Mental Health Status among University Students during The Transition Period from High School to University in Lebanon: A cross-sectional study

Mental Health Status among University Students during The Transition Period from High School to University in Lebanon: A cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mental Health Status among University Students during The Transition Period from High School to University in Lebanon: A cross-sectional study Rawad Affan, Khalil Darwich, Georges Jarrouge, Theresia Hannouch, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5642301/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 May, 2025 Read the published version in BMC Public Health → Version 1 posted 6 You are reading this latest preprint version Abstract Background The transition from high school to university is a critical life stage associated with heightened vulnerability to mental health challenges. Despite global recognition, there is limited research on the psychosocial risks faced by first-year university students in Lebanon, a region further burdened by socio-economic and political instability. Objective To assess the mental health status of first-year university students in Lebanon, focusing on the prevalence and intensity of mental health challenges such as anxiety, depression, and stress during the transitional period. Methods This cross-sectional study involved 1,024 students from multiple Lebanese universities during the 2023–2024 academic year. Data were collected via a self-reported questionnaire and the General Health Questionnaire-28 (GHQ-28), that assesses mental health across four key dimensions: somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression. Descriptive statistics, chi-square tests and P-values were used to analyze demographic, behavioral, and mental health data. Results A significant gender difference in employment (χ² = 18.81, p = 0.00086) was found. The GHQ-28 survey results indicate that 64.3% of university students experience psychological distress, with higher prevalence among females (67.3%) than males (60.8%) (χ² = 4.42, p = 0.035). 31.7% reported sleep disturbances, 27.9% felt overwhelmed, and 33.2% experienced hopelessness. 18.8% had thoughts of self-harm, and 3.1% considered ending their life. The GHQ-28 scores indicate a high prevalence of mental health challenges, taking a score of 24 as a cut off score. Conclusions The study highlights the urgent need for targeted mental health interventions for Lebanese university students, addressing both universal and region-specific challenges. The findings emphasize the importance of early intervention, increased access to mental health resources, and promoting systemic changes to improve overall student well-being. Mental health University students Transitional period Anxiety Depression Stress GHQ-28 Psychological distress Lebanon Introduction Background The rise in high-risk behaviors, psychological distress, and mental health issues among first-year university students has become a global concern due to its considerable effects on long-term mental well-being, quality of life, and academic success (Deliens et al., 2015). The move from high school to university is one of the most demanding phases in a young adult’s life, involving changes in identity, finances, and social interactions (Wong, Cheung, Chan, Ma, & Tang, 2006). These adjustments underscore the importance of mental health during this time, with estimates suggesting that 15.6% of undergraduate students and 13% of graduate students will face depression and anxiety at some point in their lives (Eisenberg et al., 2007). Additionally, a survey of around 3,100 graduate students revealed that 44.7% reported experiencing significant emotional or stressful challenges in the previous year (Hyun et al., 2006). Knapp (2024) observed that the percentage of first-year students experiencing psychological distress rose from 35% in 2016 to 55% in 2020 (Knapp et al., 2024). Likewise, Rockwell et al. (2025) found a 50% increase in depression rates among first-generation college students in the U.S. during the COVID-19 pandemic (Rockwell et al., 2025). In the Middle East, a study from 2017 in Egypt highlighted gender differences in mental health outcomes, showing that young women had poorer mental health than their male counterparts, with academic performance negatively affecting mental health. Notably, 27% of participants reported a decline in their mental health over the study period (Liu et al., 2017). Mental health plays a vital role in overall well-being during this time. For example, a 2023 study involving Egyptian university students found a high rate of psychological distress, with 68% of participants reporting symptoms of moderate to severe mental health issues (Baklola et al., 2024). Furthermore, research in Egypt indicated that academic stressors and life stage transitions were major factors contributing to moderate depression among these students (Fawzy et al., 2017). A recent study by Halat et al. (2023) highlighted the significant role of health behaviors and psychological distress in shaping academic outcomes among Lebanese university students. Their findings revealed that students with regular breakfast consumption and lower psychological distress were more likely to achieve better academic performance, while unhealthy dietary habits and high levels of stress adversely affected academic success (Halat et al., 2023) The 2022 Psychopathology in Children and Adolescents in Lebanon Study is the first national survey to estimate the prevalence of psychiatric disorders among Lebanese youth. This survey found that 32.7% of children and adolescents screened positive for at least one psychiatric disorder, with anxiety (22.58%) and PTSD (19.72%) being the most common. Risk factors included low family income, chronic illness, bullying, and poor academic performance (Maalouf et al., 2022). In Lebanon, socio-economic instability exacerbates mental health challenges. A study found that 58.7% of Lebanese healthcare workers experienced high distress during the COVID-19 pandemic, highlighting the urgent need for mental health interventions (Bizri et al., 2021). In Lebanon, the mental health crisis has worsened due to socio-economic and political instability. Farran (2021) reported that the aftermath of the 2020 Beirut explosion caused significant psychological trauma among the youth, with 83% feeling sadness, 78% experiencing anxiety, and 11.5% having suicidal thoughts. The review emphasized the urgent need for prevention, early intervention, and systemic reforms to tackle these issues. (Farran, 2021). A study by Bosqui et al. (2020) highlighted the importance of accessible psychoeducational interventions to improve mental health awareness and coping strategies among adolescents in Lebanon. These findings underscore the urgent need for targeted mental health support in communities with limited access to formal care (Bosqui et al., 2020) A study by Maddah et al. (2021) introduced the first life skills intervention aimed at enhancing well-being among university students in the Arab region. The findings demonstrated a positive impact on students' mental health, reinforcing the necessity of targeted interventions to support psychological resilience during academic transitions (Maddah et al., 2021). Rationale Despite the global focus on student mental health, there is a notable lack of thorough research in Lebanon that addresses the specific challenges faced by first-year university students. This study seeks to fill this gap by exploring the psychosocial risks and mental health status of students making the transition from high school to university in Lebanon. Objectives The main goal of this study is to examine how common, severe, and frequent mental health among university students’ issues between males and females like anxiety, depression, and stress are during this important transition period. By identifying key psychological stressors faced by students during this critical period, this research aims to contribute to the existing literature by offering insights into mental health patterns and informing targeted interventions to support student well-being. Materials and methods This cross-sectional study took place at several universities in Lebanon during the 2023–2024 academic year. Data was gathered through a self-reported recall survey. A convenience sampling method was used, with participants recruited via an online questionnaire shared through university networks and social media. The English version of the questionnaire was used. The questionnaire gathered socio-demographic details such as gender and age. Additionally, information on parental and household characteristics was gathered, including parental employment status (employed, unemployed, self-employed, retired), parental education level, number of children in the family, household income, and housing status (own vs. rent). Assessment of Mental Health Participants' mental health was assessed using the General Health Questionnaire-28 (GHQ-28), a well-validated tool that evaluates mental health status (Goldberg & Hillier, 1979). The GHQ-28 is a widely used screening tool for psychological distress and has been validated in Lebanon, demonstrating good reliability and applicability in the Lebanese population (Maalouf et al., 2022) (Bizri et al., 2021). The GHQ-28 uses a four-point Likert scale (0–3), where lower scores reflect better mental health based on responses such as ‘better than usual’ (0), ‘same as usual’ ( 1 ), ‘worse than usual’ ( 2 ), and ‘much worse than usual’ ( 3 ). The total score is then calculated and ranged from 0 to 84, with a threshold of 24 or higher indicating possible mental health concerns. Ethical Considerations The study received ethical approval from the Institutional Review Board (IRB) and Ethical Committee at the Holy Spirit University of Kaslik (approval number: HCR/EC 2024-041). The research followed the principles outlined in the Declaration of Helsinki (World Medical Association, 2013). Participants were thoroughly informed about the study’s objectives and procedures prior to their involvement. Informed consent was obtained electronically, and participation was completely voluntary. We ensured that data confidentiality and anonymity were rigorously maintained to safeguard participants’ privacy. Data Collection and Analysis