Roest Annelieke M, de Vries Ymkje Anna, Pozuelo Julia R, Petukhova Maria V, Lee Sue, Sampson Nancy A, Albor Yesica, Alhadi Ahmad N, Alonso Jordi, Al-Saud Nouf, Altwaijri Yasmin, Andersson Claes, Atwoli Lukoye, Auerbach Randy P, Muaka Caroline Ayuya, Báez-Mansur Patricia M, Ballester Laura, Bantjes Jason, Baumeister Harald, Bendtsen Marcus, Benjet Corina, Berman Anne H, Bruffaerts Ronny, Carrasco Paula, Chan Silver C N, Cohut Irina, Couder María Anabell Covarrubias Díaz, Crockett Marcelo A, Cuijpers Pim, David Oana A, Dong Dong, Ebert David D, Gaete Jorge, Forero Carlos García, Gili Margalida, Gutiérrez-García Raúl, Haro Josep Maria, Hasking Penelope, Hunt Xanthe, Husky Mathilde M, Jaguga Florence, Langer Álvaro I, Léniz Irene, Liu Yan, Mac-Ginty Scarlett, Martínez Vania, McLafferty Margaret, Miranda Andrea, Monroy-Velasco Iris Ruby, Murray Elaine K, Musyoka Catherine M, Nedelcea Catalin, Núñez Daniel, O'Neill Siobhan M, Piqueras José A, Popescu Codruta A, Prescivalli Ana Paula, Rapsey Charlene, Robinson Kealagh, Rodriguez-Jimenez Tiscar, Saal Wylene, Siu Oi-Ling, Stein Dan J, Struijs Sascha Y, Tomoiaga Cristina T, Valdés-García Karla Patricia, Vargas-Contreras Eunice, Vigo Daniel V, Wang Angel Y, Wong Samuel Y S, Kessler Ronald C
Department of Developmental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands.
Department of Child and Adolescent Psychiatry, University Medical Center Groningen, Groningen, the Netherlands.
Psychiatry Res. 2025 Sep;351:116605. doi: 10.1016/j.psychres.2025.116605. Epub 2025 Jun 20.
Mental disorders are highly prevalent among students worldwide. This study aims to examine comorbidity and temporal associations between mental disorders among students.
The study included 72,288 students from 18 countries as part of the World Mental Health International College Student (WMH-ICS) Initiative, with cross-sectional data collected between 2017 and 2023. Screening for common DSM-5 disorders was conducted using validated screening measures. Latent variables were examined using exploratory principal axis factor analysis on a correlation matrix among the lifetime mental disorders. Based on age-of-onset information, multivariable poisson regression models were used to examine associations of prior disorders with the first onset of other disorders.
27.0 % of students screened positive for only one lifetime disorder, 17.1 % for two, 10.9 % for three, and 10.6 % for 4+ disorders. In the factor analysis, three latent variables were found, comprising: internalizing disorders (generalized anxiety disorder, major depressive episode, post-traumatic stress disorder, and panic disorder), substance use disorders (drug use disorder and alcohol use disorder), and externalizing disorders (attention deficit/hyperactivity disorder and mania/hypomania). Prior internalizing and externalizing disorders were associated with the subsequent first onset of all other disorders with risk ratios ranging from 1.5-7.5. Substance use disorders were less consistently associated with the subsequent first onset of other disorders, but alcohol use disorder was associated with the first onset of drug use disorder and vice versa.
Mental disorder comorbidity is common among students, and students with disorders across the internalizing and externalizing spectrum have an increased risk of future mental disorder comorbidities.
精神障碍在全球学生中极为普遍。本研究旨在探讨学生精神障碍之间的共病情况及时间关联。
作为世界心理健康国际大学生（WMH - ICS）倡议的一部分，该研究纳入了来自18个国家的72288名学生，收集了2017年至2023年的横断面数据。使用经过验证的筛查措施对常见的DSM - 5障碍进行筛查。对终生精神障碍之间的相关矩阵进行探索性主轴因子分析，以检验潜在变量。基于发病年龄信息，使用多变量泊松回归模型来检验先前障碍与其他障碍首次发病之间的关联。
27.0%的学生仅有一种终生障碍筛查呈阳性，17.1%有两种，10.9%有三种，10.6%有四种及以上障碍。在因子分析中，发现了三个潜在变量，包括：内化障碍（广泛性焦虑障碍、重度抑郁发作、创伤后应激障碍和惊恐障碍）、物质使用障碍（药物使用障碍和酒精使用障碍）以及外化障碍（注意力缺陷多动障碍和躁狂/轻躁狂）。先前的内化和外化障碍与随后所有其他障碍的首次发病相关，风险比在1.5至7.5之间。物质使用障碍与随后其他障碍的首次发病关联不太一致，但酒精使用障碍与药物使用障碍的首次发病相关，反之亦然。
精神障碍共病在学生中很常见，在内化和外化谱系中患有障碍的学生未来发生精神障碍共病的风险增加。
