. M. Behind the graduate mental health crisis in science. Nat. Biotechnol. 42, 1749–1753 (2024). source
• Check pendingcites [4] Rahal, R.-M. et al. Quality research needs good working conditions. Nat. Hum. Behav. 7, 164–167 (2023). source
• ?Not checked — no full text of the sourcecites [5] Trang, D. et al. A survey of the severity of mental health symptoms in the planetary science community. Nat. Astron. 8, 691–696 (2024). source
• ?Not checked — no full text of the sourcecites [6] Woolston, C. Stress and uncertainty drag down graduate students’ satisfaction. Nature 610, 805–808 (2022). source
• ?Not checked — no full text of the sourcecites [7] Gewin, V. Pandemic burnout is rampant in academia. Nature 591, 489–491 (2021). source

In the paper

“Doctoral students and postdoctoral researchers share many of these challenges, though some stressors may be more pronounced in doctoral students (for example, supervisor dependency, thesis progress pressure, financial strain and impostor feelings)2,13,14”

What the sources say

• ?Not checked — no full text of the sourcecites [2] Woolston, C. PhDs: the tortuous truth. Nature 575, 403–406 (2019). source
• Not checked yetcites [13] Levecque, K., Anseel, F., De Beuckelaer, A., Van Der Heyden, J. & Gisle, L. Work organization and mental health problems in PhD students. Res. Policy 46, 868–879 (2017). source
• Check pendingcites [14] Hazell, C. M. et al. Understanding the mental health of doctoral researchers: a mixed methods systematic review with meta-analysis and meta-synthesis. Syst. Rev. 9, 197 (2020). source

In the paper

“To date, only two meta-analyses have empirically examined such moderators—and only in relation to depressive10 and anxiety symptoms9.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Not checked yetcites [9] Chi, T., Cheng, L. & Zhang, Z. Global prevalence and trend of anxiety among graduate students: a systematic review and meta-analysis. Brain Behav. 13, e2909 (2023). source

In the paper

“Another meta-analysis of doctoral students found that 23% experienced mild, 17% moderate and 14% severe anxiety symptoms34.”

What the sources say

• Check pendingcites [34] Mills, L., Read, G. J. M., Bragg, J. E., Hutchinson, B. T. & Cox, J. A. A study into the mental health of PhD students in Australia: investigating the determinants of depression, anxiety, and suicidality. Sci. Rep. 14, 22636 (2024). source

In the paper

“When compared with age-matched groups in the general population, prevalence rates for ECRs are markedly elevated, with population-based studies reporting prevalence rates from 8% to 17% for depressive symptoms and 6% to 10% for anxiety symptoms31–33.”

What the sources say

• Not checked yetcites [31] Terlizzi, E. P. & Villarroel, M. A. Symptoms of Generalized Anxiety Disorder among Adults: United States, 2019 NCHS Data Brief No. 378 (Centers for Disease Control and Prevention, 2020).
• Not checked yetcites [32] Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4: Data Tables (NHS England, 2025); https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/survey-of-mental-health-and-wellbeing-england-2023-24/data-sets
• ?Not checked — no full text of the sourcecites [33] Busch, M., Maske, U., Ryl, L., Schlack, R. & Hapke, U. Prevalence of depressive symptoms and diagnosed depression among adults in Germany. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56, 733–739 (2013). source

In the paper

“Despite the growing literature on this topic35–42, most reviews and meta-analyses have focused on depression, anxiety or suicidal ideation, with prevalence and severity estimates limited to depression10 and GAD9.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Not checked yetcites [9] Chi, T., Cheng, L. & Zhang, Z. Global prevalence and trend of anxiety among graduate students: a systematic review and meta-analysis. Brain Behav. 13, e2909 (2023). source

In the paper

“While ECRs generally report high job satisfaction and intrinsic motivation8”

What the sources say

• Check pendingcites [8] Woolston, C. Satisfaction in science. Nature 562, 611–615 (2018). source

In the paper

“Systematic and narrative reviews highlight additional sample-level moderators, including protective and risk factors35–42. These include financial challenges43, self-doubt44, and social and academic loneliness14,45 as risk factors, and suggest social support, a positive and future-oriented mindset, and self-care14 as potential protective factors.”

