Mental Health Symptom Levels and Associated Sociodemographic Factors in University Students: A Large-Scale Cross-Sectional Study

This study examined the frequency of screening-positive symptom levels for depression, anxiety, attention deficit hyperactivity disorder (ADHD), and internet use, as well as factors independently associated with these outcomes among university students. We aimed to clarify interrelationships among these conditions and various sociodemographic variables, using a large sample of 4,556 students. Participants completed a web-based survey, including a sociodemographic questionnaire, the Adult ADHD Self-Report Screening Scale for DSM-5, Beck Anxiety and Depression Inventories, and Internet Addiction Test. Based on established cut-off scores, the proportions of participants screening positive were 39.8% for depression, 37.7% for anxiety, 35.5% for ADHD, and 9.1% for elevated internet use symptoms. Furthermore, 6.2% of participants reported a history of suicide attempts. In multivariable logistic regression models, screening positive for depression was independently associated with younger age, not living with family, lower family income, a history of psychiatric disorders or suicide attempts, as well as co-occurring elevated symptom levels above the established cut-offs for anxiety, ADHD, and elevated internet use. Screening positive for anxiety was independently associated with female sex, a family history of domestic migration, being in a romantic relationship, and a history of psychiatric disorder or suicide attempt, as well as co-occurring elevated symptom levels above the established cut-offs for depression, ADHD, and elevated internet use symptoms. Screening positive for elevated internet use symptoms was independently associated with male sex, a family history of international migration, suicide attempt history, and co-occurring elevated symptom levels above the established cut-offs for depression, anxiety, and ADHD. These findings indicate a high burden of elevated symptoms in university students and underscore the urgent need for accessible mental health support systems, targeted screening, and referral pathways within universities.