A longitudinal cohort study to explore the relationship between depression, anxiety and academic performance among Emirati university students

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Abstract

Background

Many university students experience depression and anxiety, both of which have been shown to affect cognitive function. However, the impact of these emotional difficulties on academic performance is unclear. This study aims to determine the prevalence of depression and anxiety in university students in United Arab Emirates (UAE). It further seeks to explore the relationship between emotional difficulties and students’ academic performance.

Methods

This longitudinal study recruited 404 students (aged 17–25 years) attending one UAE university (80.4% response rate). At baseline, participants completed a paper-based survey to assess socio-economic factors and academic performance, including most recent grade point average (GPA) and attendance warnings. PHQ-9 and GAD-7 scales were used to assess depressive and anxiety symptoms. At six-month follow-up, 134 participants (33.3%) provided details of their current GPA.

Results

Over a third of students (34.2%; CIs 29.7–38.9%) screened for possible major depressive disorder (MDD; PHQ-9 ≥ 10) but less than a quarter (22.3%; CIs 18.2–26.3%) screened for possible generalized anxiety disorder (GAD; GAD-7 ≥ 10). The Possible MDD group had lower GPAs ( p = 0.003) at baseline and were less satisfied with their studies ( p = 0.015). The MDD group also had lower GPAs at follow-up ( p = 0.035). The Possible GAD group had lower GPAs at baseline ( p = 0.003) but did not differ at follow-up. The relationship between GAD group and GPA was moderated by gender with female students in the Possible GAD group having lower GPAs ( p < 0.001) than females in the Non-GAD group. Male students in the Possible GAD group had non-significantly higher GPA scores. Higher levels of both depression and anxiety symptoms scores were associated with lower GPAs at baseline. PHQ-9 scores, but not GAD-7 scores, independently predicted lower GPA scores at follow-up ( p = 0.006). This relationship was no longer statistically significant after controlling for baseline GPA ( p < 0.09).

Conclusion

This study confirms previous findings that around a third of university students are likely to be experiencing a depressive disorder at any one time. Furthermore, it provides important evidence regarding the negative impacts of emotional difficulties on students’ academic performance. The results support the need to consider the mental health of students who are struggling academically and highlight the importance of signposting those students to appropriate support, including evidence-based therapies.

Related collections

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Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. To explore the prevalence of depression in university students. PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990. Copyright © 2012 Elsevier Ltd. All rights reserved.

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Paola Pedrelli, Maren Nyer, Albert Yeung … (2015)

Attending college can be a stressful time for many students. In addition to coping with academic pressure, some students have to deal with the stressful tasks of separation and individuation from their family of origin while some may have to attend to numerous work and family responsibilities. In this context, many college students experience the first onset of mental health and substance use problems or an exacerbation of their symptoms. Given the uniqueness of college students, there is a need to outline critical issues to consider when working with this population. In this commentary, first, the prevalence of psychiatric and substance use problems in college students and the significance of assessing age of onset of current psychopathology are described. Then, the concerning persistent nature of mental health problems among college students and its implications are summarized. Finally, important aspects of treatment to consider when treating college students with mental health problems are outlined, such as the importance of including parents in the treatment, communicating with other providers, and employing of technology to increase adherence. It is concluded that, by becoming familiar with the unique problems characteristic of the developmental stage and environment college students are in, practitioners will be able to better serve them.

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Depression is a common disorder that impacts an individual's ability to perform life activities, including those required by the workplace. Academic performance can be viewed as a direct parallel to workforce performance, with students belonging to a unique set of individuals whose ability to perform can be measured on criteria applied by an observer and by self-report. While the prevalence of depression for this group is high and preparation for entry into the workplace is critical for these individuals, this relationship has not been adequately investigated. This study investigates the relationship between depression and its treatments and the academic performance of undergraduate students. Data regarding academics, health and productivity for students from Western Michigan University were obtained from the University's Registrar's Office, the campus Health Center and a survey delivered to the students. The primary outcomes of interest were the student's grade point average (GPA), an objective, observer generated measure of academic productivity, and the students' self-reported academic performance. Diagnosed depression was associated with a 0.49 point, or half a letter grade, decrease in student GPA, while treatment was associated with a protective effect of approximately 0.44 points. The self-reported data regarding the impact of depression on the performance of academic tasks was consistent with these findings. Depressed students reported a pattern of increasing interference of depression symptoms with academic performance peaking in the month of diagnosis and decreasing thereafter with the lowest levels reported in months 4 through 6 post-diagnosis, each of which is significantly less than the month of diagnosis. The finding of a significant relationship between depression and academic performance was robust to the variety of analyses employed within this study. However, interpretation of the findings must be tempered by a number of facts. The sample was drawn from a subset of students at a single university, those willing to complete a questionnaire regarding their health and productivity. Due to non-availability of the treatment data from other health care providers, the treatment variable used within the regression models represents an imprecise proxy for the totality of treatment methods received by depressed subjects from a variety of on-campus and off-campus health care providers. Another challenge to the interpretation of this data is the interrelatedness of depression and school performance. Because of this, it was not possible to evaluate the extent to which the association between depression and academic performance is driven by causality in either direction. While depression and its effects have been studied in many different population groups and subgroups, the effect of this disease on college students has not been well documented. This research demonstrates the impact of depression and the effectiveness of its treatment on a student sample. From a public health perspective, this analysis highlights the importance of access to mental health treatment facilities among the college aged and the potential value of efforts to educate this population segment on the availability of that resource.

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Author and article information

Contributors

Cris Glazebrook: cris.glazebrook@nottingham.ac.uk

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 11 September 2020

Publication date PMC-release: 11 September 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 448

Affiliations

[1 ]GRID grid.4563.4, ISNI 0000 0004 1936 8868, Division of Psychiatry and Applied Psychology, , University of Nottingham, ; Nottingham, NG7 2UH UK

[2 ]GRID grid.444464.2, ISNI 0000 0001 0650 0848, College of Natural and Health Sciences Department of Psychology, , Zayed University, ; Dubai, United Arab Emirates

[3 ]GRID grid.499433.0, NIHR MindTech MedTech Cooperative Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, ; Triumph Road, Nottingham, NG7 2TU UK

Article

Publisher ID: 2854

DOI: 10.1186/s12888-020-02854-z

PMC ID: 7488388

PubMed ID: 32917172

SO-VID: 80993166-8cf6-4e28-a94a-eed7878e91db

License:

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