Prevalence of depression, anxiety, and stress among university students in the post-COVID-19 period: a systematic review and meta-analysis

BACKGROUND: The COVID-19 pandemic has had lasting effects on university students' mental health. While numerous studies have examined depression, anxiety, and stress during the pandemic, the post-pandemic burden of these conditions remains unclear. This systematic review and meta-analysis aimed to estimate the pooled prevalence of depression, anxiety, and stress among university students during the post-COVID-19 period. METHODS: A systematic search of PubMed, Web of Science, MEDLINE, and Scopus was conducted from inception to August 2025 following PRISMA guidelines (OSF: 10.17605/OSF.IO/S3R2E). Cross-sectional studies published between 2022 and 2025 reporting the prevalence of depression, anxiety, and/or stress among university students using validated assessment tools were included. Study quality was assessed using the Joanna Briggs Institute checklist. Single-arm meta-analyses of proportions were performed using logit transformation. Subgroup analyses by geographic region, meta-regression, sensitivity analyses, and publication bias assessments were conducted. RESULTS: Sixty-three studies involving more than 255,000 university students across multiple global regions were included. The pooled prevalence of overall depression was 45.1% (95% CI: 38.5% to 51.8%), with prevalence estimates of 21.9% for mild, 12.8% for moderate, and 4.1% for severe depression. The pooled prevalence of overall anxiety was 43.6% (95% CI: 35.3% to 52.3%), with 23.1% mild, 13.7% moderate, and 6.1% severe anxiety. Overall stress prevalence was 45.6% (95% CI: 32.9% to 58.8%), while high perceived stress affected 14.5% of students. Significant regional variations were observed for depression and anxiety. Meta-regression indicated no consistent temporal trends, although prevalence varied by sample size and, for moderate and severe anxiety, by publication year. Sensitivity analyses confirmed robust findings. Publication bias was detected in mild depression, mild anxiety, and severe anxiety subgroups. CONCLUSIONS: Depression, anxiety, and stress remain highly prevalent among university students in the post-pandemic period, highlighting a sustained mental health burden. Most studies were cross-sectional and relied on self-reported measures, with variability in sample sizes and sociocultural contexts, hindering comparability and generalizability. Despite these constraints, these findings highlight the urgent need for targeted mental health screening, preventive strategies, and accessible psychological support services within higher education settings.