The association between depression, anxiety and substance use among Canadian post-secondary students

Figures & data

Table 1 Descriptive statistics

Variables	Categories	Percent	Total
Depression	No	85.33	36,896
	Yes	14.67	6,345
Anxiety	No	81.62	35,328
	Yes	18.38	7,957
Other mental health disordersa	No	75.50	32,812
	Yes	24.50	10,648
Alcohol use	Neverb	15.56	6,761
	Formerc	15.12	6,567
	Currentd	69.32	30,116
Cannabis use	Never	58.44	25,350
	Former	23.65	10,261
	Current	17.91	7,770
Tobacco use	Never	73.10	31,780
	Former	15.90	6,913
	Current	11.00	4,781
Other substance usee	Never	81.53	35,534
	Former	12.14	5,292
	Current	6.33	2,758
Gender	Male	29.19	12,615
	Female	67.93	29,359
	Non-binary	2.89	1,248
Age	18–20 years	40.28	17,419
	21–23 years	32.27	13,955
	24 years and older	27.45	11,870
Ethnicity	White	70.74	30,561
	Black	3.25	1,402
	Hispanic/Latino	2.06	888
	Asian/Pacific Islander	13.67	5,905
	Aboriginal	3.94	1,701
	Biracial/multiracial	3.38	1,462
	Other	2.97	1,283
Marital status	Single	82.99	35,966
	Married	12.69	5,498
	Separated/divorced	1.26	547
	Others	3.06	1,327
Study status	Undergraduate	83.24	36,021
	Graduate	13.92	6,026
	Others	2.84	1,228
Enrollment status	Full-time	93.25	40,528
	Part-time	5.65	2,454
	Others	1.10	478
International student	No	90.56	39,284
	Yes	9.44	4,094
Housing	Off-campus	53.34	23,141
	On-campus	14.07	6,106
	With parents	32.58	14,135
Grade point average	A	36.45	15,799
	B	45.13	19,562
	C	15.27	6,619
	D/F	1.44	626
	Not applicable	1.71	742

Notes: Missing data: <2% of the total participants.

a Other mental health disorders: anorexia, attention-deficit hyperactivity disorder, bipolar disorder, bulimia, insomnia and schizophrenia.

b Never users: never used the substance.

c Former users: used the substance but not within the past 30 days.

d Current users: used the substance within the past 30 days.

e Other substance use: cocaine, methamphetamine, sedatives, hallucinogens, opiates, inhalants, 3, 4-methylenedioxymethamphetamine, and other club and illegal drugs.

