Mental Health and Healthy Habits in University Students

Mental Health and Healthy Habits in University Students: History

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The move to university is a stage of constant psychosocial and academic changes, where anxious and depressive symptomatologies usually appear, in addition to the aggravation of previous mental health problems. The prevalence of psychopathology found was high, especially depressive and anxious pathologies. This incidence tends to be higher in undergraduates and/or Arts and Humanities, coinciding with those who tend to have poorer lifestyle habits.

university students
mental health
healthy habits
area of knowledge
educational level

1. Introduction

Recently, Auerbach et al. [4], in the first phase of the World Health Organization (WHO), Geneva, Switzerland global project for university students, explored the prevalence of psychological disorders in more than 13,000 students from 19 universities in eight countries. In that study, they found that at least 35% of the respondents suffered from mental health problems. The results show that major depression disorder (MDD) was the most common, with a prevalence of 21.2–18.5%, followed by generalized anxiety disorder (GAD) with 18.6–16.7%. In Spain, it was observed that 23.1% of the students showed symptomatology consistent with MDD, and 19.3% with GAD. Moreover, 20% of the students reported comorbidity [2]. The high prevalence of mental health problems found among university students is considered a challenge within the third Sustainable Development Goal (SDG), which seeks to ensure the promotion of all persons at every stage of their lives [5].

1.1. Mental Health According to Educational Level and Area of Knowledge

Research has focused on undergraduates, mainly freshman students. It has been considered that, when entering university, they face a greater number of vital changes (new social relations, independence, economic responsibility or study methods, among others). Bassols et al. [6] found that 30.8% of freshman students showed symptoms of anxiety compared to 9.4% of senior students. Auerbach et al. [4] found that 83.1% of students with a psychopathology identified in the first academic years had its onset before starting university and that the prevalence of students who develop mental health problems during university years is actually lower. However, others have considered the importance of delving into the mental health problems that occur in the last years of undergraduate or graduate studies associated with academic pressure, stress about future career decisions, competitiveness in the labor market and other age-related responsibilities (family or economic responsibilities) [7,8,9].

The area of knowledge has also been considered a relevant factor in the mental health of university students [10]. Most studies have focused on Health Science students, mainly doctors and nurses, as they are considered a risk sector [11]. Although a high prevalence of stress, anxiety, somatic symptoms and depression has been found in these [6,12,13], some works have found similar or even higher profiles in Engineering, Arts and Humanities, Sciences and/or Social Sciences [7,8,14,15].

1.2. Healthy Habits According to Educational Level and Area of Knowledge

Healthy lifestyle habits are commonly understood as the incorporation of habits related to a balanced diet, playing sports regularly, rest, hygiene, responsible alcohol consumption and avoiding drug use [5,13,16,17]. In addition to improving physical health, a healthy lifestyle affects people’s emotional well-being, both in the general adult and university populations [13,16]. This relationship suggests the importance of influencing the maintenance of good habits for the promotion of mental health. In Spain, the Healthy Universities Network (REUS) was created with the aim of turning the university into an environment that promotes health and physical, psychological and social well-being [17].

In this sense, it is internationally recognized that university students tend to have unhealthy lifestyle habits due to changes in environment, schedules and freedom of choice for their own lifestyle, such as high consumption of tobacco, drugs and alcohol [8,16], low sports activity [18,19] and/or poor quality and/or few hours of sleep [14,20]. These studies are generally descriptive, and whether these habits relate to the course of study (degree, master’s degree or doctorate) or area of knowledge is unknown. Often, studies on lifestyle habits in university students tend to describe health-related behaviors and relate them to mental health.

2. Prevalence of Psychopathological Symptomatology in a Sample of University Students

Table 1 shows that 33.7% presented severe levels in depression, 10.2% in hostility, 17.6% in interpersonal sensitivity, 20.4% in somatization and 45.1% in anxiety. In contrast, only 2.4% presented mild symptoms in depression, 13.4% in somatic symptoms and 17.3% in interpersonal sensitivity.

Table 1. Frequency and prevalence of symptomatology by severity levels.

Symptomatology (SA–45) ¹	M ± SD	Mild *	Moderate *	Severe *
Depression	7.6 ± 4.8	39 (2.4)	893 (63.6)	473 (33.7)
Hostility	2.5 ± 2.8	-	1261 (89.8)	144 (10.2)
Interpersonal Sensitivity	5.9 ± 4.5	244 (17.3)	914 (65.1)	247 (17.6)
Somatization	4.4± 3.7	189 (13.4)	930 (66.2)	286 (20.4)
Anxiety	6.9 ± 4.2	-	814 (57.9)	591 (45.1)

* Data were presented as n (%). ¹ Symptom Assessment–45 Questionnaire.

