Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors

Background. The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life. Aim. The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms. Methods. A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann-Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05. Results. Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being "better off dead." The study found lower anxiety and depressive symptoms (p<0.05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (p<0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p<0.001). Conclusions. There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students' mental health.