Symptoms of Anxiety and Depression within the UNiversity community: the cross-sectional UN-SAD study

The academic profession is in some ways atypical: professionals are intrinsically motivated and in most cases experience high levels of job satisfaction, but they can suffer from high levels of external pressure, leading to psychological problems [1]. Recently, many concerns have been raised about the potential impact of working conditions and research and career opportunities on the mental health of academics [2‐4]. Indeed, the complexity of the academia has increased, in recent years, as more attention has been paid to accountability, resource management and the internationalization of research [5‐7]. All these changes have affected traditional academic profiles, which are mainly characterized by the key role of teaching, research, and institutional mission [8]. Recent studies have shown that despite the remaining positive elements that characterize the academic profession, the main causes of stress are the increase in bureaucratic procedures, the number of students, and the professionals competing for reduced funding opportunities [9]. Some authors noted that the “publish or perish” imperative very often has a counterproductive effect and puts enormous pressure on the publication of research results, leading to increased stress levels and lower job satisfaction, especially among younger academics and women [10‐13]. Increased workload, reduced autonomy and salary, overuse of fixed-term contracts, and resulting job insecurity, along with lack of promotion opportunities and difficulty balancing work life, can have a significant impact on the mental health of academics, especially younger academics [2‐4, 13‐16]. Moreover, some previous research suggests greater vulnerability among women who experience high levels of family and work stress and increased pressure to publish scientific papers, leading them to consider leaving their jobs [17, 18].

Despite these conditions, there is still a lack of knowledge about the current burden of mental illness in the academic community. Recent studies looking at anxiety and depressive symptoms in medical students and physicians during their residency program found a prevalence of mental health problems ranging from 20.9 to 43.2% [19‐21]. These data are much higher than the prevalence in the general population, which is 4.6–9.3% [22, 23]. A 2003 study by Winefield et al. conducted at 17 Australian universities provides preliminary evidence of the high levels of stress experienced by academic professionals: 43% of them suffered from some degree of psychological distress. Their findings suggest that academics are more affected by mental health problems compared to technical and administrative staff at the same university [24].

A total of 1,550 participants were eligible (600 senior academics, 500 junior academics and 450 administrative staff personnel). Of them, 366 participated in the survey, for a response rate of 23.6% (366/1550). Of these, 146 (39.9%) were senior academics, 109 (29.8%) were junior academics and 111 (30.3%) were administrative staff. In the groups of junior academics and administrative staff, most respondents were female (204; 55.7%), while the senior academics group was predominantly male (86; 58.9%). The mean age of all respondents was 47.9 ± 12.0 years, with a lower age for junior academics (33.2 ± 6.4 years). The most represented departments were Basic Sciences and Engineering (150; 41.0%) and Humanities (41; 11.2%). The full list of sociodemographic variables is shown in Table 1.

The prevalence of depressive and anxiety symptoms in the studied population was 25.7% (95% IC 21.5–30.4) and 22.7% (95% IC 18.7–27.2), respectively (dichotomous scoring criteria). Junior academics reported higher rates of depressive (39.4%) and anxiety (33.0%) symptoms than senior academics (depressive symptoms 14.4% and anxiety symptoms 15.1%) and administrative staff (depressive symptoms 27.0% and anxiety symptoms 22.5%), using dichotomous scoring criteria. Moreover, the severity of both mental disorders was higher in junior academics than in the other two groups (p < 0.001). Table 2 shows the PHD-9 and GAD-7 scores, and the risk of depressive and anxiety symptoms for all groups in the academic community.

In univariate analysis, junior academics were more likely to suffer from depressive and anxiety symptoms OR (95% CI) 3.86 (2.12–7.14) and 2.77 (1.52–5.13), respectively, compared with senior academics; similar results, although less severe, were found for administrative staff, who reported a higher frequency of depressive symptoms 2.20 (1.18–4.15) and anxiety symptoms 1.64 (0.86–3.12) compared with senior academics. In our population, female sex was associated with a significantly higher risk for anxiety symptoms OR 1.89 (1.13-3.17), whereas no statistically significant differences were found for depressive symptoms OR 1.48 (0.91–2.39).

