A systematic review of studies of depression prevalence in university students

doi:10.1016/j.jpsychires.2012.11.015

Journal of Psychiatric Research

Volume 47, Issue 3, March 2013, Pages 391-400

https://doi.org/10.1016/j.jpsychires.2012.11.015 Get rights and content

Abstract

Background

Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings.

Purpose

To explore the prevalence of depression in university students.

Method

PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating.

Results

Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%.

Conclusions

The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.

Section snippets

Background

Depression is one of the most common health problems for university students (Lyubomirsky et al., 2003; Vredenburg et al., 1988). Depression is considered as a multi-problematic disorder that leads to impairment in inter-personal, social, and occupational functioning (Sadock and Kaplan, 2007). The basic characteristic of depression is a loss of positive affect which manifests itself in a range of symptoms, including sleep disturbance, lack of self-care, poor concentration, anxiety and lack of

Method

A systematic literature review of PubMed, PsycINFO, BioMed Central and Medline databases was carried out to identify peer-reviewed studies, published between January 1990 and October 2010, reporting on depression among undergraduate university students. Searches used the keywords depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults were used in the searches. Additional articles were

Quality evaluation

The 24 articles were read extensively and, as there is no agreed quality assessment instrument for epidemiological prevalence studies, we adapted one developed by Parker and colleagues (Parker et al., 2008). Articles scored one point for each of the following quality markers: (1) the target population was defined clearly, (2) complete, random or consecutive recruitment, (3) the targeted sample is representative or the report presents evidence that the results can be generalized to the general

Results

Out of a total of 2303 publications, only 24 studies satisfied all the inclusion and exclusion criteria Fig. 1. The majority of the included studies (n = 15) had been carried out in Western countries. Nine had been carried out in the USA (Eisenberg et al., 2007; Garlow et al., 2008; Goebert et al., 2009; Hendryx et al., 1991; Roberts et al., 2010; Rosal et al., 1997; Schwenk et al., 2010; Thompson et al., 2010; Tjia et al., 2005), one in Canada (Dion and Giordano, 1990), one in Sweden (Dahlin

Discussion

The current review included studies published between January 1990 and October 2010 and reporting on depression among undergraduate university students including medical students. According to this current review the average depression prevalence is 30.6%, a higher rate than the 9% found in the general population rates of the US (range 6–12%) (Gonzalez et al., 2010). Moreover, a community-based cross-national survey of depression prevalence carried out in 10 countries in North America, Latin

Conclusion and recommendations

Although there is a need for more in-depth research to confirm the findings of this review, there is accumulating evidence to suggest that depression represents a significant health concern in university populations with, on average, nearly a third of students affected. Furthermore the weighted mean prevalence of depressive disorders in students of 30.6% is considerably higher than rates reported in general populations. This systematic review emphasizes that depression is a common mental health

Conflict of interest

None.

Contributors

Authors contributed equally to the work.

Role of funding source

None.

Acknowledgments

I am very grateful for the Ministry of Higher Education, Egyptian Government specially Assiut University for sponsoring my whole studies. It is a pleasure to express my deepest gratitude and grateful appreciation to the University of Nottingham for supporting this study.

References (90)

T. Gladstone et al.
The prevention of adolescent depression
Psychiatric Clinics of North America
(2011)
J. Hunt et al.
Mental health problems and help-seeking behavior among college students
Journal of Adolescent Health
(2010)
A. Ibrahim et al.
Reliability and validity of an Arabic version of Hamilton depression scale in an Egyptian University student sample
Comprehensive Psychiatry
(2012)
G. Kaplan et al.
Socioeconomic determinants of psychological well-being: the role of income, income change, and income sources during the course of 29 years
Annals of Epidemiology
(2008)
W. Katon et al.
Epidemiology of depression in primary care. Special section: developing guidelines for treating depressive disorders in the primary care setting
General Hospital Psychiatry
(1992)
A. Martin et al.
Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population
General Hospital Psychiatry
(2006)
Z. Mehanna et al.
Prevalence of anxiety and depressive disorders in medical students. Transversal study in medical students in the Saint-Joseph University of Beirut
Encephale
(2006)
Y. Song et al.
Depression in college: depressive symptoms and personality factors in Beijing and Hong Kong college freshmen
Comprehensive Psychiatry
(2008)
S. Van de Velde et al.
Gender differences in depression in 25 European countries after eliminating measurement bias in the CES-D
Social Science Research
(2010)
C. Young et al.
Depression in Asian–American and Caucasian undergraduate students
Journal of Affective Disorders
(2010)

T. Aalto-Setälä et al.

One-month prevalence of depression and other DSM-IV disorders among young adults

Psychological Medicine

(2001)

L. Andrade et al.

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

International Journal of Methods in Psychiatric Research

(2003)