What the sources say

• ?Not checked — no full text of the sourcecites [35] Inguaggiato, G. et al. The experience of women researchers during the COVID-19 pandemic: a scoping review. Res. Ethics 20, 780–811 (2024). source
• Check pendingcites [36] Jackman, P. C., Jacobs, L., Hawkins, R. M. & Sisson, K. Mental health and psychological wellbeing in the early stages of doctoral study: a systematic review. Eur. J. High. Educ. 12, 293–313 (2022). source
• ?Not checked — no full text of the sourcecites [37] Lokhtina, I. A. et al. The impact of the COVID-19 pandemic on early career researcher activity, development, career, and well-being: the state of the art. Stud. Grad. Postdr. Educ. 13, 245–265 (2022). source
• ?Not checked — no full text of the sourcecites [38] Mackie, S. A. & Bates, G. W. Contribution of the doctoral education environment to PhD candidates’ mental health problems: a scoping review. High. Educ. Res. Dev. 38, 565–578 (2019). source
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  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [39] Melián, E., Reyes, J. I. & Meneses, J. The online PhD experience: a qualitative systematic review. Int. Rev. Res. Open Distrib. Learn. 24, 137–158 (2023).
• Check pendingcites [40] Nicholls, H., Nicholls, M., Tekin, S., Lamb, D. & Billings, J. The impact of working in academia on researchers’ mental health and well-being: a systematic review and qualitative meta-synthesis. PLoS ONE 17, e0268890 (2022). source
• Check pendingcites [41] Schmidt, M. & Hansson, E. Doctoral students’ well-being: a literature review. Int. J. Qual. Stud. Health Well Being 13, 1508171 (2018). source
• Check pendingcites [42] Martínez-García, I., De Witte, H., García-Martínez, J. & Cano-García, F. J. A systematic review and a comprehensive approach to PhD students’ wellbeing. Appl. Psychol. Health Well Being 16, 1565–1583 (2024). source
• ?Not matched

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

  cites [43] Eisenberg, D., Golberstein, E. & Hunt, J. B. Mental health and academic success in college. B. E. J. Econom. Anal. Policy 9, 40 (2009).
• ?Not checked — no full text of the sourcecites [44] Richardson, C. M. E., Trusty, W. T. & George, K. A. Trainee wellness: self-critical perfectionism, self-compassion, depression, and burnout among doctoral trainees in psychology. Couns. Psychol. Q. 33, 187–198 (2020). source

In the paper

“Although the magnitude of this difference depends on the reference data61, population-based studies of young adults using comparable screening thresholds (for example, PHQ-9 ≥ 10; GAD-7 ≥ 10) typically report prevalences of 8–17% for depressive symptoms and 6–10% for anxiety symptoms31–33.”

What the sources say

• Not checked yetcites [31] Terlizzi, E. P. & Villarroel, M. A. Symptoms of Generalized Anxiety Disorder among Adults: United States, 2019 NCHS Data Brief No. 378 (Centers for Disease Control and Prevention, 2020).
• Not checked yetcites [32] Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4: Data Tables (NHS England, 2025); https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/survey-of-mental-health-and-wellbeing-england-2023-24/data-sets
• ?Not checked — no full text of the sourcecites [33] Busch, M., Maske, U., Ryl, L., Schlack, R. & Hapke, U. Prevalence of depressive symptoms and diagnosed depression among adults in Germany. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56, 733–739 (2013). source

In the paper

“While the prevalence moderately increased during the COVID-19 pandemic, our findings indicate that elevated rates of depressive symptoms in particular and psychological distress in general predate the pandemic and have persisted over time10.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source

In the paper

“When compared with age-matched groups in the general population, our results indicate that depressive (29%) and anxiety symptoms (29%) were markedly elevated among ECRs.”

In the paper

“The limited evidence for sample-level moderators suggests that psychological distress among ECRs is not limited to specific subgroups but instead reflects a broader and systematic issue in academia.”

