College students with depression are twice as likely as their classmates to drop out of school, new research shows.
However, the research also indicates that lower grade point averages depended upon a student's type of depression, according to Daniel Eisenberg, assistant professor in the University of Michigan School of Public Health and principal investigator of the study.
There are two core symptoms of depression---loss of interest and pleasure in activities, or depressed mood---but only loss of interest is associated with lower grade point averages.
"The correlation between depression and academic performance is mainly driven by loss of interest in activities," Eisenberg said. "This is significant because it means individuals can be very depressed and very functional, depending on which type of depression they have. I think that this can be true for many high achieving people, who may feel down and hopeless but not lose interest in activities.
"Lots of students who have significant depression on some dimension are performing just fine, but may be at risk and go unnoticed because there is no noticeable drop in functioning."
Students with both depression and anxiety had especially poor academic performance.
"If you take a student at the 50th percentile of the GPA distribution and compare them to a student with depression alone, the depressed student would be around the 37th percentile---a 13 percent drop," Eisenberg said. "However, a student with depression and anxiety plummets to about the 23rd percentile, a 50 percent drop."
In the study, Eisenberg and his colleagues conducted a Web survey of a random sample of approximately 2,800 undergraduate and graduate students about a range of mental health issues in fall 2005, and conducted a follow-up survey with a subset of the sample in fall 2007.
The dropout rate for University of Michigan students is about 5 percent per year, which is much lower than the national average, Eisenberg says. This likely reflects the type of high-achieving students Michigan attracts, along with U-M's support network for students experiencing emotional problems or depression.
"Michigan does seem to be a leader in many respects in terms of things the university has done related to student mental health," said Eisenberg, who noted that the next step in the research is a large scale study. "I see this study as suggesting that there is value in a large randomized trial of screening and treating depressed students, in which the academic outcomes are measured carefully. That's what it will take to really see what the value is in reducing the dropout rate and improving GPA. As far as I know this has not been done."
Many students with depression---as with the general population---remain untreated.
"Maybe the biggest reason is only about 50 percent of people with depression say they think they need help," Eisenberg said. "College students in particular may feel that stress is normal."
According to Eisenberg's research, certain types of students have higher levels of stigma. Males, students from lower-income backgrounds and Asian students, in particular, report higher levels of stigma about mental health.
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