The survey was distributed among university students throughout Lebanon to obtain a diverse sample of the student population. Since participants were recruited through voluntary participation, the sample may not fully represent all first-year students. This is a convenient sample. The data collected through the questionnaires were anonymized and securely stored. Statistical analyses were performed using IBM SPSS Statistics (version 22). Descriptive statistics were utilized to summarize demographic and behavioral characteristics. Statistical results were presented using frequencies, percentages, chi-square test results, and corresponding p-values. Results Table 1 Demographic and Work-Related Characteristics of University Students Category Male Female Chi-square χ² P-value Gender 474 (46.3%) 550 (53.7%) Work Status Part-time: 120 (25.3%) 135 (24.5%) 18.81 0.00086 (< 0.05) Day Shift: 40 (8.4%) 24 (4.4%) Night Shift: 32 (6.7%) 22 (4%) Full-time: 19 (4%) 10 (1.8%) None: 263 (55.5%) 359 (65.3%) The analysis reveals key insights into university students' demographics, academic choices, and work status. The sample is evenly divided between males (46.3%) and females (53.7%), and all respondents were aged 17–23 years . As for work status, 60.7% of students did not work during their studies, with females (65.3%) being more likely to be non-working compared to males (55.5%). Among those who worked, 24.9% were employed part-time, and 2.8% worked full-time. A Chi-Square Test for Independence confirmed a statistically significant difference in work status between males and females (χ² = 18.81, p = 0.00086), indicating that these differences are unlikely to be due to chance. Males were more likely than females to work day-shifts (8.4% vs. 4.4%), night shifts (6.7% vs. 4.0%), and full-time jobs (4.0% vs. 1.8%), further reinforcing the gender-based disparity in employment during studies. Table 2 Parental and Household Characteristics of University Students Category Total Father's Occupation Employed 734 (71.7%) Unemployed 47 (4.6%) Self-employed 179 (17.5%) Retired 64 (6.3%) Mother's Occupation Employed 629 (61.4%) Unemployed 259 (25.3%) Self-employed 105 (10.3%) Retired 31 (3%) Status of Father Alive 962 (93.9%) Deceased 35 (3.4%) Status of Mother Alive 960 (93.8%) Deceased 37 (3.6%) Divorced parents 27 (2.6%) Number of Children in Family 1 107 (10.4%) 2 396 (38.7%) 3 259 (25.3%) 4 188 (18.4%) More than 4 74 (7.2%) Highest Level of Parental Education Less than high school 34 (3.3%) High school 154 (15%) Diploma 150 (14.6%) Some college/Technical training 252 (24.6%) Bachelor's degree 320 (31.3%) Graduate/professional degree 114 (11.1%) Monthly Household Income Less than $ 500 56 (5.5%) $ 500 - $ 1000 266 (26%) $ 1000 - $ 1500 316 (30.9%) $ 1500 - $ 2000 232 (22.7%) $ 2000 - $ 2500 94 (9.2%) More than $ 2500 60 (5.9%) Housing Status of Family Renting 197 (19.2%) Own 812 (79.3%) Others 15 (1.5%) The analysis of parental and household characteristics shows that most students come from families with employed parents, with 71.7% of fathers and 61.4% of mothers employed. The majority of parents are alive, with a small percentage divorced or deceased. Most families have two or three children, and many parents have attained higher education, with 31.3% holding a bachelor's degree. In terms of income, the most common household earnings fall between $ 1000 and $ 1500 per month, and the majority of families own their homes. These findings suggest that students generally come from stable and moderately affluent households, with a significant portion benefiting from higher educational backgrounds. Table 3 Health-Related Habits and Medication Use Among University Students Category Total Do You Smoke? Yes 314 (30.7%) No 710 (69.3%) Frequency of Physical Exercise Never 256 (25%) once a month 369 (36%) 1–2 times per week 211 (20.6%) 3–5 times per week 126 (12.3%) Daily 62 (6.1%) Frequency of Alcohol Consumption Never 584 (57%) once a month 276 (27%) 1–2 times per week 129 (12.6%) 3–5 times per week 21 (2.1%) Daily 14 (1.4%) Do You Take Any Specific Medications? Chronic diseases 49 (4.8%) Mental disorders 42 (4.1%) Psychological disorders 29 (2.8%) Headache 77 (7.5%) Menstrual pain 164 (16%) None 663 (64.7%) The analysis of health-related habits and medication use among university students shows that 69.3% of students do not smoke, with 30.7% reporting smoking. Most students engage in limited physical activity, with 36% exercising rarely and 25% not exercising at all. 57% of students report never consuming alcohol, while 27% drink rarely, and a small percentage consume alcohol regularly. In terms of medication use, 64.7% of students do not take any specific medications, but common reasons for medication use include menstrual pain (16%), headaches (7.5%), and chronic diseases (4.8%). Table 4 Mental Health Assessment Using the GHQ-28 Survey Question Likert scale indicators A) Somatic Symptoms 1- Feeling well and in good health? Better than usual (199, 19.4%) Same as usual (531, 51.9%) Worse than usual (214, 20.9%) Much worse than usual (80, 7.8%) 2- Feeling in need of a tonic? Not at all (492, 48.0%) No more than usual (301, 29.4%) Rather more than usual (164, 16.0%) Much more than usual (67, 6.5%) 3- Feeling run-down and out of sorts? Not at all (361, 35.3%) No more than usual (377, 36.8%) Rather more than usual (238, 23.2%) Much more than usual (48, 4.7%) 4- Felt that you are ill? Not at all (401, 39.2%) No more than usual (375, 36.6%) Rather more than usual (202, 19.7%) Much more than usual (46, 4.5%) 5- Pains in your head? Not at all (409, 39.9%) No more than usual (331, 32.3%) Rather more than usual (210, 20.5%) Much more than usual (74, 7.2%) 6- Feeling of tightness or pressure? Not at all (404, 39.5%) No more than usual (348, 34.0%) Rather more than usual (200, 19.5%) Much more than usual (72, 7.0%) 7- Hot or cold spells? Not at all (444, 43.4%) No more than usual (328, 32.0%) Rather more than usual (192, 18.8%) Much more than usual (60, 5.9%) B) Anxiety and Insomnia 8- Lost sleep over worry? Not at all (364, 35.5%) No more than usual (336, 32.8%) Rather more than usual (219, 21.4%) Much more than usual (105, 10.3%) 9- Difficulty staying asleep once off? Not at all (413, 40.3%) No more than usual (345, 33.7%) Rather more than usual (174, 17.0%) Much more than usual (92, 9.0%) 10- Feeling constantly under strain? Not at all (406, 39.6%) No more than usual (341, 33.3%) Rather more than usual (203, 19.8%) Much more than usual (74, 7.2%) 11- Getting edgy and bad-tempered? Not at all (411, 40.1%) No more than usual (353, 34.5%) Rather more than usual (191, 18.7%) Much more than usual (69, 6.7%) 12- Getting scared or panicky for no reason? Not at all (433, 42.3%) No more than usual (331, 32.3%) Rather more than usual (190, 18.6%) Much more than usual (70, 6.8%) 13- Everything getting on top of you? Not at all (401, 39.2%) No more than usual (314, 30.7%) Rather more than usual (216, 21.1%) Much more than usual (93, 9.1%) 14- Feeling nervous and strung-up? Not at all (453, 44.2%) No more than usual (336, 32.8%) Rather more than usual (149, 14.6%) Much more than usual (86, 8.4%) C) Social Dysfunction 15- Managing to keep busy and occupied? More so than usual (270, 26.4%) Same as usual (497, 48.5%) Rather less than usual (197, 19.2%) Much less than usual (60, 5.9%) 16- Taking longer over tasks? Quicker than usual (192, 18.8%) Same as usual (464, 45.3%) Longer than usual (279, 27.2%) Much longer than usual (89, 8.7%) 17- Doing things well? Better than usual (217, 21.2%) About the same (487, 47.6%) Less well than usual (246, 24.0%) Much less well (74, 7.2%) 18- Satisfied with tasks? More satisfied (224, 21.9%) About the same (412, 40.2%) Less satisfied (281, 27.4%) Much less satisfied (107, 10.4%) 19- Playing a useful part? More so than usual (205, 20.0%) Same as usual (472, 46.1%) Less useful (251, 24.5%) Much less useful (96, 9.4%) 20- Capable of making decisions? More so than usual (216, 21.1%) Same as usual (440, 43.0%) Less so (258, 25.2%) Much less capable (110, 10.7%) 21- Enjoying day-to-day activities? More so than usual (175, 17.1%) Same as usual (452, 44.1%) Less so (266, 26.0%) Much less (131, 12.8%) D) Severe Depression 22- Thinking of self as worthless? Not at all (458, 44.7%) No more than usual (307, 30.0%) Rather more (184, 18.0%) Much more (75, 7.3%) 23- Life entirely hopeless? Not at all (372, 36.3%) No more than usual (312, 30.5%) Rather more (258, 25.2%) Much more (82, 8.0%) 24- Life isn’t worth living? Not at all (490, 47.9%) No more than usual (287, 28.0%) Rather more (151, 14.7%) Much more (96, 9.4%) 25- Thought of ending life? Definitely not (456, 44.5%) I don’t think so (344, 33.6%) Has crossed mind (192, 18.8%) Definitely have (32, 3.1%) 26- Nerves too bad to act? Not at all (426, 41.6%) No more than usual (317, 31.0%) Rather more than usual (197, 19.2%) Much more than usual (84, 8.2%) 27- Wishing you were dead? Not at all (490, 47.9%) No more than usual (278, 27.1%) Rather more than usual (172, 16.8%) Much more than usual (84, 8.2%) 28- Idea of ending life keeps coming? Definitely not (556, 54.3%) I don’t think so (294, 28.7%) Has crossed mind (142, 13.9%) Definitely has (32, 3.1%) The GHQ-28 survey results highlight significant psychological distress among university students. The results indicated that the mean GHQ-28 score among participants was 27.88 (SD = 0.93), with observed scores ranging from 0 to 54. It was used to assess mental health status across four key domains: Somatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression. In the Somatic Symptoms domain , 28.7% of students reported feeling worse than usual or much worse than usual in terms of overall health. Additionally, 26.5% experienced a sense of being run-down, while 27.7% complained of headaches, and 26.5% reported feelings of tightness or pressure. For Anxiety and Insomnia , 31.7% of participants reported losing sleep over worry more than usual, while 26.6% experienced persistent strain. Additionally, 27.9% of students reported feeling overwhelmed, and 25.4% suffered from frequent panic or nervousness. The Social Dysfunction domain revealed that 26.4% of students struggled to keep busy, 27.2% reported taking longer to complete tasks, and 35.9% experienced difficulties in decision-making. Moreover, 38.8% of students indicated a decline in their ability to enjoy daily activities. In terms of Severe Depression , 33.2% of students reported feelings of hopelessness, while 24.1% considered their life entirely hopeless. Alarmingly, 18.8% had thoughts of self-harm, and 3.1% seriously considered ending their life. Additionally, 25% of students felt worthless more than usual. Table 5 Classification of Psychiatric and Non-Psychiatric Groups Based on GHQ-28 Scores Male Female Total Chi-square χ² P-value Non-Psychiatric 186, 39.2% 180, 32.7% 366, 35.7% 4.42 0.0035 (< 0.05) Psychiatric 288, 60.8% 370, 67.3% 658, 64.3% Based on GHQ-28 scores, participants were categorized into ‘Psychiatric’ and ‘Non-Psychiatric’ groups. Participants scoring ≥ 24 are classified as ‘Psychiatric,’ while those scoring < 24 are classified as ‘Non-Psychiatric.’ The total possible scores range from 0 to 84. The results indicate that 64.3% of the total population falls under the ‘Psychiatric’ category, suggesting a high prevalence of mental health issues such as anxiety, stress, or depression, while 35.7% were classified as ‘Non-Psychiatric,’ indicating stable mental well-being. Among males, 60.8% (288 participants) were classified as ‘Psychiatric,’ while 39.2% (186 participants) were in the ‘Non-Psychiatric’ group. For females, 67.3% (370 participants) were categorized as ‘Psychiatric,’ whereas 32.7% (180 participants) were in the ‘Non-Psychiatric’ group. These results suggest a slightly higher proportion of females experiencing psychological distress compared to males. A Chi-Square Test for Independence was performed to assess whether gender and psychiatric classification are significantly associated. The results yielded a Chi-Square statistic (χ²) of 4.42 (df = 1) and a p-value of 0.035 indicating a statistically significant relationship between gender and psychiatric classification. Discussion The shift from high school to university is a crucial time for students, filled with academic, social, and personal challenges that can greatly affect their mental health. This study found that 64.3% of participants showed signs of psychological distress based on their GHQ-28 scores, which aligns with global patterns indicating increased susceptibility to mental health issues during this transition (Eisenberg et al., 2007; Knapp et al., 2024). Auerbach et al. (2016) noted that about one-third of first-year university students face a mental disorder, with anxiety and depression being the most prevalent worldwide (Auerbach et al., 2016). A 2024 cross-sectional study in India by Sharma et al. revealed that 61.4% of university students reported depressive symptoms during their first year, with academic stress and familial expectations being significant contributors. These results closely resemble our findings, reinforcing the notion that the high prevalence of depressive symptoms is a global issue among university students (Sharma et al. 2022). In a study from Nigeria, Okafor et al. (2022) explored the mental health of university students and found that 48.6% experienced moderate to severe anxiety, primarily due to academic pressure and social adjustment challenges. This is comparable to the 26.6% of Lebanese students reporting anxiety in our study, indicating shared stressors among student populations in developing nations (Okafor et al., 2022). The prevalence of severe depressive symptoms was concerning, with 33.2% of participants feeling hopeless and 3.1% contemplating self-harm. Similar studies have shown that depressive symptoms tend to spike during transitional phases due to a mix of academic, social, and financial pressures (Beiter et al., 2015). These results are in line with research from Egypt, where 68% of university students reported experiencing moderate to severe mental health issues, primarily due to academic pressures and life changes (Baklola et al., 2024). Likewise, a study focusing on first-generation college students in the United States found a 50% rise in depression rates during the COVID-19 pandemic (Rockwell et al., 2025). The study by Halat et al. (2023) found that better dietary habits, such as regular breakfast consumption, and lower psychological distress positively influenced academic performance among Lebanese university students (Halat et al., 2023). Comparatively, our research emphasizes that 64.3% of students are psychiatric among first-year students. Our study findings are comparable to the 58.7% distress observed among Lebanese healthcare workers in the study by Bizri et al. (2021). Both studies utilized the General Health Questionnaire-28 (GHQ-28) to assess mental health, reinforcing the validity of our findings within the Lebanese context. (Bizri et al., 2021). Our findings align with Bosqui et al. (2020), who emphasized the role of psychoeducational interventions in addressing mental health challenges among adolescents in Lebanon. While their study focused on using a comic book to disseminate mental health knowledge, both studies highlight the prevalence of psychological distress and the necessity of culturally adapted mental health resources (Bosqui et al., 2020). This situation may stem from cultural attitudes toward mental health and the availability of support systems. In contrast, Lebanese students encounter distinct stressors, such as ongoing socio-economic instability and the lingering effects of traumatic events like the 2020 Beirut explosion, which have increased psychological vulnerability (Farran, 2021). The socio-economic challenges in Lebanon complicate the mental health landscape for students. The study revealed a concerning prevalence of feelings of hopelessness and worthlessness, with 33.2% of students reporting these symptoms. This is particularly alarming when compared to the global average, where such severe symptoms are reported by about 15–20% of university students (Hyun et al., 2006). This significant difference highlights the urgent need for mental health initiatives specifically designed for the Lebanese context. Strengths and Limitations The limitations of this study it was a convenient cross-sectional study and that’s why findings cannot be generalized. The strength of the study is that’s the first one which has been done in Lebanon, in a large sample of university students, to study the mental health status in the transition period from high school to university. Conclusion This study highlights the high prevalence of mental health issues among university students in Lebanon during their transition from high school, with 64.3% of participants being psychiatric. These findings underscore the pressing need to address student mental health, particularly considering Lebanon’s unique socio-economic and political challenges. When compared to global data, the results reveal both shared and region-specific trends. Similarities with neighboring countries, such as Egypt, suggest common socio-cultural pressures, while differences from Western and Asian contexts reflect the distinct impact of Lebanon’s socio-political instability on student well-being. By providing a clearer picture of the mental health landscape among Lebanese university students, this research emphasizes the importance of proactive measures to support student well-being. Universities, policymakers, and healthcare providers should prioritize early intervention, improved access to mental health services, and the promotion of healthy coping strategies. Future research should focus on tracking long-term mental health trends and evaluating the effectiveness of interventions tailored to the Lebanese context. Declarations Acknowledgment to the holy spirit university of kaslik. Ethics Approval: This research is approved by the university ethical committee and the Institutional Review Board (approval number: HCR/EC 2024-041). Informed Consent: All participants provided written informed consent prior to their enrollment in the study, and participation was completely voluntary. We ensured that data confidentiality and anonymity were rigorously maintained to safeguard participants’ privacy. Conflict of Interest: All the authors declare no competing interests. Funding Declaration: This research is not funded. References Deliens: Deliens, T., Clarys, P., De Bourdeaudhuij, I., & Deforche, B. (2013). Weight, socio-demographics, and health behaviour related correlates of academic performance in first year university students. 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Journal of Health Psychology, 27(6), 1288–1300. https://doi.org/10.1177/1359105321991630 Farran, Natali. “Mental health in Lebanon: Tomorrow’s silent epidemic.” Mental Health & Prevention, vol. 24, Dec. 2021, p. 200218. https://doi.org/10.1016/j.mhp.2021.200218. Bosqui, T., Mayya, A., Younes, L., Baker, M. C., & Annan, I. M. (2020). Disseminating evidence-based research on mental health and coping to adolescents facing adversity in Lebanon: A pilot of a psychoeducational comic book ‘Somoud.’ Conflict and Health, 14(78). https://doi.org/10.1186/s13031-020-00324-7 Maddah, D., Saab, Y., Safadi, H., Abi Farraj, N., Hassan, Z., Turner, S., Echeverri, L., Alami, N. H., Kababian-Khasholian, T., & Salameh, P. (2021). The first life skills intervention to enhance well-being amongst university students in the Arab world: 'Khotwa' pilot study. Health psychology open, 8(1), 20551029211016955. https://doi.org/10.1177/20551029211016955 Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9(1), 139–145. https://doi.org/10.1017/S0033291700021644 World Medical Association. (2013). Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Demyttenaere, K., Florescu, S., … Bruffaerts, R. (2016). Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychological medicine, 46(14), 2955–2970. https://doi.org/10.1017/S0033291716001665 Sharma, S. K., Joseph, J., Varkey, B. P., Dhandapani, M., Varghese, A., Sharma, S., Kumar, T. K. A., Kaririya, S., & Mathews, E. (2022). Prevalence of anxiety and depressive symptoms during COVID-19 pandemic among the general population in India: A systematic review and meta-analysis. Journal of neurosciences in rural practice, 13(4), 608–617. https://doi.org/10.25259/JNRP-2022-1-21-R3-(2324) Okafor, K. C., Bimba, J. S., Adekeye, O. A., Obateru, A. P., & Idoko, L. O. (2022). The Prevalence and Pattern of Use of Alcohol among Undergraduate Students in Jos Plateau State, Nigeria. Open Journal of Preventive Medicine, 12(8), 141–154. https://doi.org/10.4236/ojpm.2022.128011 Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of affective disorders, 173, 90–96. https://doi.org/10.1016/j.jad.2014.10.054 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 19 May, 2025 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 29 Apr, 2025 Reviews received at journal 23 Apr, 2025 Reviewers agreed at journal 18 Apr, 2025 Reviewers invited by journal 02 Apr, 2025 Submission checks completed at journal 02 Apr, 2025 First submitted to journal 31 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5642301","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":437589968,"identity":"d746d330-c8ff-46c4-aca1-d5a898d2ded3","order_by":0,"name":"Rawad Affan","email":"data:image/png;base64,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","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":true,"prefix":"","firstName":"Rawad","middleName":"","lastName":"Affan","suffix":""},{"id":437589969,"identity":"6a821d21-a5a3-44d9-ba51-1f348c0da94d","order_by":1,"name":"Khalil Darwich","email":"","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":false,"prefix":"","firstName":"Khalil","middleName":"","lastName":"Darwich","suffix":""},{"id":437589970,"identity":"d35e3941-fb62-428a-95aa-980e20ed2718","order_by":2,"name":"Georges Jarrouge","email":"","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":false,"prefix":"","firstName":"Georges","middleName":"","lastName":"Jarrouge","suffix":""},{"id":437589971,"identity":"5309a6f5-22bb-4251-9c3e-db7d82314361","order_by":3,"name":"Theresia Hannouch","email":"","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":false,"prefix":"","firstName":"Theresia","middleName":"","lastName":"Hannouch","suffix":""},{"id":437589972,"identity":"36552634-ea63-4c97-9b44-8617c180b445","order_by":4,"name":"Shafika Assaad","email":"","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":false,"prefix":"","firstName":"Shafika","middleName":"","lastName":"Assaad","suffix":""}],"badges":[],"createdAt":"2024-12-14 08:23:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5642301/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5642301/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-23087-3","type":"published","date":"2025-05-19T15:57:36+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":83460021,"identity":"452f79b2-4d92-481e-b38a-f4fbb002f7fc","added_by":"auto","created_at":"2025-05-26 16:09:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":992045,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5642301/v1/c1062545-8e0c-4ec9-b8fa-ca0ee593b7fa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mental Health Status among University Students during The Transition Period from High School to University in Lebanon: A cross-sectional study","fulltext":[{"header":"Introduction","content":"\n\u003ch3\u003eBackground\u003c/h3\u003e\n\u003cp\u003eThe rise in high-risk behaviors, psychological distress, and mental health issues among first-year university students has become a global concern due to its considerable effects on long-term mental well-being, quality of life, and academic success (Deliens et al., 2015).\u003c/p\u003e \u003cp\u003eThe move from high school to university is one of the most demanding phases in a young adult\u0026rsquo;s life, involving changes in identity, finances, and social interactions (Wong, Cheung, Chan, Ma, \u0026amp; Tang, 2006). These adjustments underscore the importance of mental health during this time, with estimates suggesting that 15.6% of undergraduate students and 13% of graduate students will face depression and anxiety at some point in their lives (Eisenberg et al., 2007). Additionally, a survey of around 3,100 graduate students revealed that 44.7% reported experiencing significant emotional or stressful challenges in the previous year (Hyun et al., 2006).\u003c/p\u003e \u003cp\u003eKnapp (2024) observed that the percentage of first-year students experiencing psychological distress rose from 35% in 2016 to 55% in 2020 (Knapp et al., 2024). Likewise, Rockwell et al. (2025) found a 50% increase in depression rates among first-generation college students in the U.S. during the COVID-19 pandemic (Rockwell et al., 2025).\u003c/p\u003e \u003cp\u003eIn the Middle East, a study from 2017 in Egypt highlighted gender differences in mental health outcomes, showing that young women had poorer mental health than their male counterparts, with academic performance negatively affecting mental health. Notably, 27% of participants reported a decline in their mental health over the study period (Liu et al., 2017).\u003c/p\u003e \u003cp\u003eMental health plays a vital role in overall well-being during this time. For example, a 2023 study involving Egyptian university students found a high rate of psychological distress, with 68% of participants reporting symptoms of moderate to severe mental health issues (Baklola et al., 2024). Furthermore, research in Egypt indicated that academic stressors and life stage transitions were major factors contributing to moderate depression among these students (Fawzy et al., 2017).\u003c/p\u003e \u003cp\u003eA recent study by Halat et al. (2023) highlighted the significant role of health behaviors and psychological distress in shaping academic outcomes among Lebanese university students. Their findings revealed that students with regular breakfast consumption and lower psychological distress were more likely to achieve better academic performance, while unhealthy dietary habits and high levels of stress adversely affected academic success (Halat et al., 2023)\u003c/p\u003e \u003cp\u003eThe 2022 Psychopathology in Children and Adolescents in Lebanon Study is the first national survey to estimate the prevalence of psychiatric disorders among Lebanese youth. This survey found that 32.7% of children and adolescents screened positive for at least one psychiatric disorder, with anxiety (22.58%) and PTSD (19.72%) being the most common. Risk factors included low family income, chronic illness, bullying, and poor academic performance (Maalouf et al., 2022).\u003c/p\u003e \u003cp\u003eIn Lebanon, socio-economic instability exacerbates mental health challenges. A study found that 58.7% of Lebanese healthcare workers experienced high distress during the COVID-19 pandemic, highlighting the urgent need for mental health interventions (Bizri et al., 2021).\u003c/p\u003e \u003cp\u003eIn Lebanon, the mental health crisis has worsened due to socio-economic and political instability. Farran (2021) reported that the aftermath of the 2020 Beirut explosion caused significant psychological trauma among the youth, with 83% feeling sadness, 78% experiencing anxiety, and 11.5% having suicidal thoughts. The review emphasized the urgent need for prevention, early intervention, and systemic reforms to tackle these issues. (Farran, 2021).\u003c/p\u003e \u003cp\u003eA study by Bosqui et al. (2020) highlighted the importance of accessible psychoeducational interventions to improve mental health awareness and coping strategies among adolescents in Lebanon. These findings underscore the urgent need for targeted mental health support in communities with limited access to formal care (Bosqui et al., 2020)\u003c/p\u003e \u003cp\u003eA study by Maddah et al. (2021) introduced the first life skills intervention aimed at enhancing well-being among university students in the Arab region. The findings demonstrated a positive impact on students' mental health, reinforcing the necessity of targeted interventions to support psychological resilience during academic transitions (Maddah et al., 2021).\u003c/p\u003e\n\u003ch3\u003eRationale\u003c/h3\u003e\n\u003cp\u003eDespite the global focus on student mental health, there is a notable lack of thorough research in Lebanon that addresses the specific challenges faced by first-year university students. This study seeks to fill this gap by exploring the psychosocial risks and mental health status of students making the transition from high school to university in Lebanon.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eThe main goal of this study is to examine how common, severe, and frequent mental health among university students\u0026rsquo; issues between males and females like anxiety, depression, and stress are during this important transition period. By identifying key psychological stressors faced by students during this critical period, this research aims to contribute to the existing literature by offering insights into mental health patterns and informing targeted interventions to support student well-being.\u003c/p\u003e \u003c/div\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis cross-sectional study took place at several universities in Lebanon during the 2023\u0026ndash;2024 academic year. Data was gathered through a self-reported recall survey. A convenience sampling method was used, with participants recruited via an online questionnaire shared through university networks and social media. The English version of the questionnaire was used. The questionnaire gathered socio-demographic details such as gender and age. Additionally, information on parental and household characteristics was gathered, including parental employment status (employed, unemployed, self-employed, retired), parental education level, number of children in the family, household income, and housing status (own vs. rent).\u003c/p\u003e\n\u003ch3\u003eAssessment of Mental Health\u003c/h3\u003e\n\u003cp\u003eParticipants' mental health was assessed using the General Health Questionnaire-28 (GHQ-28), a well-validated tool that evaluates mental health status (Goldberg \u0026amp; Hillier, 1979). The GHQ-28 is a widely used screening tool for psychological distress and has been validated in Lebanon, demonstrating good reliability and applicability in the Lebanese population (Maalouf et al., 2022) (Bizri et al., 2021). The GHQ-28 uses a four-point Likert scale (0\u0026ndash;3), where lower scores reflect better mental health based on responses such as \u0026lsquo;better than usual\u0026rsquo; (0), \u0026lsquo;same as usual\u0026rsquo; (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), \u0026lsquo;worse than usual\u0026rsquo; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), and \u0026lsquo;much worse than usual\u0026rsquo; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The total score is then calculated and ranged from 0 to 84, with a threshold of 24 or higher indicating possible mental health concerns.