In the paper

“These findings are broadly consistent with those of other meta-analyses10,11, which also reported no consistent effect of gender, country income level or academic system.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Check pendingcites [11] Satinsky, E. N. et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci. Rep. 11, 14370 (2021). source

In the paper

“Risk-of-bias assessment was based on nine criteria from the Joanna Briggs Institute (JBI) checklist: sample frame, sampling, sample size, study description, data analysis, validity of methods, measuring of condition, statistical analysis and response rate48.”

What the sources say

• Not checked yetcites [48] Critical Appraisal Checklist for Prevalence Studies (JBI, 2020); https://jbi.global/sites/default/files/2020-08/Checklist_for_Prevalence_Studies.pdf

In the paper

“Supervisor relationships have been described as either a risk or protective factor depending on their quality14,46.”

What the sources say

• Check pendingcites [14] Hazell, C. M. et al. Understanding the mental health of doctoral researchers: a mixed methods systematic review with meta-analysis and meta-synthesis. Syst. Rev. 9, 197 (2020). source
• ?Not checked — no full text of the sourcecites [46] Barry, K. M., Woods, M., Martin, A., Stirling, C. & Warnecke, E. A randomized controlled trial of the effects of mindfulness practice on doctoral candidate psychological status. J. Am. Coll. Health 67, 299–307 (2019). source

In the paper

“However, these effect sizes were minimal and unlikely to be practically meaningful.”

In the paper

“However, clinical thresholds for suicidal ideation have been increasingly criticized, as systematic reviews show that these cut-off scores have low predictive value of actual suicide.”

What the sources say

• Not checked yetcites [59] Carter, G. et al. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br. J. Psychiatry 210, 387–395 (2017). source
• ?Not checked — no full text of the sourcecites [60] Fergusson, D. M., Horwood, L. J., Ridder, E. M. & Beautrais, A. L. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch. Gen. Psychiatry 62, 66–72 (2005). source

In the paper

“The type of measurement scale and the syndrome or symptom domain explained a substantial proportion of the variance (R2 of up to 51%), indicating that which outcome is measured and how it is measured strongly shapes prevalence and severity estimates.”

In the paper

“Taken together, these results underscore the methodological challenges in estimating psychological distress among ECRs.”

In the paper

“This suggests that depressive symptom prevalence among ECRs is approximately two to three times higher, and anxiety symptom prevalence about three to five times higher, than among same-age peers in the general population.”

In the paper

“Together, these findings indicate that the prevalence and severity of psychological distress were largely similar across demographics and individual protective and risk factors, with only minor associations with sample-level moderators.”

In the paper

“The high prevalence of psychological distress is accompanied by, on average, generally mild symptom severity in the overall investigated samples, which reflects that mental-health issues are widespread rather than focused on subgroups with high symptom severity.”

In the paper

“These shifts incentivize research that is safe, short-term and likely to generate high citation counts, while discouraging riskier, long-term or niche projects4,68,73,74.”

What the sources say

• Check pendingcites [4] Rahal, R.-M. et al. Quality research needs good working conditions. Nat. Hum. Behav. 7, 164–167 (2023). source
• Check pendingcites [68] Hanitzsch, T., Markiewitz, A. & Bødker, H. Publish and perish: mental health among communication and media scholars. J. Commun. 74, 429–442 (2024). source
• ?Not checked — no full text of the sourcecites [73] van Dalen, H. P. & Henkens, K. Intended and unintended consequences of a publish-or-perish culture: a worldwide survey. J. Am. Soc. Inf. Sci. Technol. 63, 1282–1293 (2012). source
• Check pendingcites [74] Schmidt, M., McDonald, J. K. & Moore, S. The research we don’t need will persist until we dismantle the systems that sustain it. J. Comput. High. Educ. 37, 507–542 (2025). source

In the paper

“Our findings are broadly consistent with those of other meta-analyses, but they fall on the higher end of previously reported ranges of 21–24% for depressive symptoms and 17–30% for anxiety symptoms9–11.”

What the sources say

• Not checked yetcites [9] Chi, T., Cheng, L. & Zhang, Z. Global prevalence and trend of anxiety among graduate students: a systematic review and meta-analysis. Brain Behav. 13, e2909 (2023). source
• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Check pendingcites [11] Satinsky, E. N. et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci. Rep. 11, 14370 (2021). source

In the paper

“At the same time, norms about research productivity have shifted towards metric-based performance indicators (for example, h-index, citation count, external funding and publication output), which increasingly shape hiring, tenure and funding decisions69.”