J. Angst et al.

Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies

European Archives of Psychiatry and Clinical Neuroscience

(2002)

G. Arslan et al.

Prevalence of depression, its correlates among students, and its effect on health-related quality of life in a Turkish university

Upsala Journal of Medical Sciences

(2009)

J. Ayuso-Mateos et al.

Depressive disorders in Europe: prevalence figures from the ODIN study

British Journal of Psychiatry

(2001)

A. Bayati et al.

Depression prevalence and related factors in Iranian students

Pakistan Journal of Biological Sciences

(2009)

M. Ben-Ezra et al.

Depression and anxiety in developing countries

The Lancet

(2004)

C. Blanco et al.

Mental health of college students and their non-college-attending peers: results from the national epidemiologic study on alcohol and related conditions

Archives of General Psychiatry

(2008)

R. Bonita et al.

Basic epidemiology

(2006)

B. Carroll et al.

The Carroll rating scale for depression, development, reliability and validation

British Journal of Psychiatry

(1981)

A. Ceyhan et al.

Investigation of university students' depression

Eurasian Journal of Educational Research

(2009)

M. Choi

Symptoms, depression, and coping behaviors of university students

Taehan Kanho Hakhoe Chi

(2003)

T. Curran et al.

Depression, suicidality and alcohol abuse among medical and business students

Irish Medical Journal

(2009)

M. Dahlin et al.

Stress and depression among medical students: a cross-sectional study

Medical Education

(2005)

L. Denise et al.

Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11–21

Journal of Consulting and Clinical Psychology

(1996)

M. Denscombe

The length of responses to open-ended questions: a comparison of online and paper questionnaires in terms of a mode effect

Social Science Computer Review

(2008)

M. Denscombe

Item non-response rates: a comparison of online and paper questionnaires

International Journal of Social Research Methodology

(2009)

K. Dion et al.

Ethnicity and sex as correlates of depression symptoms in a Canadian university sample

International Journal of Social Psychiatry

(1990)

H. Dubben et al.

Systematic review of publication bias in studies on publication bias

BMJ

(2005)

L. Dyrbye et al.

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students

Academic Medicine

(2006)

D. Eisenberg et al.

Prevalence and correlates of depression, anxiety, and suicidality among university students

American Journal of Orthopsychiatry

(2007)

S. El-Gendawy et al.

Epidemiological aspects of depression among Assiut University students

Assiut Medical Journal

(2005)

M. Fawzy et al.

The Zagazig depression scale manual

(1982)

S. Garlow et al.

Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College screening project at Emory University

Depress and Anxiety

(2008)

S. Ghodasara et al.

Assessing student mental health at the Vanderbilt University School of Medicine

Academic Medicine

(2011)

D. Goebert et al.

Depressive symptoms in medical students and residents: a multischool study

Academic Medicine

(2009)

R. Goldney et al.

Changes in the prevalence of major depression in an Australian community sample between 1998 and 2008

Australian and New Zealand Journal of Psychiatry

(2010)

O. Gonalez et al.

Current depression among adults – United States, 2006 and 2008

MMWR

(2010)

S. Harvey et al.

Depression and work performance: an ecological study using web-based screening

Occupational Medicine

(2011)

M. Hendryx et al.

Dimensions of alexithymia and their relationships to anxiety and depression

Journal of Personality Assessment

(1991)

A. Hysenbegasi et al.

The impact of depression on the academic productivity of university students

Journal of Mental Health Policy and Economics

(2005)

IBM-SPSS

Statistical package for social science

(2009)

A. Ibrahim et al.

Establishing the reliability and validity of the Zagazig depression scale in a UK student population: an online pilot study

BMC Psychiatry

(2010)

A. Ibrahim et al.

Analysis of an Egyptian study on the socioeconomic distribution of depressive symptoms among undergraduates

Social Psychiatry and Psychiatric Epidemiology

(2011)

H. Jeon

Depression and suicide

Journal of the Korean Medical Association

(2011)

Cited by (1067)

