title: The relation of depression and anxiety to life-stress and achievement in students.
abstract: OBJECTIVE
  An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance.
  
  
  METHODS
  351 UK-domiciled undergraduates completed questionnaires one month before university entry and mid-course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid-course.
  
  
  RESULTS
  By mid-course 9% of previously symptom-free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre-entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid-course predicted a decrease in exam performance from first to second year.
  
  
  CONCLUSIONS
  This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre-existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.
authors.affiliation: Royal Holloway University of London, UK. b.andrews@rhul.ac.uk
authors.forename: Bernice
authors.initials: B
authors.lastname: Andrews
authors.forename: John M
authors.initials: JM
authors.lastname: Wilding
mesh_terms: D000124:Achievement; D000328:Adult; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000523:psychology*; D013334:Students / Q000523:psychology*