Psychological distress and well-being in university and high school students: a cross-sectional study in Italy

Objective: Adolescence is a transitional period marked by psychosocial changes that can impact well-being. Mental disorders before university are linked to dropout and lower employment rates, affecting long-term outcomes. This study examines the psychological well-being of Italian students aged 18-25, exploring factors related to distress. Design: Cross-sectional survey. Setting: High schools and university in Verona, northern Italy. Participants: A total of 1766 students (88.96% university students and 11.04% high school students in their final year) were recruited. Inclusion criteria were being enrolled in high school or university in Verona, aged 18-25, with adequate Italian language proficiency and informed consent. No exclusion criteria were applied. Primary and secondary outcome measures: Primary outcomes were levels of psychological distress (Kessler Psychological Distress Scale-10-item - Kessler-10), anxiety and depression (Patient Health Questionnaire Anxiety and Depression Scale - PHQ-ADS) and well-being (WHO-Five Well-Being Index - WHO-5). Secondary analyses examined the association of these outcomes with sociodemographic and educational variables. Results: Most participants (88.6%) reported psychological distress (mean K-10=22.95, SD=6.64). Mild symptoms of anxiety and depression were reported by 47.1% and 43.3% of participants, respectively. Only 16.5% reported high psychological well-being. Female and non-binary students had worse mental health outcomes than males (p value <0.001). Students in their first 3 years of university exhibited better mental health compared with those in later years or high school (p value <0.001). Students living in owned properties had lower levels of anxiety and depression (p value=0.004). Conclusions: Psychological distress, anxiety and depression are widespread among Italian students. Gender, academic stage and living situation significantly impact mental health outcomes. The findings emphasise the need for targeted mental health interventions, particularly for non-binary and female students, as well as those in advanced academic years.