Fifteen-year trends in depression symptoms by sex, race, and financial stress among U.S. College Students.

INTRODUCTION

Depression has become increasingly prevalent in the last three decades. Close to half of the general population currently receives mental health services. Depression rates are especially high among youth and cause significant disability, especially among racial minority groups, women, and people of lower socio-economic status. However, more research is needed to understand differences in depression symptom presentation among different socio-demographic groups and overtime in college students.

METHODS

We analyzed item-level depression data from approximately 560,000 U.S. college students across 450 institutions using the Healthy Minds Study data (2007-2022). Depression was assessed using the Patient Health Questionnaire (PHQ-9). We conducted ANOVAs to compare yearly means and linear mixed-effects models to estimate symptom trends over time. Moderators included sex assigned at birth, race, ethnicity, and financial stress.

RESULTS

All PHQ-9 items increased in average score from 2007 to 2022. The largest percentage increases were seen in suicidal ideation (+153.9 %), psychomotor agitation/restlessness (+79.6 %), and trouble concentrating (+77.7 %). These increases were most pronounced among women, intersex, and financially stressed students, and those belonging to several racial minority groups. Suicidal ideation increased across all demographic groups without significant differences by race.

CONCLUSIONS

These findings reveal that the rise in symptoms of depression is not uniform across demographic groups and symptom domains. The consistently steeper increases among women, students of racial minority groups, and those experiencing financial stress highlight growing mental health disparities. The growth of suicide ideation across all groups signals an urgent need for targeted prevention and support strategies on college campuses.