3. Differences in Psychopathological Symptomatology According to Educational Levels and Area of Knowledge

After examining the differences in psychopathological symptomatology depending on the educational levels being studied, it can be observed that, in depression, F(2,1402) = 7.45, p = 0.001, in interpersonal sensitivity, F(2,1402) = 8.53, p = 0.00 and in anxiety, F(2,1402) = 3.97, p = 0.019, there were significantly higher means in the degree compared to the doctorate (see Table 2). In particular, we observed that the prevalence of severe symptomatology in the degree was between 15.5–35.8% versus 0.6–2.8% in the doctorate level. Differences were only observed between the degree, the master’s degree and the doctorate in the variable hostility, with higher means in the degree, F(2,1402) = 7.25, p = 0.001. The effect size of the significant differences was medium, ranging from 0.24–0.38. No significant differences in somatization were observed.

Table 2. Psychopathological symptomatology (SA–45) according to the educational levels.

SA–45	Degree (Degr) *	Master’s Degree (M) *	Doctorate (PhD) *	F_(2,1402)	η_p^{2 6}	d ⁷ (95% CI)	Post Hoc
D ¹	7.86 ± 4.83	7.18 ± 4.50	6.18 ± 4.53	7.45 ***	0.01	0.35 (0.16, 0.54)	PhD-Degr ⁸
H ²	2.68 ± 2.89	1.98 ± 2.56	1.92 ± 2.46	7.25 ***	0.01	0.25–0.27 (0.08, 0.46)	PhDM-Degr ⁹
SI ³	6.16 ± 4.61	5.48 ± 4.30	4.46 ± 3.67	8.53 ***	0.01	0.38 (0.19, 0.56)	PhD-Degr ⁹
S ⁴	4.48 ± 3.76	4.59 ± 3.74	4.45 ± 3.89	0.06	-	-	-
A ⁵	7.14 ± 4.35	6.58 ± 3.97	6.10 ± 4.17	3.97 **	0.005	0.24 (0.05, 0.43)	PhD-Degr ⁹

* Data were presented as mean ± standard deviations. ¹ depression; ² hostility; ³ interpersonal sensitivity; ⁴ somatization; ⁵ anxiety; ⁶ partial eta squared; ⁷ range of the effect size of significant comparisons; ⁸ Tukey test, ⁹ Games–Howell; ** p ≤ 0.05. *** p ≤ 0.001.

4. Findings

Concerning the first objective, it can be observed that university students had a high prevalence of moderate–severe psychopathological symptomatology, in line with recent results from other works [29]. Degree students have been identified in the literature as a risk group for presenting high rates of symptoms and/or anxious-depressive pictures, albeit with lower percentages than those found in this entry [2,4]. Mood disorders and anxiety are known to occur more frequently in women [3,8]. These data could explain the high prevalence found in our results, as 70.9% of our sample are women and most of them are degree students (80.8%). In any case, it is very important to take into account the possible existence of a self-selection bias, given the methodology used. This phenomenon has been observed in works such as those of Bantjes et al. [3] and Whatnall et al. [21].

Second, the differences in psychopathology between the different academic areas were analyzed. Although the literature has focused on university students of Health Sciences due to the high prevalence of anxious-depressive symptomatology, this study found that the students of Arts and Humanities present higher rates of depressive, anxious and interpersonal sensitivity symptomatology. This could be due, among other aspects, to the higher percentage of women enrolled in this discipline [33] and the known high prevalence of mental health problems in their case.

Martínez et al. [34] and Morales et al. [24] noted that students committed to their studies tend to have more psychological resources and this, in turn, improves their mental health and academic performance. The relationship between mental health and academic performance has been well established [1]. A low university entrance score and a high dropout rate may suggest difficulties in academic performance and, consequently, poor mental health. In this sense, the figures of the Spanish university system of the 2018/19 academic year indicate that both the lowest access grade for degree studies and the highest dropout rate after the first year of the year coincide with the studies of Arts and Humanities, as opposed to the studies of Health Sciences [33].

There is evidence that bad habits, such as low sports activity, poor sleep quality and substance use are among the factors related to the mental health of university students [12,13,21]. Of the habits contemplated, sports have shown the clearest results. Works such as those of Cecchini et al. [36] and Whatnall et al. [21] have found that moderate and high levels of physical activity were significantly and inversely associated with anxiety and depression. In this sense, sports could act as a protective factor of mental health. Regarding alcohol consumption, there is a trend for undergraduate and master’s students to consume more alcoholic beverages and tobacco than doctoral students. In the literature, the consumption of alcohol and/or substances have been considered strategies to deal with depressive symptoms and stress [18,37].

5. Conclusions

The prevalence of psychopathology and unhealthy lifestyle habits is high in university students. There are significant differences with respect to academic variables in both psychopathology (depression, hostility, interpersonal sensitivity and anxiety) and sports practice. The literature finds that there is an inverse relationship between these constructs. In this work, undergraduate students presented higher scores of psychopathological symptoms than doctoral students. At the same time, these are the ones who practice sports less frequently and tend to have less healthy practices. Similar results were found for students of Arts and Humanities, according to the branches of knowledge. Early detection of risk profiles would facilitate prevention and psychological intervention on these high prevalences.

This entry is adapted from the peer-reviewed paper 10.3390/ejihpe12020010

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