\u003c/p\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e The study received ethical approval from the Institutional Review Board (IRB) and Ethical Committee at the Holy Spirit University of Kaslik (approval number: HCR/EC 2024-041). The research followed the principles outlined in the Declaration of Helsinki (World Medical Association, 2013). Participants were thoroughly informed about the study\u0026rsquo;s objectives and procedures prior to their involvement. Informed consent was obtained electronically, and participation was completely voluntary. We ensured that data confidentiality and anonymity were rigorously maintained to safeguard participants\u0026rsquo; privacy.\u003c/p\u003e\n\u003ch3\u003eData Collection and Analysis\u003c/h3\u003e\n\u003cp\u003eThe survey was distributed among university students throughout Lebanon to obtain a diverse sample of the student population. Since participants were recruited through voluntary participation, the sample may not fully represent all first-year students. This is a convenient sample. The data collected through the questionnaires were anonymized and securely stored. Statistical analyses were performed using IBM SPSS Statistics (version 22). Descriptive statistics were utilized to summarize demographic and behavioral characteristics. Statistical results were presented using frequencies, percentages, chi-square test results, and corresponding p-values.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic and Work-Related Characteristics of University Students\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChi-square χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e474 (46.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e550 (53.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePart-time:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e135 (24.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e18.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.00086 (\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay Shift:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (8.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (4.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNight Shift:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull-time:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e263 (55.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e359 (65.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe analysis reveals key insights into university students' demographics, academic choices, and work status. The sample is evenly divided between males (46.3%) and females (53.7%), and all respondents were aged \u003cb\u003e17\u0026ndash;23 years\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eAs for work status, 60.7% of students did not work during their studies, with females (65.3%) being more likely to be non-working compared to males (55.5%). Among those who worked, 24.9% were employed part-time, and 2.8% worked full-time. A Chi-Square Test for Independence confirmed a statistically significant difference in work status between males and females (χ\u0026sup2; = 18.81, p\u0026thinsp;=\u0026thinsp;0.00086), indicating that these differences are unlikely to be due to chance. Males were more likely than females to work day-shifts (8.4% vs. 4.4%), night shifts (6.7% vs. 4.0%), and full-time jobs (4.0% vs. 1.8%), further reinforcing the gender-based disparity in employment during studies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParental and Household Characteristics of University Students\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather's Occupation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e734 (71.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (4.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e179 (17.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (6.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMother's Occupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e629 (61.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e259 (25.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e105 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStatus of Father\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e962 (93.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeceased\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35 (3.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStatus of Mother\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e960 (93.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeceased\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDivorced parents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (2.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of Children in Family\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e396 (38.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e259 (25.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e188 (18.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHighest Level of Parental Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e154 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e150 (14.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSome college/Technical training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e252 (24.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e320 (31.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduate/professional degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Household Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than \u003cspan\u003e$\u003c/span\u003e500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56 (5.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e500 - \u003cspan\u003e$\u003c/span\u003e1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e266 (26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e1000 - \u003cspan\u003e$\u003c/span\u003e1500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e316 (30.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e1500 - \u003cspan\u003e$\u003c/span\u003e2000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e232 (22.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e2000 - \u003cspan\u003e$\u003c/span\u003e2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (9.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than \u003cspan\u003e$\u003c/span\u003e2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousing Status of Family\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e197 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOwn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e812 (79.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (1.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe analysis of parental and household characteristics shows that most students come from families with employed parents, with 71.7% of fathers and 61.4% of mothers employed. The majority of parents are alive, with a small percentage divorced or deceased. Most families have two or three children, and many parents have attained higher education, with 31.3% holding a bachelor's degree. In terms of income, the most common household earnings fall between \u003cspan\u003e$\u003c/span\u003e1000 and \u003cspan\u003e$\u003c/span\u003e1500 per month, and the majority of families own their homes. These findings suggest that students generally come from stable and moderately affluent households, with a significant portion benefiting from higher educational backgrounds.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHealth-Related Habits and Medication Use Among University Students\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo You Smoke?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e314 (30.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e710 (69.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of Physical Exercise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e256 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eonce a month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e369 (36%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;2 times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e211 (20.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (6.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of Alcohol Consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e584 (57%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eonce a month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e276 (27%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;2 times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e129 (12.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo You Take Any Specific Medications?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (4.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeadache\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMenstrual pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e164 (16%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e663 (64.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe analysis of health-related habits and medication use among university students shows that 69.3% of students do not smoke, with 30.7% reporting smoking. Most students engage in limited physical activity, with 36% exercising rarely and 25% not exercising at all. 57% of students report never consuming alcohol, while 27% drink rarely, and a small percentage consume alcohol regularly. In terms of medication use, 64.7% of students do not take any specific medications, but common reasons for medication use include menstrual pain (16%), headaches (7.5%), and chronic diseases (4.8%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMental Health Assessment Using the GHQ-28 Survey\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eLikert scale indicators\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eA) Somatic Symptoms\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1- Feeling well and in good health?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetter than usual (199, 19.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (531, 51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWorse than usual (214, 20.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch worse than usual (80, 7.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2- Feeling in need of a tonic?