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Depress Anxiety. 2018 Sep;35(9):802-814. doi: 10.1002/da.22778. Epub 2018 May 30.

Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project.

Author information

1
Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
2
Pompeu Fabra University (UPF), Barcelona, Spain.
3
CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
4
Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.
5
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
6
Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.
7
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
8
Department for Psychology, Clinical Psychology and Psychotherapy Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany.
9
School of Psychology, Ulster University, Londonderry, United Kingdom.
10
Campus Salamanca, De La Salle Bajio University, León, Mexico.
11
School of Education, Boston University, Boston, MA, USA.
12
School of Psychology & Speech Pathology, Curtin University, Perth, Australia.
13
SAMRC/UCT/SU Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.
14
Department of Psychology, Harvard University, Cambridge, MA, USA.
15
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

College entrance is a stressful period with a high prevalence of mental disorders.

AIMS:

To assess the role impairment associated with 12-month mental disorders among incoming first-year college students within a large cross-national sample.

METHODS:

Web-based self-report surveys assessing the prevalence of DSM-IV mental disorders and health-related role impairment (Sheehan Disability Scale) were obtained and analyzed from 13,984 incoming first-year college students (Response = 45.5%), across 19 universities in eight countries. Impairment was assessed in the following domains: home management, work (e.g., college-related problems), close personal relationships, and social life.

RESULTS:

Mean age of the sample was 19.3 (SD = 0.59) and 54.4% were female. Findings showed that 20.4% of students reported any severe role impairment (10% of those without a mental disorder vs. 42.9% of those with at least one disorder, P < 0.01). In bivariate analyses, panic disorder, and mania were associated most frequently with severe impairment (60.6% and 57.5%, respectively). Students reporting three or more mental disorders had almost fivefold more frequently severe impairment relative to those without mental disorders. Multiple logistic regression showed that major depression (OR = 4.0; 95%CI = 3.3, 4.8), generalized anxiety (OR = 3.9; 95%CI = 3.1, 4.8), and panic disorder (OR = 2.9; 95%CI 2.4, 4.2) were associated with the highest odds of severe impairment. Only minimal deviations from these overall associations were found across countries.

CONCLUSION:

Mental disorders among first-year college students are associated with substantial role impairment. Providing preventative interventions targeting mental disorders and associated impairments is a critical need for institutions to address.

KEYWORDS:

anxiety disorders; depression; disability; drug use disorders; intimate relationships; role impairment; social function; suicide/self-harm; university students

PMID:
29847006
PMCID:
PMC6123270
[Available on 2019-09-01]
DOI:
10.1002/da.22778
[Indexed for MEDLINE]

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