Population Psychiatry Suicide and Informatics, Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK.
School of Allied Health and Community, University of Worcester, Worcester, UK.
Br J Psychiatry. 2024 Sep;225(3):389-400. doi: 10.1192/bjp.2024.90.
Concern that self-harm and mental health conditions are increasing in university students may reflect widening access to higher education, existing population trends and/or stressors associated with this setting.
To compare population-level data on self-harm, neurodevelopmental and mental health conditions between university students and non-students with similar characteristics before and during enrolment.
This cohort study linked electronic records from the Higher Education Statistics Agency for 2012-2018 to primary and secondary healthcare records. Students were undergraduates aged 18 to 24 years at university entry. Non-students were pseudo-randomly selected based on an equivalent age distribution. Logistic regressions were used to calculate odds ratios. Poisson regressions were used to calculate incidence rate ratios (IRR).
The study included 96 760 students and 151 795 non-students. Being male, self-harm and mental health conditions recorded before university entry, and higher deprivation levels, resulted in lower odds of becoming a student and higher odds of drop-out from university. IRRs for self-harm, depression, anxiety, autism spectrum disorder (ASD), drug use and schizophrenia were lower for students. IRRs for self-harm, depression, attention-deficit hyperactivity disorder, ASD, alcohol use and schizophrenia increased more in students than in non-students over time. Older students experienced greater risk of self-harm and mental health conditions, whereas younger students were more at risk of alcohol use than non-student counterparts.
Mental health conditions in students are common and diverse. While at university, students require person-centred stepped care, integrated with local third-sector and healthcare services to address specific conditions.
人们对大学生自残和心理健康问题的担忧可能反映了高等教育的普及、现有人口趋势以及与这一环境相关的压力因素。
比较有大学入学背景和无大学入学背景的学生在入学前后，其自残、神经发育和心理健康状况的人群数据。
本队列研究将 2012-2018 年高等教育统计局的电子记录与初级和二级医疗记录进行了关联。学生为年龄在 18 至 24 岁的本科生。非学生是根据等效年龄分布随机选择的。使用逻辑回归计算比值比，使用泊松回归计算发病率比（IRR）。
研究纳入了 96760 名学生和 151795 名非学生。入学前存在男性、自残和心理健康状况，以及较高的贫困水平，这使得成为学生的可能性降低，而退学的可能性增加。与非学生相比，学生的自残、抑郁、焦虑、自闭症谱系障碍（ASD）、药物使用和精神分裂症的 IRR 较低。随着时间的推移，学生的自残、抑郁、注意力缺陷多动障碍、ASD、酒精使用和精神分裂症的 IRR 增长幅度高于非学生。年龄较大的学生自残和心理健康问题的风险更高，而年龄较小的学生比非学生更容易出现酒精使用问题。
学生的心理健康问题普遍存在且多样化。在校期间，学生需要以人为本的阶梯式护理，与当地第三部门和医疗服务相结合，以解决特定的问题。