Univariate regression confirmed that administrative staff also had a higher risk for depressive symptoms OR 2.20 (1.18–4.15), but not for anxiety symptoms OR 1.64 (0.86–3.12). However, when both sex and age were taken into account (with mean age as the cutoff), the significance of the role association decreased with a relative risk for depressive symptoms of 1.92 for junior academics (0.86–4.41) and 1.91 (0.99–3.71) for administrative staff. This model for depressive symptoms showed no difference with respect to sex (p = 0.33), but the overall risk for depression decreased with age OR 0.43 (0.21–0.88). For anxiety symptoms, the risk was higher among junior academics OR 2.12 (0.92–5.28) and among administrative staff OR 1.30 (0.70–2.55) than among senior academics. The risk for anxiety symptoms was significantly higher in women than in men (OR 1.85 (1.07–3.19)), while there was no significant association with age (p = 0.54). No significant differences were found in any of the multivariate models with respect to years of work experience, commuting distance, educational profile, marital status, or university department, so these results were not presented. The results of the multivariate model are presented in Table 3.

The UN-SAD study aimed to determine the prevalence of anxiety and depressive symptoms among academics at the University of Udine, to obtain data on mental health problems in academia [30, 31].

The results on depressive symptoms revealed a prevalence of 25.7% in our academic community, which seems to confirm a higher prevalence of moderate or severe depressive symptoms among academics compared to the general population, as reported both nationally [21] and internationally [7, 22, 23, 32]. The prevalence of depressive symptoms among junior academics (39.4%) is higher than among PhD students in biomedical sciences (10.1%) and in economics (18.0%), as well as among colleagues pursuing a master’s degree (39.0%) [30, 33, 34]. In addition, the distribution of PHQ-9 scores showed that a high proportion of junior academics suffered from moderate (28.4%), severe or moderately severe (11%) depressive symptoms. As for anxiety symptoms, only 22.7% of participants reported suffering from this mental health problem. Studies conducted in other countries such as Australia or the United Kingdom (UK) using the General Health Questionnaire (GHQ) to assess mental illness found that the prevalence of mental disorders in Australia was 43.7% [35], whereas in the UK it ranged from 31.8% among lecturers and senior lecturers [36] to 53% among academic staff [37]. It is likely that differences in the tool used for this assessment may have prevented us from making a fair comparison across data.

This study supports previous findings suggesting that the academic community is at higher risk for mental illness, particularly junior academics, compared with the general population and other occupations as reported by Winefield, e.g., engineers, transportation workers, general university staff [35]. Although some authors found no significant difference according to position or age [38, 39] and others found higher stress levels among senior positions [40], several studies reported higher stress levels among teachers in junior positions [6, 41, 42]. Some authors explained this by lower autonomy, lower salary, and greater job insecurity [1, 6, 13, 43]. In contrast to reports on Italian medical students [44], a higher prevalence of depressive or anxiety symptoms was not found among members of the academic community working away from home. Although some studies have not found an association between depressive or anxiety symptoms and sex or age [24, 31], our findings are consistent with those reporting higher levels of stress among women in academia, confirming the presence of some known gender differences in mental health problems [45, 46] even within the academic community, where women experience high levels of family and work stress [47]. In addition, depressive and anxiety symptoms occurred more frequently in our younger academics, confirming the observation of their higher levels of stress, which may be related to job insecurity [39]. In contrast to the reports of Winefield et al. [24], senior academics were less likely to suffer from depressive and anxiety symptoms than junior academics and administrative staff.

High external pressure, commonly referred to as the “publish or perish” aphorism, may play an important role in the mental health of academics. The higher prevalence of depressive and anxiety symptoms among junior academics may be an impact of career uncertainty and experiences in the demanding academic environment on the mental health of the younger ones. Because mental health problems are in turn associated with poor academic outcomes and productivity [48, 49] as well as retention in academic careers, investing in providing coping tools for junior academics could be strategic for both personal and professional empowerment. Universities should provide greater support to early career academics to encourage their effective and healthy contribution to the advancement of research. Nonetheless, strategies aimed at overcoming career uncertainty and supporting the process of fundraising for research would certainly contribute positively to this public health problem.