Depression, anxiety, substance use, and academic success among undergraduates: A healthy minds secondary analysis

Objective: To examine associations between depression, anxiety, substance use, and academic success among undergraduate students. Participants: Data were drawn from 76,406 students in the 2022–2023 Healthy Minds Study, with undergraduate analytic subsamples ranging from approximately 23,600 to 47,400 complete cases. Methods: Secondary analyses were conducted using zero-inflated Poisson regressions to assess relationships among depression, anxiety, alcohol, and marijuana use. Ordinary least squares and ordered logit models evaluated associations between mental health, substance use, and academic success. Results: Depression and anxiety were associated with alcohol and marijuana use, with depression showing a stronger association with alcohol involvement. Anxiety attenuated the association between depression and alcohol consumption. Depression and more frequent marijuana use were associated with lower self-reported grades, while anxiety showed a positive association with grades in multivariable models. Conclusions: Depression was consistently associated with substance use and academic outcomes, although effect sizes were small and associations were modest in magnitude.