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Published in: BMC Psychiatry 1/2020

01-12-2020 | Mood Disorders | Research article

A longitudinal cohort study to explore the relationship between depression, anxiety and academic performance among Emirati university students

Authors: Suheir Awadalla, E. Bethan Davies, Cris Glazebrook

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Many university students experience depression and anxiety, both of which have been shown to affect cognitive function. However, the impact of these emotional difficulties on academic performance is unclear. This study aims to determine the prevalence of depression and anxiety in university students in United Arab Emirates (UAE). It further seeks to explore the relationship between emotional difficulties and students’ academic performance.

Methods

This longitudinal study recruited 404 students (aged 17–25 years) attending one UAE university (80.4% response rate). At baseline, participants completed a paper-based survey to assess socio-economic factors and academic performance, including most recent grade point average (GPA) and attendance warnings. PHQ-9 and GAD-7 scales were used to assess depressive and anxiety symptoms. At six-month follow-up, 134 participants (33.3%) provided details of their current GPA.

Results

Over a third of students (34.2%; CIs 29.7–38.9%) screened for possible major depressive disorder (MDD; PHQ-9 ≥ 10) but less than a quarter (22.3%; CIs 18.2–26.3%) screened for possible generalized anxiety disorder (GAD; GAD-7 ≥ 10). The Possible MDD group had lower GPAs (p = 0.003) at baseline and were less satisfied with their studies (p = 0.015). The MDD group also had lower GPAs at follow-up (p = 0.035). The Possible GAD group had lower GPAs at baseline (p = 0.003) but did not differ at follow-up. The relationship between GAD group and GPA was moderated by gender with female students in the Possible GAD group having lower GPAs (p < 0.001) than females in the Non-GAD group. Male students in the Possible GAD group had non-significantly higher GPA scores. Higher levels of both depression and anxiety symptoms scores were associated with lower GPAs at baseline. PHQ-9 scores, but not GAD-7 scores, independently predicted lower GPA scores at follow-up (p = 0.006). This relationship was no longer statistically significant after controlling for baseline GPA (p < 0.09).

