Monitoring the Mental Health of Portuguese University Students: Insights from Three Academic Years

Abstract

Objective: To assess the prevalence of depressive and anxiety symptoms in university students across three academic years and the factors contributing to these symptoms. Methods: A repeated cross-sectional study was conducted using independent samples each academic year. An online questionnaire was administered to students from seven higher education institutions during the academic years 2022/2023, 2023/2024, and 2024/2025. Depressive symptoms were assessed using the PHQ-9, and anxiety symptoms using the GAD-7. Descriptive and correlational analyses were performed. Results: The samples included 3399, 2136, and 2212 students, respectively. The prevalence of depressive symptoms was 23.7% in the first year, 24.9% in the second, and 23.4% in the third. Rates of moderately severe symptoms were 30.6%, 31.7%, and 33.1%, respectively, and severe symptoms were reported by 6.9%, 7.2%, and 7.9%. For anxiety symptoms, mild levels were reported by 37.9%, 37.7%, and 36.8%; moderate by 22.8%, 23.5%, and 24%; and severe by 14.3%, 15.7%, and 16.3%. No significant differences were observed across academic years. Higher levels of depressive and anxiety symptoms were significantly associated with being female (p < 0.001 across all years) and reporting lower socio-economic status (p < 0.001 across all years, except for anxiety in the first year: p < 0.05). Conversely, more frequent visits home (p < 0.05 in the first year; p < 0.001 in the second and third) and better perceived academic performance (p < 0.05 in the first year; p < 0.001 in the second and third) were associated with fewer symptoms. Conclusions: There is a persistently high prevalence of depressive and anxiety symptoms among Portuguese university students over the three-year period, with no significant variation over time. Female sex and lower socio-economic status were consistent risk factors, while more frequent home visits and better academic self-perception emerged as protective factors. These findings underscore the urgent need for sustained and targeted mental health interventions in higher education settings, particularly for the most vulnerable student populations.