Evaluation of metabolomics-based urinary biomarker models for recognizing major depression disorder and bipolar disorder
2024, Journal of Affective Disorders
Major depressive disorder (MDD) and bipolar disorder (BD) are psychiatric disorders with overlapping symptoms, leading to high rates of misdiagnosis due to the lack of biomarkers for differentiation. This study aimed to identify metabolic biomarkers in urine samples for diagnosing MDD and BD, as well as to establish unbiased differential diagnostic models.
We utilized a metabolomics approach employing ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) to analyze the metabolic profiles of urine samples from individuals with MDD (n = 50), BD (n = 12), and healthy controls (n = 50). The identification of urine metabolites was verified using MS data analysis tools and online metabolite databases.
Two diagnostic panels consisting of a combination of metabolites and clinical indicators were identified—one for MDD and another for BD. The discriminative capacity of these panels was assessed using the area under the receiver operating characteristic (ROC) curve, yielding an area under the curve (AUC) of 0.9084 for MDD and an AUC value of 0.9017 for BD.
High-resolution mass spectrometry-based assays show promise in identifying urinary biomarkers for depressive disorders. The combination of urine metabolites and clinical indicators is effective in differentiating healthy controls from individuals with MDD and BD. The metabolic pathway indicating oxidative stress is seen to significantly contribute to depressive disorders.
Depression and lifestyle among university students: A one-year follow-up study
2024, European Journal of Psychiatry
University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students.
First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD.
1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44).
Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.
Vegetable and fruit wastes: Valuable source for organic fertilizer for effective growth of short-term crops: Solanum lycopersicum and Capsicum annum
2024, Environmental Research
Agriculture plays a vital role in the food security and economies of Asian countries. Annually, numerous metric tons of vegetable and fruit wastes are disposed of. This research aimed to convert the food wastes encompassing the vegetable and fruit wastes into solid and liquid organic fertilizer and to evaluate their influence on the growth (germination, phytochemicals, and biomolecules) of Solanum lycopersicum and Capsicum annum. Solanum lycopersicum, known as tomato, and Capsicum annum, known as bell pepper or chili pepper, are globally significant crops valued for their medicinal properties and economic importance. The pot experiment was performed with organic fertilizers (solid and liquid organic fertilizer) and compared with the influence of chemical fertilizer and control soil without fertilizers. Interestingly, the liquid organic fertilizer effectively enhanced the biometric profile and chlorophyll content of S. lycopersicum and C. annum Viz., 1.23 mg g⁻¹ and 0.89 mg g⁻¹, respectively. The results of a 30-days pot experiment with various fertilizer treatments showed significant influence of liquid organic fertilizer on the fresh and dry weight biomass of both S. lycopersicum and C. annum. Subsequently, the solid organic fertilizer showed considerable influence on test crops, and the influence of these organic fertilizers was more significant than the chemical fertilizer on crop growth in 30-days experiment. These results suggest that the sustainable approach can effectively convert vegetables and fruit waste into valuable organic fertilizer enriched with plant growth supporting essential nutritional elements.
How do setting-level changes in universities affect mental health and wellbeing? A systematic mixed studies review
2024, Mental Health and Prevention
Mental ill health is persistent and pervasive in universities, with calls for setting-level change to improve mental health and wellbeing. However, rather than addressing setting-level factors, most research evaluates individual-level change, and most previous reviews privilege quantitative studies. Research on setting-level change remains limited and under-synthesised.
This review addressed three questions: (i) what are the domains of setting-level change evaluated for mental health impacts in universities? (ii) what are the quantified effects of setting-level changes in universities upon student and staff mental health and wellbeing? and (iii) what are the perspectives of students and staff with respect to setting-level changes in universities?
A systematic mixed studies review was conducted. APA PsycINFO, MEDLINE via Ovid, and Web of Science were searched twice – on 19 December 2022 and 20 January 2023 – with 3,643 records returned. Peer-reviewed journal articles reporting qualitative, quantitative, and mixed-methods studies on mental health outcomes, perspectives, and experiences arising from setting-level changes in universities were included. Included studies were critically appraised using the Mixed Methods Appraisal Tool.
Sixteen studies, reported in 18 articles, were included. All studies evaluated setting-level changes in relation to students’ mental health and wellbeing; none focused on staff. Two domains of setting-level change were identified: (i) learning and teaching, and (ii) student-focused policy. Studies varied in design and methodological quality.
Most setting-level changes modify how students are taught. Further research should prioritise impacts upon staff, employ rigorous study designs, and include comprehensive review of the grey literature.
Associations of problematic smartphone use with depressive symptoms and suicidal ideation in university students before and after the COVID-19 outbreak: A meta-analysis
2024, Addictive Behaviors
Problematic smartphone use (PSU) has been suggested to present with depressive symptoms and suicidal ideation (SI) as well as sleep disturbance, lack of social support, and emotional isolation. The aim of this systematic review and meta-analysis was to evaluate the association between PSU with depressive symptoms and SI in university students, and to determine the potential influence of the coronavirus disease 2019 (COVID-19) outbreak.
Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, Cochrane Library, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings.
Eighteen datasets from 17 case-control studies, including 24,019 university students, were included. Among them, 8,775 (36.5 %) had PSU. A higher prevalence of depressive symptoms (odds ratio [OR]: 2.40, 95 % confidence interval [CI]: 2.19 to 2.63, p < 0.001; prediction interval: 1.95 to 2.96) was observed in university students with higher scores for PSU measures. A subgroup analysis showed a stronger association between PSU and depressive symptoms after the COVID-19 outbreak as compared to that before the outbreak (OR: 2.76 versus 2.16, p for subgroup difference = 0.002), which explained the heterogeneity. The association between PSU and depressive symptoms in university students was similar to those reported in studies from China and other countries, and in studies with different quality scores. Finally, a meta-analysis of three studies suggested that PSU was also associated with the prevalence of SI (OR: 2.18, 95 % CI: 1.77 to 2.68, p < 0.001; I² = 0 %).
In university students, PSU may be a risk factor for depressive symptoms and SI, and the association between PSU and depressive symptoms became stronger after the COVID-19 outbreak.
The prevalence of depression among paramedical students and workers with highlights from the COVID-19 pandemic: A meta-analysis of prevalence
2024, General Hospital Psychiatry
To estimate the prevalence and risk factors of depression among paramedical workers/students.
6205 paramedics (reported in 25 cross-sectional studies) were meta-analyzed after searching seven electronic databases. The main outcome was the prevalence of depression. Subgroup analyses were conducted based on year and country of investigation, pandemic status and wave, population type, and disease severity. Several risk factors were also examined (gender, marital status, and population type).
34% [95%CI: 26–43%] of paramedics have depression, mostly of the mild form [19%, 95%CI: 13–27%]. Depression was highest in India and Australia. Students [45%, 95%CI: 30–62%] were more vulnerable to depression than workers [29%, 95%CI: 18–40%]. No linear trend was observed for depression over the years. Depression was lower during the pandemic compared to the pre-pandemic period [25% vs. 39%] with similar rates across all pandemic waves. Male [MD = 1.40; 95%CI: 0.57: 2.23] and married paramedics [MD = -1.33, 95%CI: −2.04: −0.62] were significant predictors of depression; however, no significant difference in depression was noted between paramedics and non-paramedics [logOR = 0.08; 95%CI: −0.10: 0.25].
One in every three paramedics have depression, with higher rates among students and before the COVID-19 pandemic. Gender and marital status are risk factors of depression.