Table 2 Univariate analysis: depression and anxiety

Variables	Categories	Depression		Anxiety
		OR (95% CI)	P-value	OR (95% CI)	P-value
Alcohol use (Ref = Nevera)	Formerb	1.68 (1.51–1.87)	<0.001	1.80 (1.63–1.98)	<0.001
	Currentc	1.74 (1.60–1.90)		1.92 (1.77–2.08)
Cannabis use (Ref = Never)	Former	1.71 (1.60–1.82)	<0.001	1.62 (1.53–1.72)	<0.001
	Current	2.23 (2.08–2.38)		2.00 (1.88–2.13)
Tobacco use (Ref = Never)	Former	1.86 (1.74–1.99)	<0.001	1.64 (1.54–1.74)	<0.001
	Current	2.49 (2.31–2.68)		2.04 (1.90–2.19)
Other substancesd (Ref = Never)	Former	2.16 (2.01–2.32)	<0.001	1.90 (1.78–2.03)	<0.001
	Current	3.63 (3.33–3.96)		3.18 (2.93–3.46)
Other mental health disorderse (Ref = No)	Yes	45.52 (41.99–49.34)	<0.001	54.21 (50.47–58.22)	<0.001
Gender (Ref = Male)	Female	1.79 (1.68–1.92)	<0.001	2.29 (2.15–2.44)	<0.001
	Non-binary	3.89 (3.40–4.46)		4.07 (3.57–4.64)
Age categories (Ref = Age 18–20 years)	21–23 years	1.10 (1.03–1.17)	<0.001	1.16 (1.09–1.22)	<0.001
	24 years and older	1.34 (1.26–1.43)		1.20 (1.13–1.27)
Ethnicity (Ref = White)	Black	0.58 (0.49–0.70)	<0.001	0.42 (0.35–0.51)	<0.001
	Hispanic/Latino	0.89 (0.73–1.08)		0.79 (0.66–0.94)
	Asian/Pacific Islander	0.53 (0.48–0.58)		0.41 (0.37–0.45)
	Aboriginal	1.56 (1.38–1.75)		1.32 (1.18–1.48)
	Biracial or multiracial	1.27 (1.11–1.46)		1.23 (1.08–1.39)
	Other	1.01 (0.86–1.18)		0.94 (0.81–1.08)
Marital status (Ref = Single)	Married	1.07 (0.99–1.16)	<0.001	0.99 (0.92–1.07)	<0.001
	Separated/divorced	2.98 (2.48–3.57)		2.49 (2.09–2.98)
	Others	1.43 (1.24–1.64)		1.38 (1.21–1.57)
Study status (Ref = Graduate students)	Undergraduate students	1.29 (1.18–1.40)	<0.001	1.24 (1.15–1.33)	<0.001
	Others	1.72 (1.47–2.03)		1.45 (1.24–1.69)
Enrollment status (Ref = Full-time)	Part-time	1.58 (1.43–1.75)	<0.001	1.43 (1.30–1.58)	<0.001
	Others	1.66 (1.33–2.07)		1.54 (1.25–1.90)
International student (Ref = No)	Yes	0.65 (0.59–0.72)	<0.001	0.55 (0.50–0.61)	<0.001
Housing (Ref = On-campus)	Off-campus	1.19 (1.10–1.29)	<0.001	1.12 (1.04–1.21)	<0.001
	With parents	0.95 (0.87–1.04)		0.96 (0.88–1.03)
Grade point average (Ref = A)	B	1.21 (1.14–1.29)	<0.001	1.10 (1.04–1.16)	<0.001
	C	1.74 (1.61–1.88)		1.42 (1.32–1.52)
	D/F	2.48 (2.06–2.98)		1.73 (1.44–2.08)
	Not applicable	1.27 (1.03–1.56)		1.07 (0.88–1.30)

Notes:

a Never users: never used the substance.

b Former users: used the substance but not within the past 30 days.

c Current users: used the substance within the past 30 days.

d Other substance use: cocaine, methamphetamine, sedatives, hallucinogens, opiates, inhalants, 3, 4-methylenedioxymethamphetamine, and other club and illegal drugs.

e Other mental health disorders: anorexia, attention-deficit hyperactivity disorder, bipolar disorder, bulimia, insomnia and schizophrenia.

Table 3 Multivariate analysis: depression and substance use

Variables	Categories	OR (95% CI)	P-value
Tobacco use (Ref = Nevera)	Formerb	1.20 (1.09–1.33)	<0.001
	Currentc	1.36 (1.22–1.52)	<0.001
Cannabis use by other mental health disordersd (Ref = Nevera)	Other mental health disorders (No)		<0.05
	Formerb	1.38 (1.16–1.65)
	Currentc	1.29 (1.05–1.57)
	Other mental health disorders (Yes)
	Formerb	1.06 (0.95–1.17)
	Currentc	1.17 (1.05–1.31)
Other substances usee (Ref = Nevera)	Formerb	1.23 (1.10–1.36)	<0.001
	Currentc	1.37 (1.21–1.55)	<0.001
Gender (Ref = Male)	Female	1.39 (1.28–1.51)	<0.001
	Non-binary	2.10 (1.75–2.52)	<0.001
Age categories (Ref = Age 18–20 years)	21–23 years	1.00 (0.92–1.09)	0.98
	24 years and older	1.21 (1.09–1.34)	0.003
Marital status (Ref = Single)	Married	0.98 (0.87–1.10)	0.72
	Divorced	1.58 (1.22–2.04)	0.005
	Others	1.07 (0.89–1.29)	0.49
Study status (Ref = Graduate students)	Undergraduate students	1.19 (1.06–1.35)	0.005
	Others	1.46 (1.17–1.82)	<0.001
Enrollment status (Ref = Full-time)	Part time	1.34 (1.17–1.54)	<0.001
	Others	1.26 (0.93–1.71)	0.13
Grade point average (Ref = A)	B	1.13 (1.04–1.23)	0.003
	C	1.53 (1.37–1.70)	<0.001
	D/F	1.79 (1.39–2.31)	<0.001
	Not applicable	1.19 (0.91–1.57)	0.21