What the sources say

• Check pendingcites [69] Herbert, D. L., Coveney, J., Clarke, P., Graves, N. & Barnett, A. G. The impact of funding deadlines on personal workloads, stress and family relationships: a qualitative study of Australian researchers. BMJ Open 4, e004462 (2014). source

In the paper

“Overall study quality was low to moderate and varied substantially between samples (M = 4.6; s.d. = 1.2; range, 2.5–7.2; Supplementary Table 13 and Supplementary Fig. 3).”

In the paper

“Importantly, subthreshold levels of suicidal ideation still include suicidal thoughts, which can be clinically relevant59,60.”

What the sources say

• Not checked yetcites [59] Carter, G. et al. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br. J. Psychiatry 210, 387–395 (2017). source
• ?Not checked — no full text of the sourcecites [60] Fergusson, D. M., Horwood, L. J., Ridder, E. M. & Beautrais, A. L. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch. Gen. Psychiatry 62, 66–72 (2005). source

In the paper

“Deviations from the preregistration are recorded in Supplementary Table 33.”

In the paper

“Together, these structural factors create substantial psychological strain and probably contribute to elevated levels of anxiety, stress and sleep problems among ECRs.”

In the paper

“An independent screening based on title, abstract and full text was conducted, which resulted in 148 records that met the predefined inclusion criteria.”

In the paper

“Publication bias was visually assessed via funnel plots for multilevel meta-analysis using the code provided by Fernández-Castilla and colleagues243, and formally with the three-level version of Egger’s regression test244,245.”

What the sources say

• ?Not matched

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

  cites [243] Fernández-Castilla, B. et al. Visual representations of meta-analyses of multiple outcomes: extensions to forest plots, funnel plots, and caterpillar plots. Methodol. Eur. J. Res. Methods Behav. Soc. Sci. 16, 299–315 (2020).
• Check pendingcites [244] Nakagawa, S. et al. Methods for testing publication bias in ecological and evolutionary meta-analyses. Methods Ecol. Evol. 13, 4–21 (2022). source
• Check pendingcites [245] Yang, Y., Lagisz, M., Williams, C., Noble, D. W. A. & Nakagawa, S. A two-step approach for robust point and variance estimation for meta-analyses with selective reporting and dependent effect sizes. GitHub https://yefeng0920.github.io/BiasRobustMA_tutorial/#evidence-of-publication-bias (2023). source

In the paper

“These results indicate a widespread and systemic burden of psychological distress among ECRs, with mild overall symptom severity nonetheless signalling heightened risk for future mental problems.”

In the paper

“The study protocol was registered on 13 October 2024 in PROSPERO (ID: CRD42024596813).”

In the paper

“Furthermore, due to convenience sampling, generalizing the results to a greater sample frame remains difficult, as the pooled effect sizes might be biased by self-selection86.”

What the sources say

• ?Not checked — no full text of the sourcecites [86] Keiding, N. & Louis, T. A. Web-based enrollment and other types of self-selection in surveys and studies: consequences for generalizability. Annu. Rev. Stat. Its Appl. 5, 25–47 (2018). source

In the paper

“To account for multiple testing, the Benjamini–Hochberg240 correction was applied, and the FDR was controlled at 5%.”

What the sources say

• ?Not checked — no full text of the sourcecites [240] Benjamini, Y. & Hochberg, Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J. R. Stat. Soc. B Stat. Methodol. 57, 289–300 (1995). source

In the paper

“Future research should prioritize lesser-studied outcomes and expand to geographically diverse samples, as the current evidence disproportionately draws on Western (especially US-based) samples, which may obscure variation in ECR mental health across academic systems and cultural contexts94,95.”