Conclusion

This study confirms previous findings that around a third of university students are likely to be experiencing a depressive disorder at any one time. Furthermore, it provides important evidence regarding the negative impacts of emotional difficulties on students’ academic performance. The results support the need to consider the mental health of students who are struggling academically and highlight the importance of signposting those students to appropriate support, including evidence-based therapies.
Literature
1.
go back to reference Quince T, Wood D, Parker R, Benson J. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open. 2012;2(4):e001519.PubMedPubMedCentralCrossRef Quince T, Wood D, Parker R, Benson J. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open. 2012;2(4):e001519.PubMedPubMedCentralCrossRef
2.
go back to reference Sarokhani D, Delpisheh A, Veisani Y, Sarokhani M, Manesh R, Sayehmiri K. Prevalence of depression among university students: a systematic review and meta-analysis study. Depress Res Treat. 2013;2013:1–7.CrossRef Sarokhani D, Delpisheh A, Veisani Y, Sarokhani M, Manesh R, Sayehmiri K. Prevalence of depression among university students: a systematic review and meta-analysis study. Depress Res Treat. 2013;2013:1–7.CrossRef
3.
go back to reference Ibrahim A, Kelly S, Adams C, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400.PubMedCrossRef Ibrahim A, Kelly S, Adams C, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400.PubMedCrossRef
4.
go back to reference Youssef J, Deane F. Factors influencing mental-health help-seeking in Arabic-speaking communities in Sydney, Australia. Ment Health Relig Cult. 2006;9(1):43–66.CrossRef Youssef J, Deane F. Factors influencing mental-health help-seeking in Arabic-speaking communities in Sydney, Australia. Ment Health Relig Cult. 2006;9(1):43–66.CrossRef
5.
go back to reference Ibrahim A, Kelly S, Glazebrook C. Socioeconomic status and the risk of depression among UK higher education students. Soc Psychiatry Psychiatr Epidemiol. 2013;48(9):1491–501.PubMedCrossRef Ibrahim A, Kelly S, Glazebrook C. Socioeconomic status and the risk of depression among UK higher education students. Soc Psychiatry Psychiatr Epidemiol. 2013;48(9):1491–501.PubMedCrossRef
6.
go back to reference Beck A. Cognitive therapy and the emotional disorders. London: Penguin; 1991. Beck A. Cognitive therapy and the emotional disorders. London: Penguin; 1991.
7.
go back to reference Brackney B, Karabenick S. Psychopathology and academic performance: the role of motivation and learning strategies. J Couns Psychol. 1995;42(4):456–65.CrossRef Brackney B, Karabenick S. Psychopathology and academic performance: the role of motivation and learning strategies. J Couns Psychol. 1995;42(4):456–65.CrossRef
8.
go back to reference Mellal AABU, Albluwe T, Al-ashkar D. The prevalence of depressive symptoms and its socioeconomic determinants among university students in AL AIN, UAE. Int J Pharm Pharm Sci. 2014;6(5):6–9. Mellal AABU, Albluwe T, Al-ashkar D. The prevalence of depressive symptoms and its socioeconomic determinants among university students in AL AIN, UAE. Int J Pharm Pharm Sci. 2014;6(5):6–9.
9.
go back to reference Andrews B, Wilding J. The relation of depression and anxiety to life-stress and achievement in students. Br J Psychol. 2004;95(4):509–21.PubMedCrossRef Andrews B, Wilding J. The relation of depression and anxiety to life-stress and achievement in students. Br J Psychol. 2004;95(4):509–21.PubMedCrossRef
10.
go back to reference Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of university students. J Ment Health Policy Econ. 2005;8:145–51.PubMed Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of university students. J Ment Health Policy Econ. 2005;8:145–51.PubMed
11.
go back to reference Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2014;39(5):503–11.PubMedPubMedCentralCrossRef Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2014;39(5):503–11.PubMedPubMedCentralCrossRef
12.
go back to reference Fouilloux Morales C, Barragán Pérez V, Ortíz León S, Jaimes Medrano A, Urrutia Aguilar M, Guevara-Guzmán R. Depressive symptoms and academic performance in medical students. Salud Ment. 2013;36(1):59.CrossRef Fouilloux Morales C, Barragán Pérez V, Ortíz León S, Jaimes Medrano A, Urrutia Aguilar M, Guevara-Guzmán R. Depressive symptoms and academic performance in medical students. Salud Ment. 2013;36(1):59.CrossRef
13.
go back to reference Heiligenstein E, Guenther G, Hsu K, Herman K. Depression and academic impairment in college students. J Am Coll Heal. 1996;45(2):59–64.CrossRef Heiligenstein E, Guenther G, Hsu K, Herman K. Depression and academic impairment in college students. J Am Coll Heal. 1996;45(2):59–64.CrossRef
14.
go back to reference Ngasa S, Sama C, Dzekem B, Nforchu K, Tindong M, Aroke D, et al. Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study. BMC Psychiatry. 2017;17(1):216.PubMedPubMedCentralCrossRef Ngasa S, Sama C, Dzekem B, Nforchu K, Tindong M, Aroke D, et al. Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study. BMC Psychiatry. 2017;17(1):216.PubMedPubMedCentralCrossRef
15.
go back to reference Wilson D, Warton C, Louw G. Stress, anxiety and academic performance among medical students at the University of Cape Town. South Afr J Child Adolesc Ment Health. 1998;10(1):23–31.CrossRef Wilson D, Warton C, Louw G. Stress, anxiety and academic performance among medical students at the University of Cape Town. South Afr J Child Adolesc Ment Health. 1998;10(1):23–31.CrossRef