Notes: Model diagnostic values: Akaike information criterion =20,702.923; receiver operating characteristic =0.89; Hosmer–Lemeshow goodness-of-fit test =0.86.

a Never users: never used the substance.

b Former users: used the substance but not within the past 30 days.

c Current users: used the substance within the past 30 days.

d Other mental health disorders: anorexia, attention-deficit hyperactivity disorder, bipolar disorder, bulimia, insomnia and schizophrenia.

e Other substance use: cocaine, methamphetamine, sedatives, hallucinogens, opiates, inhalants, 3, 4-methylenedioxymethamphetamine, and other club and illegal drugs.

Table 4 Multivariate analysis: anxiety and substance use

Variables	Categories	OR (95% CI)	P-value
Alcohol use by gender (Ref = Nevera)	Male		<0.05
	Formerb	1.27 (0.97–1.68)
	Currentc	0.97 (0.78–1.20)
	Female
	Formerb	1.43 (1.22–1.68)
	Currentc	1.41 (1.24–1.62)
	Non-binary
	Formerb	1.56 (0.84–2.89)
	Currentc	1.65 (0.98–2.76)
Other substances used (Ref = Nevera)	Formerb	1.09 (0.98–1.20)	0.08
	Currentc	1.28 (1.14–1.45)	<0.001
Other Mental Health Disorderse (Ref = No)	Yes	50.77 (47.10–54.72)	<0.001
Age categories (Ref = Age 18–20 years)	21–23 years	1.18 (1.08–1.28)	<0.001
	24 years and older	1.01 (0.92–1.11)	0.66
Ethnicity (Ref = White)	Black	0.59 (0.46–0.75)	<0.001
	Hispanic or Latino	0.79 (0.62–1.01)	0.06
	Asian or Pacific Islander	0.59 (0.52–0.67)	<0.001
	Aboriginal	0.89 (0.76–1.05)	0.13
	Biracial or multiracial	1.07 (0.90–1.28)	0.51
	Other	0.90 (0.74–1.10)	0.22
Marital status (Ref = Single)	Married	0.86 (0.77–0.96)	<0.001
	Divorced	1.24 (0.95–1.62)	0.09
	Others	1.02 (0.84–1.23)	0.82
Enrollment status (Ref = Full-time)	Part time	1.23 (1.07–1.42)	<0.001
	Others	1.33 (0.97–1.81)	0.07
International student (Ref = Yes)	No	1.32 (1.15–1.53)	<0.001
Grade point average (Ref = A)	B	0.91 (0.84–0.99)	0.02
	C	1.06 (0.96–1.18)	0.32
	D/F	0.92 (0.71–1.20)	0.53
	Not applicable	1.03 (0.78–1.36)	0.94

Notes: Model diagnostic values: Akaike information criterion =21,641.852; receiver operating characteristic =0.91; Hosmer–Lemeshow goodness-of-fit test =0.72.

a Never users: never used the substance.

b Former users: used the substance but not within the past 30 days.

c Current users: used the substance within the past 30 days.

d Other substance use: cocaine, methamphetamine, sedatives, hallucinogens, opiates, inhalants, 3, 4-methylenedioxymethamphetamine, and other club and illegal drugs.

e Other mental health disorders: anorexia, attention-deficit hyperactivity disorder, bipolar disorder, bulimia, insomnia and schizophrenia.