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (492, 48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (301, 29.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (164, 16.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (67, 6.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3- Feeling run-down and out of sorts?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (361, 35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (377, 36.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (238, 23.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (48, 4.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4- Felt that you are ill?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (401, 39.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (375, 36.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (202, 19.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (46, 4.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5- Pains in your head?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (409, 39.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (331, 32.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (210, 20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (74, 7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6- Feeling of tightness or pressure?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (404, 39.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (348, 34.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (200, 19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (72, 7.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7- Hot or cold spells?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (444, 43.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (328, 32.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (192, 18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (60, 5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eB) Anxiety and Insomnia\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8- Lost sleep over worry?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (364, 35.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (336, 32.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (219, 21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (105, 10.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9- Difficulty staying asleep once off?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (413, 40.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (345, 33.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (174, 17.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (92, 9.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10- Feeling constantly under strain?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (406, 39.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (341, 33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (203, 19.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (74, 7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11- Getting edgy and bad-tempered?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (411, 40.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (353, 34.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (191, 18.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (69, 6.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12- Getting scared or panicky for no reason?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (433, 42.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (331, 32.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (190, 18.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (70, 6.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13- Everything getting on top of you?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (401, 39.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (314, 30.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (216, 21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (93, 9.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14- Feeling nervous and strung-up?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (453, 44.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (336, 32.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (149, 14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (86, 8.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eC) Social Dysfunction\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15- Managing to keep busy and occupied?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore so than usual (270, 26.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (497, 48.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather less than usual (197, 19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less than usual (60, 5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16- Taking longer over tasks?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuicker than usual (192, 18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (464, 45.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLonger than usual (279, 27.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch longer than usual (89, 8.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e17- Doing things well?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetter than usual (217, 21.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbout the same (487, 47.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess well than usual (246, 24.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less well (74, 7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18- Satisfied with tasks?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore satisfied (224, 21.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbout the same (412, 40.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess satisfied (281, 27.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less satisfied (107, 10.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e19- Playing a useful part?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore so than usual (205, 20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (472, 46.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess useful (251, 24.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less useful (96, 9.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20- Capable of making decisions?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore so than usual (216, 21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (440, 43.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess so (258, 25.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less capable (110, 10.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21- Enjoying day-to-day activities?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore so than usual (175, 17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSame as usual (452, 44.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess so (266, 26.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch less (131, 12.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eD) Severe Depression\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e22- Thinking of self as worthless?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (458, 44.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (307, 30.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more (184, 18.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more (75, 7.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e23- Life entirely hopeless?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (372, 36.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (312, 30.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more (258, 25.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more (82, 8.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24- Life isn\u0026rsquo;t worth living?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (490, 47.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (287, 28.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more (151, 14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more (96, 9.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25- Thought of ending life?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinitely not (456, 44.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eI don\u0026rsquo;t think so (344, 33.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHas crossed mind (192, 18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDefinitely have (32, 3.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26- Nerves too bad to act?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (426, 41.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (317, 31.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (197, 19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (84, 8.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e27- Wishing you were dead?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all (490, 47.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo more than usual (278, 27.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRather more than usual (172, 16.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMuch more than usual (84, 8.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28- Idea of ending life keeps coming?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinitely not (556, 54.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eI don\u0026rsquo;t think so (294, 28.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHas crossed mind (142, 13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDefinitely has (32, 3.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe GHQ-28 survey results highlight significant psychological distress among university students. The results indicated that the mean GHQ-28 score among participants was 27.88 (SD\u0026thinsp;=\u0026thinsp;0.93), with observed scores ranging from 0 to 54.\u003c/p\u003e \u003cp\u003eIt was used to assess mental health status across four key domains: Somatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression.\u003c/p\u003e \u003cp\u003e \u003cb\u003eIn the Somatic Symptoms domain\u003c/b\u003e, 28.7% of students reported feeling worse than usual or much worse than usual in terms of overall health. Additionally, 26.5% experienced a sense of being run-down, while 27.7% complained of headaches, and 26.5% reported feelings of tightness or pressure.