Prevalence, age-of-onset, and course of mental disorders among 72,288 first-year university students from 18 countries in the World Mental Health International College Student (WMH-ICS) initiative

Abstract

Background

The college years are a developmentally sensitive period for mental disorder onset. Reliable epidemiological data are critical for informing public health responses. This study aimed to estimate prevalence and socio-demographic distributions of common DSM-5 mental disorders among first-year university students from 77 universities across 18 countries.

Methods

Data were collected 2017–2023 in the World Mental Health International College Student Initiative with n = 72,288 university students. Online surveys assessed alcohol use, attention-deficit/hyperactivity, bipolar, drug use, generalized anxiety, major depression, panic, and post-traumatic stress disorders with validated screening scales. Socio-demographics included student age, sex at birth, gender modality, sexual orientation, and parent education.

Results

The weighted mean response rate was 20.8%. Data were calibrated for differential response rates by sex at birth and age. 65.2% of respondents screened positive for lifetime mental disorders and 57.4% for 12-month mental disorders. Females had higher prevalence of internalizing disorders and males of substance and attention-deficit/hyperactivity disorders. Older age was associated with lower prevalence of most 12-month but not lifetime mental disorders. Non-heterosexual sexual orientation and identifying as transgender were associated with highest prevalence of most mental disorders. Parent education was for the most part uncorrelated with prevalence.

Conclusions

Although prevalence might have been overestimated due to the low response rate and possible screening scale miscalibration, results nonetheless suggest that mental disorders are highly prevalent among first-year university students worldwide and are widely distributed with respect to socio-demographic characteristics. These findings highlight the need to implement effective interventions to better support first-year university student mental health.