What the sources say

• ?Not checked — no full text of the sourcecites [94] Ghai, S. It’s time to reimagine sample diversity and retire the WEIRD dichotomy. Nat. Hum. Behav. 5, 971–972 (2021). source
• Check pendingcites [95] Ghai, S. et al. A manifesto for a globally diverse, equitable, and inclusive open science. Commun. Psychol. 3, 16 (2025). source

In the paper

“To evaluate the adequacy of response rates (that is, the rate of persons contacted by the study authors who also consented to participate in the study), an external cut-off criterion of 45% was employed, on the basis of the average online survey response rate234.”

What the sources say

• Check pendingcites [234] Wu, M.-J., Zhao, K. & Fils-Aime, F. Response rates of online surveys in published research: a meta-analysis. Comput. Hum. Behav. Rep. 7, 100206 (2022). source

In the paper

“During the screening, it became apparent that several publications had used the same datasets. In these cases, we decided to include the primary datasets rather than derivative articles, resulting in a screening of the databases.”

In the paper

“However, both the use of self-rating scales and convenience sampling appear to inflate effect sizes10,85.”

What the sources say

• ?Not checked — no full text of the sourcecites [10] Guo, L. et al. Prevalence and changes in depressive symptoms among postgraduate students: a systematic review and meta-analysis from 1980 to 2020. Stress Health 37, 835–847 (2021). source
• Check pendingcites [85] Levis, B. et al. Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review. BMC Med. 17, 65 (2019). source

In the paper

“For parameter estimation, restricted maximum likelihood estimation was applied, and for standard errors, P values and 95% CIs, Knapp and Hartung’s adjustment47,227 was used.”

What the sources say

• Not checked yetcites [47] Assink, M. & Wibbelink, C. J. M. Fitting three-level meta-analytic models in R: a step-by-step tutorial. Quant. Methods Psychol. 12, 154–174 (2016). source
• ?Not checked — no full text of the sourcecites [227] Harrer, M., Cuijpers, P., Furukawa, T. A. & Ebert, D. D. Doing Meta-Analysis in R (Chapman & Hall/CRC, 2021). source

In the paper

“To ensure coding reliability and to mitigate inconsistencies in the data extraction223, 30 articles were randomly selected and independently coded by author D.F. Any inconsistencies were discussed to reach consensus, also drawing on a third author (U.S.T.), if needed.”

What the sources say

• ?Not checked — no full text of the sourcecites [223] Cooper, H. M. Research Synthesis and Meta-Analysis: A Step-by-Step Approach (Sage, 2017). source

In the paper

“We used the JBI critical appraisal tool for epidemiological studies233, which evaluates the methodological quality of a study on the basis of nine categories: (1) sample frame, (2) sampling, (3) sample size, (4) description of study subjects and setting, (5) sufficient coverage for data analysis of the identified sample, (6) validity of methods used for identifying the condition/mental health synd”

What the sources say

• ?Not matched

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

  cites [233] Munn, Z., Moola, S., Lisy, K., Riitano, D. & Tufanaru, C. in JBI Manual for Evidence Synthesis (eds Aromataris, E. & Munn, Z.) 177–217 (JBI, 2020).

In the paper

“The range of prevalence rates is doubly bounded, in that they range from zero to unity227.”

What the sources say

• ?Not checked — no full text of the sourcecites [227] Harrer, M., Cuijpers, P., Furukawa, T. A. & Ebert, D. D. Doing Meta-Analysis in R (Chapman & Hall/CRC, 2021). source

In the paper

“Fourth, our clustering of countries was exploratory.”

In the paper

“An overall I2 greater than 50% was considered to be indicative of substantial heterogeneity239.”

What the sources say

• ?Not checked — no full text of the sourcecites [239] Higgins, J. P. T. et al. (eds) Cochrane Handbook for Systematic Reviews of Interventions (Wiley-Blackwell, 2019). source

In the paper

“This classification was then further validated using two other LLMs (Gemini 2 Flash by Google and ChatGPT-5.1 by OpenAI; Supplementary Material 1 and Supplementary Tables 3–7).”

In the paper

“Thresholds were based on psychometric validation studies or on common practice (for example, PHQ-9 item 9 to assess suicidal ideation).”

In the paper

“This review was conducted in accordance with the PRISMA 2020100 guidelines.”

What the sources say

• Not checked yetcites [100] Page, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71 (2021). source