16.
go back to reference Al-Qaisy L. The relation of depression and anxiety in academic achievement among group of university students. Int J Psychol Couns. 2011;3(5):96–100 Cited 25 July 2018. Al-Qaisy L. The relation of depression and anxiety in academic achievement among group of university students. Int J Psychol Couns. 2011;3(5):96–100 Cited 25 July 2018.
17.
go back to reference Zolezzi M, Alamri M, Shaar S, Rainkie D. Stigma associated with mental illness and its treatment in the Arab culture: a systematic review. Int J Soc Psychiatry. 2018;64(6):597–609.PubMedCrossRef Zolezzi M, Alamri M, Shaar S, Rainkie D. Stigma associated with mental illness and its treatment in the Arab culture: a systematic review. Int J Soc Psychiatry. 2018;64(6):597–609.PubMedCrossRef
18.
go back to reference Dardas L, Bailey D Jr, Simmons L. Adolescent depression in the Arab region: a systematic literature review. Issues Ment Health Nurs. 2016;37(8):569–85.PubMedCrossRef Dardas L, Bailey D Jr, Simmons L. Adolescent depression in the Arab region: a systematic literature review. Issues Ment Health Nurs. 2016;37(8):569–85.PubMedCrossRef
19.
go back to reference Lachenbruch P, Lwanga S, Lemeshow S. Sample size determination in health studies: a practical manual. J Am Stat Assoc. 1991;86(416):1149.CrossRef Lachenbruch P, Lwanga S, Lemeshow S. Sample size determination in health studies: a practical manual. J Am Stat Assoc. 1991;86(416):1149.CrossRef
20.
go back to reference Boyce W, Torsheim T, Currie C, Zambon A. The family affluence scale as a measure of national wealth: validation of an adolescent self-report measure. Soc Indic Res. 2006;78(3):473–87.CrossRef Boyce W, Torsheim T, Currie C, Zambon A. The family affluence scale as a measure of national wealth: validation of an adolescent self-report measure. Soc Indic Res. 2006;78(3):473–87.CrossRef
22.
go back to reference Association A. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5®). Washington, D.C.: American Psychiatric Publishing; 2013.CrossRef Association A. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5®). Washington, D.C.: American Psychiatric Publishing; 2013.CrossRef
23.
go back to reference Kroenk K, Spitzer R, Williams J. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. Kroenk K, Spitzer R, Williams J. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.
24.
go back to reference Rodebaugh T, Holaway R, Heimberg R. The factor structure and dimensional scoring of the generalized anxiety disorder questionnaire for DSM-IV. Assessment. 2008;15(3):343–50.PubMedCrossRef Rodebaugh T, Holaway R, Heimberg R. The factor structure and dimensional scoring of the generalized anxiety disorder questionnaire for DSM-IV. Assessment. 2008;15(3):343–50.PubMedCrossRef
25.
go back to reference Spitzer R, Kroenke K, Williams J, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166(10):1092.CrossRefPubMed Spitzer R, Kroenke K, Williams J, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166(10):1092.CrossRefPubMed
26.
go back to reference Al-Busaidi Z, Bhargava K, Al-Ismaily A, Al-Lawati H, Al-Kindi R, Al-Shafaee M, et al. Prevalence of depressive symptoms among university students in Oman. Oman Med J. 2011;26(4):235–9. Al-Busaidi Z, Bhargava K, Al-Ismaily A, Al-Lawati H, Al-Kindi R, Al-Shafaee M, et al. Prevalence of depressive symptoms among university students in Oman. Oman Med J. 2011;26(4):235–9.
27.
go back to reference Deroma VM, Leach JB, Leverett JP. The relationship between depression and college students. Coll Stud J. 2009;43(2):325–34. Deroma VM, Leach JB, Leverett JP. The relationship between depression and college students. Coll Stud J. 2009;43(2):325–34.
28.
go back to reference Mihăilescu A, Diaconescu L, Ciobanu A, Donisan T, Mihailescu C. The impact of anxiety and depression on academic performance in undergraduate medical students. Eur Psychiatry. 2016;33:S284.CrossRef Mihăilescu A, Diaconescu L, Ciobanu A, Donisan T, Mihailescu C. The impact of anxiety and depression on academic performance in undergraduate medical students. Eur Psychiatry. 2016;33:S284.CrossRef
29.
go back to reference Bostani M, Nadri A, Nasab A. A study of the relation between mental health and academic performance of students of the Islamic Azad University Ahvaz Branch. Procedia Soc Behav Sci. 2014;116:163–5.CrossRef Bostani M, Nadri A, Nasab A. A study of the relation between mental health and academic performance of students of the Islamic Azad University Ahvaz Branch. Procedia Soc Behav Sci. 2014;116:163–5.CrossRef
30.
go back to reference Eisenberg D, Golberstein E, Hunt J. Mental health and academic success in college. BE J Econ Anal Policy. 2009;9(1):1-37. Eisenberg D, Golberstein E, Hunt J. Mental health and academic success in college. BE J Econ Anal Policy. 2009;9(1):1-37.
32.
go back to reference Abu Ruz M, Al-Akash H, Jarrah S. Persistent (anxiety and depression) affected academic achievement and absenteeism in nursing students. Open Nurs J. 2018;12(1):171–9.PubMedPubMedCentralCrossRef Abu Ruz M, Al-Akash H, Jarrah S. Persistent (anxiety and depression) affected academic achievement and absenteeism in nursing students. Open Nurs J. 2018;12(1):171–9.PubMedPubMedCentralCrossRef
