Osborn Tom G, Saunders Rob, Fonagy Peter
CORE Data Lab, Research Department of Clinical, Educational and Health Psychology, 1-19 Torrington Place, UCL, London, WC1E 7HB, England.
Division of Psychology and Language Sciences, 26 Bedford Way, London, WC1H 0AP, England.
Soc Psychiatry Psychiatr Epidemiol. 2025 May 19. doi: 10.1007/s00127-025-02922-3.
It is unclear whether attending university is associated with health service use for mental health problems in emerging adulthood. As this can be a marker of the onset of mental disorders, we aimed to investigate whether attending university was associated with health service use for a mental health problem by age 24.
We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The analytic sample comprised of 2,649 individuals with data on university attendance reported approximately between ages 25 and 26, and health service use for a mental health problem reported around age 24. Logistic regression models were used to investigate the association between university attendance and health service use, employing confounder adjustment, multiple imputation and propensity score matching to assess the robustness of associations. The study was reported using STROBE guidelines.
University attendees were less likely to report having used services for mental health problems by 24 years compared to non-university attendees (6.5% vs. 11.4%, odds ratio (OR) = 0.54[95%CI = 0.40;0.72], p < 0.001). This association was robust in the fully adjusted model (aOR = 0.38[95%CI = 0.15;0.94], p = 0.04), propensity score matching and multiple imputation. There was evidence of a differential association among those who were and were not heterosexual and according to maternal education level.
Our findings suggest individuals who attend university are less likely to use a health service for a mental health problem. Further longitudinal research is needed to investigate potential explanations for these differences.
PRE-REGISTRATION: A study protocol was submitted to the ALSPAC team.
在成年初期，上大学是否与心理健康问题的医疗服务利用有关尚不清楚。由于这可能是精神障碍发作的一个标志，我们旨在调查到24岁时上大学是否与心理健康问题的医疗服务利用有关。
我们使用了阿冯父母与儿童纵向研究（ALSPAC）的数据。分析样本包括2649名个体，他们在25至26岁左右报告了大学就读情况，并在24岁左右报告了心理健康问题的医疗服务利用情况。使用逻辑回归模型来研究大学就读与医疗服务利用之间的关联，采用混杂因素调整、多重填补和倾向得分匹配来评估关联的稳健性。本研究按照加强流行病学观察性研究报告规范（STROBE）指南进行报告。
与未上大学的人相比，上大学的人在24岁时报告使用心理健康问题服务的可能性较小（6.5%对11.4%，优势比（OR）=0.54[95%置信区间（CI）=0.40；0.72]，p<0.001）。在完全调整模型（调整后OR=aOR=0.38[95%CI=0.15；0.94]，p=0.04）、倾向得分匹配和多重填补中，这种关联是稳健的。有证据表明，在异性恋和非异性恋者以及根据母亲教育水平之间存在差异关联。
我们的研究结果表明，上大学的人使用心理健康问题医疗服务的可能性较小。需要进一步的纵向研究来调查这些差异的潜在原因。
一项研究方案已提交给ALSPAC团队。
