Depression, anxiety, and suicidal ideation among graduate students in doctoral degree programs: systematic review and meta-analysis

Emily Satinsky, MSc

Massachusetts General Hospital
Depression, anxiety, and suicidal ideation among graduate students in doctoral degree programs: systematic review and meta-analysis

Scientific Abstract

Background: University administrators and mental health clinicians have raised concerns about depression and anxiety among graduate students in doctoral degree programs. Mental health problems are known to be highly prevalent among undergraduate and professional degree students, but doctoral students face unique uncertainties and stressors. However, no study has systematically synthesized the evidence on mental health problems in this population.

Methods: We searched PubMed, Embase, PsycINFO, ERIC, Business Source Complete, and the grey literature for studies of doctoral students in which depression, anxiety, and/or suicidal ideation were assessed using validated screening instruments.

Results: Thirty-two published articles and unpublished reports, describing 29 unique studies, were identified and included in the review. Twenty (69%) studies were conducted in the United States. The median sample size was 172 students (IQR, 68–654; range, 6–6,405).

Among 16 studies reporting the prevalence of clinically significant symptoms of depression across 23,469 graduate students in five countries, the estimates ranged from 7-50%. Our pooled estimate of the proportion of graduate students with depression was 0.24 (95% confidence interval [CI], 0.18–0.31; 95% predictive interval [PI], 0.04-0.54), with substantial between-study heterogeneity (I2 = 98.75%). A subgroup analysis restricted to the seven US studies reporting depression prevalence yielded similar findings, with no appreciable reduction in heterogeneity. In a meta-analysis of the nine studies reporting the prevalence of anxiety, the estimated proportion of graduate students with anxiety was 0.17 (95% CI, 0.12- 0.23; 95% PI, 0.02-0.41; I2 = 98.05%).

Conclusions: We conclude that depression and anxiety are highly prevalent among doctoral students. Data limitations precluded our ability to estimate differences in prevalence across subgroups of students, determine drivers of depression and anxiety, or obtain a pooled estimate of suicidal ideation prevalence. Programs to support the mental health and wellbeing of doctoral students are urgently needed.

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research Areas

Authors

Emily N. Satinsky, MSc, Tomoki Kimura, MD, Mathew V. Kiang, ScD, Rediet Abebe, PhD, Scott Cunningham, PhD, Hedwig Lee, PhD, Xiaofei Lin, BA, Cindy H. Liu, PhD, Igor Rudan, MD, PhD, Srijan Sen, MD, PhD, Mark Tomlinson, PhD, Miranda Yaver, PhD, Alexander C. Tsai, MD, PhD

Principal Investigator

Alexander C. Tsai, MD, PhD