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFor Anxiety and Insomnia\u003c/b\u003e, 31.7% of participants reported losing sleep over worry more than usual, while 26.6% experienced persistent strain. Additionally, 27.9% of students reported feeling overwhelmed, and 25.4% suffered from frequent panic or nervousness.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe Social Dysfunction domain\u003c/b\u003e revealed that 26.4% of students struggled to keep busy, 27.2% reported taking longer to complete tasks, and 35.9% experienced difficulties in decision-making. Moreover, 38.8% of students indicated a decline in their ability to enjoy daily activities.\u003c/p\u003e \u003cp\u003e \u003cb\u003eIn terms of Severe Depression\u003c/b\u003e, 33.2% of students reported feelings of hopelessness, while 24.1% considered their life entirely hopeless. Alarmingly, 18.8% had thoughts of self-harm, and 3.1% seriously considered ending their life. Additionally, 25% of students felt worthless more than usual.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClassification of Psychiatric and Non-Psychiatric Groups Based on GHQ-28 Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChi-square χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNon-Psychiatric\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e186, 39.2%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e180, 32.7%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e366, 35.7%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e4.42\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.0035\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(\u0026lt;\u0026thinsp;0.05)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychiatric\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e288, 60.8%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e370, 67.3%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e658, 64.3%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBased on GHQ-28 scores, participants were categorized into \u0026lsquo;Psychiatric\u0026rsquo; and \u0026lsquo;Non-Psychiatric\u0026rsquo; groups. Participants scoring\u0026thinsp;\u0026ge;\u0026thinsp;24 are classified as \u0026lsquo;Psychiatric,\u0026rsquo; while those scoring\u0026thinsp;\u0026lt;\u0026thinsp;24 are classified as \u0026lsquo;Non-Psychiatric.\u0026rsquo; The total possible scores range from 0 to 84.\u003c/p\u003e \u003cp\u003eThe results indicate that 64.3% of the total population falls under the \u0026lsquo;Psychiatric\u0026rsquo; category, suggesting a high prevalence of mental health issues such as anxiety, stress, or depression, while 35.7% were classified as \u0026lsquo;Non-Psychiatric,\u0026rsquo; indicating stable mental well-being.\u003c/p\u003e \u003cp\u003eAmong males, 60.8% (288 participants) were classified as \u0026lsquo;Psychiatric,\u0026rsquo; while 39.2% (186 participants) were in the \u0026lsquo;Non-Psychiatric\u0026rsquo; group. For females, 67.3% (370 participants) were categorized as \u0026lsquo;Psychiatric,\u0026rsquo; whereas 32.7% (180 participants) were in the \u0026lsquo;Non-Psychiatric\u0026rsquo; group. These results suggest a slightly higher proportion of females experiencing psychological distress compared to males.\u003c/p\u003e \u003cp\u003eA Chi-Square Test for Independence was performed to assess whether gender and psychiatric classification are significantly associated. The results yielded a Chi-Square statistic (χ\u0026sup2;) of 4.42 (df\u0026thinsp;=\u0026thinsp;1) and a p-value of 0.035 indicating a statistically significant relationship between gender and psychiatric classification.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe shift from high school to university is a crucial time for students, filled with academic, social, and personal challenges that can greatly affect their mental health. This study found that 64.3% of participants showed signs of psychological distress based on their GHQ-28 scores, which aligns with global patterns indicating increased susceptibility to mental health issues during this transition (Eisenberg et al., 2007; Knapp et al., 2024). Auerbach et al. (2016) noted that about one-third of first-year university students face a mental disorder, with anxiety and depression being the most prevalent worldwide (Auerbach et al., 2016).\u003c/p\u003e \u003cp\u003eA 2024 cross-sectional study in India by Sharma et al. revealed that 61.4% of university students reported depressive symptoms during their first year, with academic stress and familial expectations being significant contributors. These results closely resemble our findings, reinforcing the notion that the high prevalence of depressive symptoms is a global issue among university students (Sharma et al. 2022).\u003c/p\u003e \u003cp\u003eIn a study from Nigeria, Okafor et al. (2022) explored the mental health of university students and found that 48.6% experienced moderate to severe anxiety, primarily due to academic pressure and social adjustment challenges. This is comparable to the 26.6% of Lebanese students reporting anxiety in our study, indicating shared stressors among student populations in developing nations (Okafor et al., 2022).\u003c/p\u003e \u003cp\u003eThe prevalence of severe depressive symptoms was concerning, with 33.2% of participants feeling hopeless and 3.1% contemplating self-harm. Similar studies have shown that depressive symptoms tend to spike during transitional phases due to a mix of academic, social, and financial pressures (Beiter et al., 2015).\u003c/p\u003e \u003cp\u003eThese results are in line with research from Egypt, where 68% of university students reported experiencing moderate to severe mental health issues, primarily due to academic pressures and life changes (Baklola et al., 2024). Likewise, a study focusing on first-generation college students in the United States found a 50% rise in depression rates during the COVID-19 pandemic (Rockwell et al., 2025).\u003c/p\u003e \u003cp\u003eThe study by Halat et al. (2023) found that better dietary habits, such as regular breakfast consumption, and lower psychological distress positively influenced academic performance among Lebanese university students (Halat et al., 2023). Comparatively, our research emphasizes that 64.3% of students are psychiatric among first-year students.\u003c/p\u003e \u003cp\u003eOur study findings are comparable to the 58.7% distress observed among Lebanese healthcare workers in the study by Bizri et al. (2021). Both studies utilized the General Health Questionnaire-28 (GHQ-28) to assess mental health, reinforcing the validity of our findings within the Lebanese context. (Bizri et al., 2021).\u003c/p\u003e \u003cp\u003eOur findings align with Bosqui et al. (2020), who emphasized the role of psychoeducational interventions in addressing mental health challenges among adolescents in Lebanon. While their study focused on using a comic book to disseminate mental health knowledge, both studies highlight the prevalence of psychological distress and the necessity of culturally adapted mental health resources (Bosqui et al., 2020).\u003c/p\u003e \u003cp\u003eThis situation may stem from cultural attitudes toward mental health and the availability of support systems. In contrast, Lebanese students encounter distinct stressors, such as ongoing socio-economic instability and the lingering effects of traumatic events like the 2020 Beirut explosion, which have increased psychological vulnerability (Farran, 2021).\u003c/p\u003e \u003cp\u003eThe socio-economic challenges in Lebanon complicate the mental health landscape for students. The study revealed a concerning prevalence of feelings of hopelessness and worthlessness, with 33.2% of students reporting these symptoms. This is particularly alarming when compared to the global average, where such severe symptoms are reported by about 15\u0026ndash;20% of university students (Hyun et al., 2006). This significant difference highlights the urgent need for mental health initiatives specifically designed for the Lebanese context.\u003c/p\u003e\n\u003ch3\u003eStrengths and Limitations\u003c/h3\u003e\n\u003cp\u003eThe limitations of this study it was a convenient cross-sectional study and that\u0026rsquo;s why findings cannot be generalized. The strength of the study is that\u0026rsquo;s the first one which has been done in Lebanon, in a large sample of university students, to study the mental health status in the transition period from high school to university.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the high prevalence of mental health issues among university students in Lebanon during their transition from high school, with 64.3% of participants being psychiatric. These findings underscore the pressing need to address student mental health, particularly considering Lebanon\u0026rsquo;s unique socio-economic and political challenges.\u003c/p\u003e \u003cp\u003eWhen compared to global data, the results reveal both shared and region-specific trends. Similarities with neighboring countries, such as Egypt, suggest common socio-cultural pressures, while differences from Western and Asian contexts reflect the distinct impact of Lebanon\u0026rsquo;s socio-political instability on student well-being.\u003c/p\u003e \u003cp\u003eBy providing a clearer picture of the mental health landscape among Lebanese university students, this research emphasizes the importance of proactive measures to support student well-being. Universities, policymakers, and healthcare providers should prioritize early intervention, improved access to mental health services, and the promotion of healthy coping strategies. Future research should focus on tracking long-term mental health trends and evaluating the effectiveness of interventions tailored to the Lebanese context.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgment to the holy spirit university of kaslik.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis research is approved by the university ethical committee and the Institutional Review Board (approval number: HCR/EC 2024-041).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll participants provided written informed consent prior to their enrollment in the study, and participation was completely voluntary. We ensured that data confidentiality and anonymity were rigorously maintained to safeguard participants\u0026rsquo; privacy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll the authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research is not funded.