Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis

Background To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors. Methods PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias. Results A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak. Conclusions Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.