Department of Psychology, The Pennsylvania State University, University Park, PA, United States of America.
Department of Behavioral Sciences, Long Island University, Post Campus, Brookville, NY, United States of America.
J Affect Disord. 2024 Dec 1;366:335-344. doi: 10.1016/j.jad.2024.08.098. Epub 2024 Aug 22.
Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL. This study investigated HRQoL based on demographics and comorbidity among college students with mental disorders.
Participants were students (N = 5535) across 26 U.S. colleges and universities who met criteria for depression, generalized anxiety, panic, social anxiety, post-traumatic stress, or eating disorders based on self-report measures. ANOVA and linear regressions were conducted.
Overall, female, minoritized (gender, sexual orientation, race, or ethnicity), and lower socioeconomic status students reported lower HRQoL than male, heterosexual, White, non-Hispanic, and higher socioeconomic status peers. After accounting for comorbidity, differences in physical HRQoL based on sex assigned at birth and gender were no longer significant. For mental HRQoL, only gender and sexual orientation remained significant. A greater number of comorbidities was associated with lower HRQoL regardless of demographic group.
The non-experimental design limits causal inference. The study focused on univariable associations without examining potential interactions between demographic factors. Future research should explore structural factors like discrimination.
Results suggested that increased comorbidities placed an additional burden on HRQoL and that certain demographic groups were more vulnerable to HRQoL impairment among students with mental disorders. Findings suggest the need for prevention of disorders and their comorbidity and implementing tailored interventions for specific student subgroups with increased vulnerability.
先前的研究表明，合并症和人口统计学因素增加了与健康相关的生活质量（HRQoL）的负担。只有一项研究探讨了患有精神障碍的大学生的 HRQoL 与合并症之间的关系，这使得研究结果的普遍性不确定。关于人口统计学因素对 HRQoL 的影响，人们知之甚少。本研究调查了患有精神障碍的大学生的人口统计学因素和合并症与 HRQoL 的关系。
参与者是来自 26 所美国高校的学生（N=5535），他们根据自我报告的抑郁、广泛性焦虑、惊恐、社交焦虑、创伤后应激障碍或饮食障碍的标准，符合抑郁症、广泛性焦虑症、惊恐症、社交焦虑症、创伤后应激障碍或饮食障碍的标准。采用方差分析和线性回归进行分析。
总体而言，女性、少数族裔（性别、性取向、种族或民族）和社会经济地位较低的学生的 HRQoL 低于男性、异性恋、白人、非西班牙裔和社会经济地位较高的同龄人。在考虑到合并症后，基于出生时性别和性别的身体 HRQoL 差异不再显著。对于心理健康 HRQoL，只有性别和性取向仍然显著。无论人口统计学群体如何，合并症的数量越多，HRQoL 越低。
非实验设计限制了因果推断。该研究关注的是单变量关联，而没有检查人口统计学因素之间的潜在相互作用。未来的研究应该探索歧视等结构性因素。
研究结果表明，合并症的增加给 HRQoL 带来了额外的负担，某些人口统计学群体在患有精神障碍的学生中更容易受到 HRQoL 受损的影响。研究结果表明，需要预防疾病及其合并症，并为具有较高脆弱性的特定学生亚组实施有针对性的干预措施。