\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDeliens: Deliens, T., Clarys, P., De Bourdeaudhuij, I., \u0026amp; Deforche, B. (2013). Weight, socio-demographics, and health behaviour related correlates of academic performance in first year university students. Nutrition Journal, 12(1). https://doi.org/10.1186/1475-2891-12-162 \u003c/li\u003e\n\u003cli\u003eWong, J. G., Cheung, E. P., Chan, K. K., Ma, K. K., \u0026amp; Tang, S. W. (2006). Web-based survey of depression, anxiety and stress in first-year tertiary education students in Hong Kong. The Australian and New Zealand journal of psychiatry, 40(9), 777\u0026ndash;782. https://doi.org/10.1080/j.1440-1614.2006.01883.x \u003c/li\u003e\n\u003cli\u003eEisenberg, D., Gollust, S. E., Golberstein, E., \u0026amp; Hefner, J. L. (2007). Prevalence and correlates of depression, anxiety, and suicidality among university students. The American journal of orthopsychiatry, 77(4), 534\u0026ndash;542. https://doi.org/10.1037/0002-9432.77.4.534 \u003c/li\u003e\n\u003cli\u003eHyun, J. K., Quinn, B. C., Madon, T., \u0026amp; Lustig, S. (2006). Graduate Student Mental Health: Needs Assessment and Utilization of Counseling Services. Journal of College Student Development, 47(3), 247\u0026ndash;266. https://doi.org/10.1353/csd.2006.0030 \u003c/li\u003e\n\u003cli\u003eKnapp, A., Burrows, T., Whatnall, M., Leigh, L., Leask, S., \u0026amp; Hutchesson, M. (2024). Trends in Health-Risk Behaviors and Psychological Distress among Australian First-Year University Students. International journal of environmental research and public health, 21(5), 620. https://doi.org/10.3390/ijerph21050620 \u003c/li\u003e\n\u003cli\u003eRockwell, D. M., \u0026amp; Kimel, S. Y. (2025). A systematic review of first-generation college students\u0026apos; mental health. Journal of American college health : J of ACH, 73(2), 519\u0026ndash;531. https://doi.org/10.1080/07448481.2023.2225633\u003c/li\u003e\n\u003cli\u003eLiu, J., Modrek, S., \u0026amp; Sieverding, M. (2017). The mental health of youth and young adults during the transition to adulthood in Egypt. Demographic Research, 36, 1721\u0026ndash;1758. https://doi.org/10.4054/demres.2017.36.56\u003c/li\u003e\n\u003cli\u003eBaklola, M., Terra, M., Taha, A. et al. Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study. BMC Psychiatry 24, 202 (2024). https://doi.org/10.1186/s12888-024-05620-7 \u003c/li\u003e\n\u003cli\u003eFawzy, M., \u0026amp; Hamed, S. A. (2017). Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Research, 255, 186\u0026ndash;194. https://doi.org/10.1016/j.psychres.2017.05.027 \u003c/li\u003e\n\u003cli\u003eHammoudi Halat, D., Hallit, S., Younes, S. et al. Exploring the effects of health behaviors and mental health on students\u0026rsquo; academic achievement: a cross-sectional study on lebanese university students. BMC Public Health 23, 1228 (2023). https://doi.org/10.1186/s12889-023-16184-8 \u003c/li\u003e\n\u003cli\u003eMaalouf, F. T., Alrojolah, L., Akoury-Dirani, L., Barakat, M., Brent, D., Elbejjani, M., Shamseddeen, W., \u0026amp; Ghandour, L. A. (2022). Psychopathology in children and adolescents in Lebanon study (PALS): A national household survey. Social Psychiatry and Psychiatric Epidemiology, 57(6), 761\u0026ndash;774. https://doi.org/10.1007/s00127-021-02208-4 \u003c/li\u003e\n\u003cli\u003eBizri, M., Kassir, G., Tamim, H., Kobeissy, F., \u0026amp; El Hayek, S. (2021). Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak. Journal of Health Psychology, 27(6), 1288\u0026ndash;1300. https://doi.org/10.1177/1359105321991630 \u003c/li\u003e\n\u003cli\u003eFarran, Natali. \u0026ldquo;Mental health in Lebanon: Tomorrow\u0026rsquo;s silent epidemic.\u0026rdquo; Mental Health \u0026amp; Prevention, vol. 24, Dec. 2021, p. 200218. https://doi.org/10.1016/j.mhp.2021.200218. \u003c/li\u003e\n\u003cli\u003eBosqui, T., Mayya, A., Younes, L., Baker, M. C., \u0026amp; Annan, I. M. (2020). Disseminating evidence-based research on mental health and coping to adolescents facing adversity in Lebanon: A pilot of a psychoeducational comic book \u0026lsquo;Somoud.\u0026rsquo; Conflict and Health, 14(78). https://doi.org/10.1186/s13031-020-00324-7 \u003c/li\u003e\n\u003cli\u003eMaddah, D., Saab, Y., Safadi, H., Abi Farraj, N., Hassan, Z., Turner, S., Echeverri, L., Alami, N. H., Kababian-Khasholian, T., \u0026amp; Salameh, P. (2021). The first life skills intervention to enhance well-being amongst university students in the Arab world: \u0026apos;Khotwa\u0026apos; pilot study. Health psychology open, 8(1), 20551029211016955. https://doi.org/10.1177/20551029211016955 \u003c/li\u003e\n\u003cli\u003eGoldberg, D. P., \u0026amp; Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9(1), 139\u0026ndash;145. https://doi.org/10.1017/S0033291700021644 \u003c/li\u003e\n\u003cli\u003eWorld Medical Association. (2013). Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191\u0026ndash;2194. https://doi.org/10.1001/jama.2013.281053 \u003c/li\u003e\n\u003cli\u003eAuerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Demyttenaere, K., Florescu, S., \u0026hellip; Bruffaerts, R. (2016). Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychological medicine, 46(14), 2955\u0026ndash;2970. https://doi.org/10.1017/S0033291716001665 \u003c/li\u003e\n\u003cli\u003eSharma, S. K., Joseph, J., Varkey, B. P., Dhandapani, M., Varghese, A., Sharma, S., Kumar, T. K. A., Kaririya, S., \u0026amp; Mathews, E. (2022). Prevalence of anxiety and depressive symptoms during COVID-19 pandemic among the general population in India: A systematic review and meta-analysis. Journal of neurosciences in rural practice, 13(4), 608\u0026ndash;617. https://doi.org/10.25259/JNRP-2022-1-21-R3-(2324) \u003c/li\u003e\n\u003cli\u003eOkafor, K. C., Bimba, J. S., Adekeye, O. A., Obateru, A. P., \u0026amp; Idoko, L. O. (2022). The Prevalence and Pattern of Use of Alcohol among Undergraduate Students in Jos Plateau State, Nigeria. Open Journal of Preventive Medicine, 12(8), 141\u0026ndash;154. https://doi.org/10.4236/ojpm.2022.128011 \u003c/li\u003e\n\u003cli\u003eBeiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., \u0026amp; Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of affective disorders, 173, 90\u0026ndash;96. https://doi.org/10.1016/j.jad.2014.10.054\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mental health, University students, Transitional period, Anxiety, Depression, Stress, GHQ-28, Psychological distress, Lebanon","lastPublishedDoi":"10.21203/rs.3.rs-5642301/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5642301/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe transition from high school to university is a critical life stage associated with heightened vulnerability to mental health challenges. Despite global recognition, there is limited research on the psychosocial risks faced by first-year university students in Lebanon, a region further burdened by socio-economic and political instability.\u003c/p\u003e\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTo assess the mental health status of first-year university students in Lebanon, focusing on the prevalence and intensity of mental health challenges such as anxiety, depression, and stress during the transitional period.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis cross-sectional study involved 1,024 students from multiple Lebanese universities during the 2023\u0026ndash;2024 academic year. Data were collected via a self-reported questionnaire and the General Health Questionnaire-28 (GHQ-28), that assesses mental health across four key dimensions: somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression. Descriptive statistics, chi-square tests and P-values were used to analyze demographic, behavioral, and mental health data.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA significant gender difference in employment (χ\u0026sup2; = 18.81, p\u0026thinsp;=\u0026thinsp;0.00086) was found. The GHQ-28 survey results indicate that 64.3% of university students experience psychological distress, with higher prevalence among females (67.3%) than males (60.8%) (χ\u0026sup2; = 4.42, p\u0026thinsp;=\u0026thinsp;0.035). 31.7% reported sleep disturbances, 27.9% felt overwhelmed, and 33.2% experienced hopelessness. 18.8% had thoughts of self-harm, and 3.1% considered ending their life. The GHQ-28 scores indicate a high prevalence of mental health challenges, taking a score of 24 as a cut off score.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe study highlights the urgent need for targeted mental health interventions for Lebanese university students, addressing both universal and region-specific challenges. The findings emphasize the importance of early intervention, increased access to mental health resources, and promoting systemic changes to improve overall student well-being.\u003c/p\u003e","manuscriptTitle":"Mental Health Status among University Students during The Transition Period from High School to University in Lebanon: A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-04 09:04:19","doi":"10.21203/rs.3.rs-5642301/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-29T05:46:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-23T07:38:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"147717273104406530075820811379802753141","date":"2025-04-18T10:57:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-02T18:10:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-02T11:42:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-03-31T05:02:31+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0bea5ec5-f6b0-41d4-84c8-ad830aa6767a","owner":[],"postedDate":"April 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-26T16:01:17+00:00","versionOfRecord":{"articleIdentity":"rs-5642301","link":"https://doi.org/10.1186/s12889-025-23087-3","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-05-19 15:57:36","publishedOnDateReadable":"May 19th, 2025"},"versionCreatedAt":"2025-04-04 09:04:19","video":"","vorDoi":"10.1186/s12889-025-23087-3","vorDoiUrl":"https://doi.org/10.1186/s12889-025-23087-3","workflowStages":[]},"version":"v1","identity":"rs-5642301","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5642301","identity":"rs-5642301","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}