View all citing articles on Scopus

View full text

ReviewA systematic review of studies of depression prevalence in university students

Abstract

Background

Purpose

Method

Results

Conclusions

Section snippets

Background

Method

Quality evaluation

Results

Discussion

Conclusion and recommendations

Conflict of interest

Contributors

Role of funding source

Acknowledgments

Psychiatric Clinics of North America

Journal of Adolescent Health

Comprehensive Psychiatry

Annals of Epidemiology

General Hospital Psychiatry

General Hospital Psychiatry

Encephale

Comprehensive Psychiatry

Social Science Research

Journal of Affective Disorders

One-month prevalence of depression and other DSM-IV disorders among young adults

Psychological Medicine

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

International Journal of Methods in Psychiatric Research

Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies

European Archives of Psychiatry and Clinical Neuroscience

Prevalence of depression, its correlates among students, and its effect on health-related quality of life in a Turkish university

Upsala Journal of Medical Sciences

Depressive disorders in Europe: prevalence figures from the ODIN study

British Journal of Psychiatry

Depression prevalence and related factors in Iranian students

Pakistan Journal of Biological Sciences

Depression and anxiety in developing countries

The Lancet

Mental health of college students and their non-college-attending peers: results from the national epidemiologic study on alcohol and related conditions

Archives of General Psychiatry

Basic epidemiology

The Carroll rating scale for depression, development, reliability and validation

British Journal of Psychiatry

Investigation of university students' depression

Eurasian Journal of Educational Research

Symptoms, depression, and coping behaviors of university students

Taehan Kanho Hakhoe Chi

Depression, suicidality and alcohol abuse among medical and business students

Irish Medical Journal

Stress and depression among medical students: a cross-sectional study

Medical Education

Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11–21

Journal of Consulting and Clinical Psychology

The length of responses to open-ended questions: a comparison of online and paper questionnaires in terms of a mode effect

Social Science Computer Review

Item non-response rates: a comparison of online and paper questionnaires

International Journal of Social Research Methodology

Ethnicity and sex as correlates of depression symptoms in a Canadian university sample

International Journal of Social Psychiatry

Systematic review of publication bias in studies on publication bias

BMJ

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students

Academic Medicine

Prevalence and correlates of depression, anxiety, and suicidality among university students

American Journal of Orthopsychiatry

Epidemiological aspects of depression among Assiut University students

Assiut Medical Journal

The Zagazig depression scale manual

Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College screening project at Emory University

Depress and Anxiety

Assessing student mental health at the Vanderbilt University School of Medicine

Academic Medicine

Depressive symptoms in medical students and residents: a multischool study

Academic Medicine

Changes in the prevalence of major depression in an Australian community sample between 1998 and 2008

Australian and New Zealand Journal of Psychiatry

Review
A systematic review of studies of depression prevalence in university students