The importance of physical and mental health in explaining health-related academic role impairment among college students

Chelsey R. Wilks, Randy P. Auerbach, Jordi Alonso, Corina Benjet, Ronny Bruffaerts, Pim Cuijpers, David D. Ebert, Jennifer G. Green, Claude A. Mellins, Philippe Mortier, Ekaterina Sadikova, Nancy A. Sampson, Ronald C. Kessler*

*Corresponding author for this work

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Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.

Original languageEnglish
Pages (from-to)54-61
Number of pages8
JournalJournal of Psychiatric Research
Early online date29 Jan 2020
Publication statusPublished - Apr 2020


The World Mental Health International College Student (WMH-ICS) initiative is carried out as part of the WHO World Mental Health (WMH) Survey Initiative. The WMH survey is supported by the National Institute of Mental Health (NIMH) [ R01MH070884 ], the John D. and Catherine T. MacArthur Foundation , the Pfizer Foundation , the US Public Health Service [ R13-MH066849 , R01-MH069864 , R01 DA016558 ], the Fogarty International Center (FIRCA) [ R03-TW006481 ], the Pan American Health Organization, Eli Lilly and Company , Ortho-McNeil Pharmaceutical , GlaxoSmithKline, and Bristol-Myers Squibb (RCK) . None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. A complete list of all WMH-ICS publications can be found at . WMH-ICS is funded, in part, by the US National Institute of Mental Health [ R56MH109566 ] (RPA); DIUE de la Generalitat de Catalunya [ 2017 SGR 452 ], Instituto de Salud Carlos III FEDER: Fondo Europeo de Desarrollo Regional [ PI13/00343 ] (JA); Consejo Nacional de Ciencia y Tecnología (CONACyT) [ CB-2016-01-285548 ] (CB); the Belgian Fund for Scientific Research [ 11N0514N/11N0516N/ 1114717N ], the King Baudouin Foundation [ 2014-J2140150-102905 ] and Eli Lilly [ IIT-H6U-BX-I002 ] (RB); Netherlands Organisation for Health Research and Development (ZonMw) [ 636110005 ] and the Protestants Fonds voor de Geestelijke Volksgezondheid (PFGV) in support of the student survey project (PC); BARMER , a health care insurance company for project StudiCare (DDE).

FundersFunder number
Belgian Fund for Scientific Research11N0514N/11N0516N/ 1114717N
Ortho-McNeil Pharmaceutical
Protestants Fonds voor de Geestelijke Volksgezondheid
National Institute of Mental HealthR13MH066849, R56MH109566, R01MH070884
Fogarty International Center
John D. and Catherine T. MacArthur Foundation
Eli Lilly and CompanyIIT-H6U-BX-I002
World Health Organization
U.S. Public Health ServiceR01 DA016558, R13-MH066849, R01-MH069864
Pfizer Foundation
Pan American Health Organization
Departament d'Innovació, Universitats i Empresa, Generalitat de Catalunya2017 SGR 452
Consejo Nacional de Ciencia y TecnologíaCB-2016-01-285548
Instituto de Salud Carlos IIIPI13/00343
Koning Boudewijnstichting2014-J2140150-102905


    • College students
    • Health-related academic role impairment
    • Mental health
    • Physical health


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