Mental disorders among college students in the World Health Organization World Mental Health Surveys

TLDR

Mental disorders are strong predictors of educational attainment, yet most research has focused on primary and secondary school years rather than college. Using WHO World Mental Health Surveys, the authors compared 1,572 college students to 4,178 non‑students aged 18–22 across 21 countries, assessing lifetime and 12‑month DSM‑IV/CIDI disorders with the Composite International Diagnostic Interview. About one‑fifth of college students had a 12‑month disorder, most of which began before college, and pre‑matriculation disorders—especially substance use and, in women, major depression—predicted attrition, yet only 16.4 % received treatment, underscoring the need for early detection and intervention.

Abstract

Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Method The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students ( n = 1572) and non-students in the same age range (18–22 years; n = 4178), including non-students who recently left college without graduating ( n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.