Risk factors associated with mental health outcomes and related conditions in graduate students: a systematic review

OBJECTIVE: The primary goal of this systematic review was to identify risk factors linked to mental health outcomes and related conditions, categorized across academic, biological, financial (academic/institutional funding), lifestyle, comorbidities, psychological, and social domains. The secondary goal was to estimate the prevalence of these mental health and related conditions. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review analyzed observational studies reporting risk factors associated with mental health outcomes and related conditions. RESULTS: Multiple factors associated with mental health outcomes and related conditions were identified, with the highest number of reports in the following domains: academic (37.0%; 47 factors) and psychological (19.7%; 25 factors), followed by social (13.4%; 17 factors), comorbidities (12.6%; 16 factors), biological (8.6%; 11 factors), lifestyle (6.3%; 8 factors), and financial (2.4%; 3 factors). Regarding prevalence estimates, perceived stress ranged from 18.6% to 88.0%; anxiety symptoms, from 18.8% to 75.0%; depressive symptoms, from 10.1% to 89.1%; suicide-related outcomes, from 1.8% to 9.9%; and problems with eating behavior, from 5.8% to 29.9%. CONCLUSIONS: The results of this systematic review demonstrate several risk factors associated with mental health outcomes and related conditions, suggesting that multiple aspects influence the mental health of graduate students. These findings, combined with the high prevalence estimates observed, justify the development of university policies to promote mental health in graduate education.