Modifiable behavioural factors and their association with depression and anxiety in Canadian undergraduate post-secondary students

Abstract

Background: The mental health of post-secondary students is important for academic success and overall wellness. If post-secondary students are struggling with mental health concerns, these concerns can affect various aspects of university life including transitioning to post-secondary education, socialization and making connections, physical health, academic success, and student retention. Certain lifestyle behaviours identified as modifiable behavioural factors, or behaviours that are within the students’ control, such as sleep, physical activity, and substance use, may be valuable commodities to explore to proactively and positively improve the mental health and academic achievements of post-secondary students.

Objective: This thesis explored the associations between depression and anxiety, and six modifiable behavioural factors (sleep, physical activity, cigarette smoking, e-cigarette use, marijuana use, and alcohol consumption) among female and male Canadian undergraduate post-secondary students.

Method: Data from the 2019 National College Health Assessment (NCHA) Canadian Reference Group was analyzed using logistic regression models. Models, stratified by sex at birth, explored the association between depression as a mental health indicator and six modifiable behavioural factors (sleep, physical activity, cigarette smoking, e-cigarette use, marijuana use, and alcohol consumption) while controlling for relevant covariates. The same approach, also stratified by sex at birth, explored the association between anxiety as a mental health indicator and the six modifiable behavioural factors and covariates.

Results: In this sample of Canadian undergraduate students, 53% of students reported depression and 71% of students reported anxiety. The main predictors of depression for female and male students were insufficient sleep, cigarette use, and marijuana use, but insufficient physical activity predicted depression only for female students. The main predictors of anxiety for female and male students were insufficient sleep, insufficient physical activity, cigarette use, and marijuana use. Alcohol consumption including binge drinking was either not significant or was found to have an inverse association with depression and anxiety for both sexes.

Conclusion: Mental health is a serious problem among Canadian undergraduate post-secondary students. Both depression and anxiety are linked to several modifiable behaviours: sleep, physical activity, cigarette use, and marijuana use. These finding warrant the need for effective health campaigns, programming, and institutional policies that support student well-being and decrease mental health prevalence at post-secondary institutions.