Abstract
This study sought to examine the association between lifestyle-related behaviors and depressive symptoms among college students. This cross-sectional study analyzed baseline data of a dynamic-cohort study from a public university in Central-Western Brazil, in all 21 undergraduate full-time courses. Students up to 25 years old who were enrolled for the first time in a university were included in the study, except pregnant and/or nursing women. All students who met the eligibility criteria were invited to participate in the study. From a total of 1,212 eligible students, 1,038 were included (85.6%). All participants answered a self-administered questionnaire on smoking, alcohol consumption, screen time, sleep duration, and meal patterns. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariate Poisson regression models stratified by sex were used to estimate the associations. Depressive symptoms was observed in 31.6% (males 23.6%; females 39.9%; p-value chi-square test = 0.01) of the students. Smoking, drinking spirits, and having irregular meal habits were directly associated with depressive symptoms in both males and females. The co-occurrence of two risk behaviors (men: aPR = 2.23, 95%CI: 1.25; 3.99; women: aPR = 1.54, 95%CI: 1.03; 2.30) and three or more risk behaviors (men: aPR = 3.42, 95%CI: 1.90; 6.16; women: aPR = 2.09, 95%CI: 1.39; 3.15) increased the occurrence of depressive symptoms among the students. Lifestyle-related unhealthy behaviors were associated with an increased occurrence of depressive symptoms among college students. These findings suggest the need of interventions encouraging changes in lifestyle to promote mental health and to improve the quality of life in this group.
Highlights
Depression is a mental disorder characterized by a loss of interest or pleasure in activities or depressed mood, accompanied by fluctuations in feelings of guilt and low self-esteem, suicidal thoughts, and other manifestations [1,2]
In the adjusted model, the prevalence of depressive symptoms was higher among those reporting more than 4 hours per day of screen time, smokers, who consumed beverages with a higher alcohol content, and those reporting irregular meal patterns, compared to those who did not present any of the mentioned behaviors
A census study with Brazilian college students enrolled in full-time courses showed that almost one third of them presented depressive symptoms, with higher prevalence in females; the association between unhealthy behaviors and depressive symptoms presented differences according to sex
Summary
Depression is a mental disorder characterized by a loss of interest or pleasure in activities or depressed mood, accompanied by fluctuations in feelings of guilt and low self-esteem, suicidal thoughts, and other manifestations [1,2]. Prevalence rates vary according to cultural differences, genetic vulnerability, environmental factors, and diagnostic tools. Depression is common among college students with an overall estimated prevalence rate of 30.6%, which varies among countries, ranging from 10 to 85% 3, with a higher probability of depression in first-year students compared to later levels of undergraduate or graduate students 4. Depression has been related to poor quality of life, unsatisfactory academic performance, university abandonment, and self-destructive behaviors [5,6]. Many conditions increase the vulnerability of college students to depression, the conflicts that accompany the transition from adolescence to adulthood, pressure in academic performance, job competition, and a routine with excessive time devoted to studies 7. In many cases, students move away from home, and as such there is a consequent increase in independence and autonomy that requires social and affective adaptations in the face of new situations 8
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