33.
go back to reference Marthoenis, Meutia I, Fathiariani L, Sofyan H. Prevalence of depression and anxiety among college students living in a disaster-prone region. Alexandria J Med. 2018;54(4):337–40.CrossRef Marthoenis, Meutia I, Fathiariani L, Sofyan H. Prevalence of depression and anxiety among college students living in a disaster-prone region. Alexandria J Med. 2018;54(4):337–40.CrossRef
34.
go back to reference Abdel Wahed W, Hassan S. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53(1):77–84.CrossRef Abdel Wahed W, Hassan S. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53(1):77–84.CrossRef
35.
go back to reference Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–72.PubMedCrossRef Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–72.PubMedCrossRef
36.
go back to reference Yeh Y, Yen C, Lai C, Huang C, Liu K, Huang I. Correlations between academic achievement and anxiety and depression in medical students experiencing integrated curriculum reform. Kaohsiung J Med Sci. 2007;23(8):379–86.PubMedCrossRef Yeh Y, Yen C, Lai C, Huang C, Liu K, Huang I. Correlations between academic achievement and anxiety and depression in medical students experiencing integrated curriculum reform. Kaohsiung J Med Sci. 2007;23(8):379–86.PubMedCrossRef
37.
go back to reference Ibukun Adeoye-Agboola D. The relationship between anxiety and academic performance of postgraduate international students in a British University: a cross-sectional quantitative design. Sci J Public Health. 2015;3(3):331.CrossRef Ibukun Adeoye-Agboola D. The relationship between anxiety and academic performance of postgraduate international students in a British University: a cross-sectional quantitative design. Sci J Public Health. 2015;3(3):331.CrossRef
38.
go back to reference Eysenck M, Derakshan N, Santos R, Calvo M. Anxiety and cognitive performance: attentional control theory. Emotion. 2007;7(2):336–53.PubMedCrossRef Eysenck M, Derakshan N, Santos R, Calvo M. Anxiety and cognitive performance: attentional control theory. Emotion. 2007;7(2):336–53.PubMedCrossRef
39.
go back to reference Alateeq D, AlDaoud A, AlHadi A, AlKhalaf H. The experience and impact of stigma in Saudi people with a mood disorder. Eur Psychiatry. 2016;33:S152–3.CrossRef Alateeq D, AlDaoud A, AlHadi A, AlKhalaf H. The experience and impact of stigma in Saudi people with a mood disorder. Eur Psychiatry. 2016;33:S152–3.CrossRef
40.
go back to reference Haque A. Mental health systems development in UAE. Eur Psychiatry. 2016;33:S488–9.CrossRef Haque A. Mental health systems development in UAE. Eur Psychiatry. 2016;33:S488–9.CrossRef
41.
go back to reference Sayed M. Mental health services in the United Arab Emirates: challenges and opportunities. Int J Emerg Ment Health Hum Resilience. 2015;17(3):661–3.CrossRef Sayed M. Mental health services in the United Arab Emirates: challenges and opportunities. Int J Emerg Ment Health Hum Resilience. 2015;17(3):661–3.CrossRef
42.
go back to reference Whitley J, Smith J, Vaillancourt T. Promoting mental health literacy among educators. Can J School Psychol. 2013;28(1):56–70.CrossRef Whitley J, Smith J, Vaillancourt T. Promoting mental health literacy among educators. Can J School Psychol. 2013;28(1):56–70.CrossRef
43.
go back to reference Gulliver A, Farrer L, Bennett K, Griffiths K. University staff mental health literacy, stigma and their experience of students with mental health problems. J Furth High Educ. 2017;43(3):434–42.CrossRef Gulliver A, Farrer L, Bennett K, Griffiths K. University staff mental health literacy, stigma and their experience of students with mental health problems. J Furth High Educ. 2017;43(3):434–42.CrossRef
44.
go back to reference Montero-Marín J, Araya R, Pérez-Yus M, Mayoral F, Gili M, Botella C, et al. An internet-based intervention for depression in primary care in Spain: a randomized controlled trial. J Med Internet Res. 2016;18(8):e231.PubMedPubMedCentralCrossRef Montero-Marín J, Araya R, Pérez-Yus M, Mayoral F, Gili M, Botella C, et al. An internet-based intervention for depression in primary care in Spain: a randomized controlled trial. J Med Internet Res. 2016;18(8):e231.PubMedPubMedCentralCrossRef
45.
go back to reference Rickwood D, Bradford. The role of self-help in the treatment of mild anxiety disorders in young people: an evidence-based review. Psychol Res Behav Manag. 2012;25:25–36.CrossRef Rickwood D, Bradford. The role of self-help in the treatment of mild anxiety disorders in young people: an evidence-based review. Psychol Res Behav Manag. 2012;25:25–36.CrossRef
46.
go back to reference Hakami R, Mahfouz M, Adawi A, Mahha A, Athathi A, Daghreeri H, et al. Social anxiety disorder and its impact in undergraduate students at Jazan University, Saudi Arabia. Ment Illn. 2017;9(2):42–7.CrossRef Hakami R, Mahfouz M, Adawi A, Mahha A, Athathi A, Daghreeri H, et al. Social anxiety disorder and its impact in undergraduate students at Jazan University, Saudi Arabia. Ment Illn. 2017;9(2):42–7.CrossRef
Metadata
Title
A longitudinal cohort study to explore the relationship between depression, anxiety and academic performance among Emirati university students
Authors
Suheir Awadalla
E. Bethan Davies
Cris Glazebrook
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02854-z

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