Association Between Socioeconomic Position and Depression, Anxiety and Eating Disorders in University Students: A Systematic Review

Abstract

The high prevalence of mental disorders in university students emphasizes the need to explore contributing factors. While socioeconomic position affects mental health in the general population, it is crucial to investigate if the same applies to university students. MEDLINE-Ovid, Embase-Ovid and PsycINFO databases were searched. All original peer-reviewed observational studies quantifying the association between socioeconomic position and depression, anxiety or eating disorders were included without language or date restrictions. After initial screening, eligible studies were selected, data was extracted using a spreadsheet, and their quality was assessed with the Newcastle–Ottawa scale. The results were synthesized narratively. Seventy-eight of 20,465 records identified were included. Most studies were published in English and originated from high and upper-middle-income countries. The most common socioeconomic indicators were family socioeconomic status/class, financial stress, and parental education. Most studies found a positive association between socioeconomic indicators and depressive and anxiety symptoms, but not eating disorders. The quality of the studies was mixed, with a small proportion using validated measurement tools and appropriate sample sizes. This study highlights the importance of measuring socioeconomic position accurately and applying new methods that can reveal the causal pathways and interactions of multiple identities that shape mental health disparities for the university student population.

Preregistration A protocol for this review was registered in PROSPERO (CRD42022247394).