Mental Disorders are Common Among Norwegian Students
Research findings
|Published
Many students report such significant mental health problems that they meet the diagnostic criteria for a mental disorder. This is indicated by a survey of more than 10,000 Norwegian students.
The results have been published in a scientific article in The Lancet Regional Health - Europe. For example, the survey showed that 17 percent of female students have experienced a severe depressive episode in the last 30 days, while the corresponding figure among male students was 11 percent. The prevalence of the various disorders was as follows:
| Psychic disorder |
Percentage among female students |
Percentage among male students |
|
Major depressive episode |
17,1 |
10,8 |
|
Generalized anxiety disorder |
16,0 |
8,2 |
|
Agoraphobia |
2,0 |
0,7 |
|
Panic disorder |
7,4 |
2,4 |
|
Social anxiety disorder |
10,0 |
4,9 |
|
Specific phobia |
9,6 |
3,0 |
|
Alcohol use disorder |
5,6 |
7,7 |
|
Drug use disorder |
0,5 |
1,3 |
|
Any disorder |
39,7 |
25,7 |
– In the field of mental health, a common differentiation is between mental health problems and mental disorders. Mental health problems, such as symptoms of anxiety and depression, can affect quality of life but do not always require professional treatment. A mental disorder, however, is a serious condition that meets the diagnostic criteria as specified in DSM-5 and ICD-11, such as major depressive disorder, generalized anxiety disorder, and alcohol use disorder. For students, these can significantly affect important aspects of their lives, such as school, friends, and leisure activities, says Børge Sivertsen, senior researcher at the Norwegian Institute of Public Health.
A major depressive episode (identical to a major depressive disorder, but not accounting for possible bipolar disorder) is also often called major depression, and is characterized by a persistent and intense feeling of sadness, hopelessness, and lack of interest or pleasure in things, significantly affecting the person's daily functioning and quality of life.
Sivertsen believes that decision-makers in state and local government, educational institutions, and student welfare organizations should consider whether the support systems for mental health have enough capacity to help students in need.
– The knowledge we now have shows that a significant portion of the students struggle with such severe mental health problems that they need professional health care, says Sivertsen.
– In addition, one should consider whether there is a need to increase efforts to prevent mental disorders among students. The survey shows that the prevalence is especially high among first-year students. This indicates that adjustments in the first year of study are important. There may be a need to help students socialize, and facilitate making friends, he says.
About the Study
The survey is an extension of the Students’ Health and Wellbeing Survey (SHoT), which in 2022 went out to 168,000 full-time students. Previous SHoT surveys have suggested an increase in mental health problems among students from 2010 to 2018. The 2022 study suggests that the increase continues. It also provides an estimate of the prevalence of distress so severe that it can be considered disorders. For this purpose, a supplementary survey was conducted in a sample of the 59,000 who responded to the SHoT survey, where students completed an online version of a well-established diagnostic interview (CIDI: Composite International Diagnostic Interview), developed by the World Health Organization (WHO). 10,000 of a sample of 16,000 students responded to the supplementary self-administered diagnostic interview.
A limitation is that in the SHoT survey among 168,000 students, only 35 percent responded. We do not know whether those who did not respond have more or less distress than those who did. Previous research on non-responders in similar surveys, and comparison of those who in the SHoT survey responded with those who did not participate, do not suggest that the 10,000 students in the final sample are more distressed than the student population at large. However, this is an important uncertainty and calls for caution in the use of the numbers.
Another uncertainty is that a self-administered version of the CIDI has not been compared with the traditional face-to-face or telephone versions.
– However, previous research has investigated whether digital self-reporting of mental health generally differs from other methods, and based on these numbers, we see that the method of administration has little effect and cannot explain the high prevalence figures, says Sivertsen.
At the same time, it must be emphasized that diagnosing a mental disorder requires clinical judgment face to face with the patient. The study only shows how many meet formal criteria for such a disorder. However, the CIDI instrument has shown good agreement with other diagnostic tools commonly used in clinical practice, such as the Structured Clinical Interview for DSM-IV (SCID) and Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
To avoid the diagnostic tool being too long, some mental diagnoses were not surveyed in this round: bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, ADHD, and personality disorders.
More about the SHoT Survey
The SHoT survey is a collaborative project between the three largest student welfare organizations in Norway and the Norwegian Institute of Public Health. The Norwegian Institute of Public Health is the research-responsible institution. SHoT surveys student health and wellbeing in a broad sense, with the aim of providing insight into how students are doing and how student welfare services can be improved. The survey has been conducted regularly since 2010. The results are available at studenthelse.no.
Reference
Sivertsen B, Knudsen AKS, Kirkøen B, Skogen JC, Lagerstrøm BO, Lønning KJ, Kessler RC, Reneflot A. Prevalence of mental disorders among Norwegian college and university students: a population-based cross-sectional analysis. The Lancet Regional Health – Europe 2023; 100732. Published Online Sept 19. https://doi.org/10.1016/j.lanepe.2023.100732
Change Log
This article was updated on December 15, 2023.
Study Findings and References: Revised version includes some more statistical details about mental disorders among students, and discusses various diagnostic criteria and mental health conditions more in-depth. It also has a stronger focus on differentiating between mental health problems and mental disorders, with emphasis on diagnostic criteria and impact on students' lives.
Recommendations and Implications: Revised version discusses the implications of study findings, and suggests potential measures for decision-makers, educational institutions, and health services to address mental health problems among students.
Methodological Details: Revised version includes details about the study's method, including limitations and specifications around the data collection process.