Mental health, academic performance, and addictive behaviors among university student carers

Student mental health is an emerging global public health priority in higher education. Preliminary evidence indicates that caregiving is a mental health risk factor in university students. This study investigates demographic, educational, and caregiving variables as potential risk factors for university student carer mental health (anxiety, depression), addictive behaviors, and academic performance problems. 2,533 university students in Italy completed an online cross-sectional survey assessing depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder-7), 10 addictive behaviors (Screener for Substance and Behavioral Addictions), and self-assessed academic performance. Predictors included demographics variables (sex, age, nationality), educational variables (degree programme, residential status, enrollment status), caregiving context variables (carer-care recipient relationship, care recipient's type of health condition) and caregiving responsibilities. Student carers living with a family member with a serious health condition comprised 30.1% of the sample ( n = 762). Compared with non-carers, carers reported higher depressive symptoms ( B = 1.83, 95% CI [1.33, 2.33]; β = 0.14), higher anxiety symptoms ( B = 1.32, 95% CI [0.87, 1.77]; β = 0.11), and lower academic performance ( B = −0.21, 95% CI [−0.39, −0.02]; β = −0.05). Carer status was also associated with higher odds of problematic involvement in cannabis (OR = 1.69, 95% CI [1.25, 2.28]), food consumption (OR = 1.62, 95% CI [1.34, 1.95]), shopping (OR = 1.39, 95% CI [1.09, 1.78]), videogaming (OR = 1.29, 95% CI [1.06, 1.57]), and social-network use (OR = 1.26, 95% CI [1.06, 1.50]). Within the student-carer subgroup, after adjusting for all demographic, educational, caregiving-context, and caregiving-responsibility variables, caring for a family member with a mental health condition or intellectual disability was associated with higher depressive symptoms ( B = 1.66, 95% CI [0.54, 2.79]). Greater caregiving responsibilities were associated with higher depressive symptoms ( B = 1.12, 95% CI [0.62, 1.62]), higher anxiety symptoms ( B = 1.01, 95% CI [0.57, 1.44]), and higher odds of problematic food consumption (OR = 1.32, 95% CI [1.10, 1.59]), and physical exercise (OR = 1.31, 95% CI [1.08, 1.59]). Findings replicate prior evidence showing student carers are at higher risk than non-carer peers for mental health problems. Results extend prior research showing student carers are also at higher risk for addictive behaviors and poorer self-assessed academic performance. Findings highlight the incremental and simultaneous contributions of demographic, educational, and caregiving variables as risk factors for student carer mental health and addictive behaviors.