Depression and Anxiety in

University Students

I. Živčić-Bećirević, S. Smojver-Ažić, T. Martinac Dorčić, J. JuretićDepartment of Psychology

Faculty of Humanities and Social Sciences

University of Rijeka, Croatia

Euro Global Summit and Medicare Expo on Psychiatry July 20-22, 2015 Barcelona, Spain

Outline

• Mental health of university students

• The main results of our longitudinal research project

• Implications for the preventive and intervention programs

• Evaluation of the interventions conducted in our university counseling center

College students - vulnerable population• The age with the highest prevalence of psychological

problems (16-24 years)

• Data from Australian universities show that students have more anxiety and depressive symptoms comparing to non-students of the same age (Stallman, 2008)

• 15% of university students in Croatia report some psychological or medical problems (Eurostudent, 2011)

• Research on youth mental health indicates high prevalence of psychological problems among students across universities, mostly symptoms of stress, anxiety and depression

• The number of students with different psychological problems is increasing in the last two decades

• Depression rates have doubled and suicidality rates tripled in 10 years (Russis & Wells, 2008), with increase number of students using psychopharmacs from 11% to 24%.

• Suicide is the 2nd reason for death among university students and the 3rd in general population of the same age

Psychological problems in college students

Problems for which students seek help

in our University Counseling Center - experiences from the last

17 years

29%

19%18%

14%

5%

15%academic problems

interpersonal prob-lems

anxiety

depression

stress/trauma

otherN=1300

• To determine the prevalence of psychological problems among students at the beginning of college

• To track the changes in their adjustment during 3 years of their studying

• To investigate the role of cognitive and behavioral factors that contribute to students’ psychological adjustment and their academic achievement

The main goals of our longitudinal project

• Representative sample of 492 (20 %) freshmen at University in Rijeka

• Age 18-23 years (M=19)female

60%

male40%

Sample

Live with

parents 45%

Moved out of home 55%

Procedure

• 3 measurements during 3 years

I. Semester

II.

III.

IV.

V.

VI. Psychological adjustment:• Depression (BDI)• Anxiety (BAI)

Academic achievement

• Cognitive factors (ATs, beliefs about personal control, abilities and effort)

• Behavioral factors (learning & time menagement skills)

Fear of failureFear of disappointing parentsLack of interestPositive thoughts

Results

Prevalence of depressive and anxiety symptoms when

starting college

77%

16% 5%2%

minimal mild

moderate severe

7% report suicidal thoughts

48%

34%

14%4%

Depression Anxiety

Results

The changes in psychological problems among college students

during 3-years follow-up

Change in average depressive and

anxiety symptoms Depression (BDI)

1st year 2nd year 3rd year5

6

7

8

9

10

11

12

13

14

15

16

male

femalep<.05

Anxiety (BAI)

1st year 2nd year 3rd year5

6

7

8

9

10

11

12

13

14

15

16

p<.01

p<.0013rd < 1st, 2nd

Prevalence of depressive and anxiety symptoms after 3

years at college

79%

14%4% 3%

minimal mild

moderate severe

63%

23%

11%3%

Depression Anxiety

3.5% report suicidal thughts

Results

Changes on the individual level

1st year change 2nd year %

non-depressed depressed 10

depressed non-depressed 15

non-depressed non-depressed 62

depressed depressed 13

nondepressed < cut off depressed > cut off

Groups of students according to the changes in depressive

symptoms

Differences between students who have developed and who didn’t develop depressive symptoms

Non-depressed (at 1st year)

Depressed at 2nd year (14%)More negative ATs (fear of failure

& fear of disappointing parents)

Less positive ATs

Believe they have less control over their achievement

Do not believe that their abilities and effort can contribute to their success

Non-depressed (at 2nd year)

The same number of stress events

Equal learning skills

1st year change 2nd year %

non-anxious anxious 16

anxious non-anxious 8

non-anxious non-anxious 29

anxious anxious 47

non-anxious < cut off anxious > cut off

Groups of students according to the changes in anxiety

symptoms

Differences between students who have developed and who didn’t develop anxiety symptoms

Non-anxious (at 1st year)

Anxiousat 2nd year (36%)More negative ATs (fear of failure,

fear of disappoining parents, lack of interest)

Believe less that their abilities can contribute to their success

Non-anxious (at 2nd year)

The same number of stress events

Equal learning skills

Results

Effects of anxiety and depression on academic achievement

BDI BAI02468

101214161820

succesfulfailingdropped out

p<.001

Students who dropped out of school have higher levels of anxiety and depression at the 2nd year comparing to successful students and those who fail, but who continue their study.

p<.001

Anxiety and depression in regard to academic efficacy

No correlation with GPA

Conclusions of our research

• More students experience anxiety than depressive symptoms – the average BAI result above the cut-off

• Anxiety is more pronounuced at the beginning of college (more than 50% of students are anxious at the 1st semester)

• Even if students are not depressed in average, 23% of them have BDI results above cut-off

• Depressive and anxiety symptoms are not related to students academic achievement (GPA), but they increase the risk for dropping out of school

• Cognitive factors have more significant role then behavioral factors in the increase of anxiety and depressive symptoms

Negative depressive loop

Academic failure

Depressive symptoms

Poor concentration, hopelessness,

more NATs, negative beliefs

Low motivation;

giving up from studying

Underachie-vement,

low mood

Implications

Development of preventive and intervention programs

Importance of early detection of students with signs of depression,

anxiety or academic problems

What we have already done

recommendation

feedback with personal results

on-line questionnaire

Psychoeducation (self-help materials on the website)

Contact counseling center

Early detection of students with psychological problems

Individual and group CBT focused on:

Cognitive interventions• Realistic perception of control• Coping with NATs• Restructuring and reinforcing

personal beliefs aboutabilities and effort

Behavioral interventions• Improvement of self-control• Reinforcement of personal efforts in

academic work

Academic performance

Evaluation of the individual treatment

BDI-II BAI 0

5

10

15

20

25

18.27

21.09

4.58

7.93

before treatment after treatment

Significant decrease (p< .001)

N=130

recovery64%

worsening2%

no change6%

im-prove-ment28%

Evaluation of the treatment on the individual level (RCSC

method)

Thank you!

This study is supported by University of Rijeka (project No. 13.04.1.3.15)