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Cassie M Hazell

January 12th, 2022, is doing a phd bad for your mental health.

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Estimated reading time: 6 minutes

Poor mental health amongst PhD researchers is increasingly being recognised as an issue within higher education institutions. However, there continues to be unanswered questions relating to the propensity and causality of poor mental health amongst PhD researchers. Reporting on a new comparative survey of PhD researchers and their peers from different professions, Dr Cassie M Hazell and Dr Clio Berry find that PhD researchers are particularly vulnerable to poor mental health compared to their peers. Arguing against an inherent and individualised link between PhD research and mental health, they suggest institutions have a significant role to play in reviewing cultures and working environments that contribute to the risk of poor mental health.

Evidence has been growing in recent years that mental health difficulties are common amongst PhD students . These studies understandably have caused concern in academic circles about the welfare of our future researchers and the potential toxicity of academia as a whole. Each of these studies has made an important contribution to the field, but there are some key questions that have thus far been left unanswered:

• Is this an issue limited to certain academic communities or countries?
• Do these findings reflect a PhD-specific issue or reflect the mental health consequences of being in a graduate-level occupation?
• Are the mental health difficulties reported amongst PhD students clinically meaningful?

We attempted to answer these questions as part of our Understanding the mental health of DOCtoral researchers (U-DOC) survey. To do this we surveyed more than 3,300 PhD students studying in the UK and a control group of more than 1,200 matched working professionals about their mental health. In our most recent paper , we compared the presence and severity of mental health symptoms between these two groups. Using the same measures as are used in the NHS to assess symptoms of depression and anxiety, we found that PhD students were more likely to meet criteria for a depression and/or anxiety diagnosis and have more severe symptoms overall. We found no difference between these groups in terms of their overall suicidality. However, survey responses corresponding to past suicidal thinking and behaviour, and future suicide intent were generally highly rated in both groups.

42% of PhD students reported that they believed having a mental health problem during your PhD is the norm

We also asked PhD students about their perceptions and lived experience of mental health. Sadly, 42% of PhD students reported that they believed having a mental health problem during your PhD is the norm. We also found similar numbers saying they have considered taking a break from their studies for mental health reasons, with 14% actually taking a mental health-related break. Finally, 35% of PhD students have considered ending their studies altogether because of their mental health.

We were able to challenge the working theory that the reason for our findings is that those with mental health difficulties are more likely to continue their studies at university to the doctoral level. In other words, the idea that doing a PhD doesn’t in any way cause mental health problems and these results are instead the product of pre-existing conditions. Contrary to this notion, we found that PhD students were not more likely than working professionals to report previously diagnosed mental health problems, and if anything, when they had mental health problems, these started later in life than for the working professionals. Additionally, we found that our results regarding current depression and anxiety symptoms remained even after controlling for a history of mental health difficulties.

The findings from this paper and our other work on the U-DOC project  has highlighted that PhD students seem to be particularly vulnerable to experiencing mental health problems. We found several factors to be key predictors of this poor mental health ; specifically not having interests and relationships outside of PhD studies, students’ perfectionism, impostor thoughts, their supervisory relationship, isolation, financial insecurity and the impact of stressors outside of the PhD .

the current infrastructure, systems and practices in most academic institutions, and in the wider sector, are increasing PhD students’ risk of mental health problems and undermining the potential joy of pursuing meaningful and exciting research

So, does this mean that doing a PhD is bad for your mental health? Not necessarily. There are several aspects of the PhD process that are conducive to mental health difficulties, but it is absolutely not inevitable. Our research (and our own experiences!) suggests that doing a PhD can be an incredibly positive experience that is intellectually stimulating, personally satisfying, and gives a sense of meaning and purpose. We instead believe a more appropriate conclusion to draw from our work is that the current infrastructure, systems and practices in most academic institutions, and in the wider sector, are increasing PhD students’ risk of mental health problems and undermining the potential joy of pursuing meaningful and exciting research.

Reducing this issue to the common rhetoric that “PhD studies cause mental health problems” is problematic for several reasons: Firstly, it ignores the many interacting moving parts at work here that variably increase and reduce risk of poor mental health across people, time, and place. Secondly, it does not acknowledge the pockets of incredibly good practice in the sector we can learn from and implement more widely. Finally, it reinforces the notion that poor mental health is the norm for PhD students which then becomes a self-fulfilling prophecy- and itself ignores the joy of pursuing a thesis in something potentially so personally meaningful. Nonetheless, a significant paradigm shift is needed in academia to reduce the current environmental toxins so that studying for a PhD can be a truly enjoyable and fulfilling process for all.

Note: This article gives the views of the author, and not the position of the Impact of Social Science blog, nor of the London School of Economics. Please review our  Comments Policy  if you have any concerns on posting a comment below.

Image Credit: Geralt via Pixabay. 

About the author

Dr Cassie M Hazell (she/her) is a lecturer in Social Sciences at the University of Westminster. Her research is on around mental health, with a special interest in implementation science. She is the co-founder of the international Early Career Hallucinations Research (ECHR) group and Early-Mid Career representative on the Research Council at her institution.

Dr Clio Berry is a Senior Lecturer in Healthcare Evaluation and Improvement in the Brighton and Sussex Medical School. She is interested in the application of positive and social psychology approaches to mental health problems and social outcomes for young people and students. Her work spans identification of risk and resilience factors in predicting mental health and social problems and their outcomes, and in the development and evaluation of clinical and non-clinical interventions.

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My own experience of doing a PhD (loneliness, the lack of routine, imposter syndrome) has led to my discouraging my daughter, who has a history of mental health issues, from considering it at the moment, despite her having the academic aptitude and even a topic. I would hazard a guess that the problems are worse in the humanities than in the applied sciences, where most PhD students tend to work as part of research teams and be well supported in more structured environments.

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Fascinating research… I had a terrible PhD, but most of the mental health issues arose after the fact. If you ever conducted another survey it would be interesting to include those who had recently finished a PhD.

Looking at your follow up BJPsyche paper, I noticed you haven’t gone into the correlation between subject and mental health. I’d be interested to know how sciences vs humanities compared.

I see that your work is very restrained in discussing the causes of mental health issues, and I’m sure you have plenty of hypothesis. In my experience, a key factor is that there is no mechanism to hold supervisors to account for the quality of their supervision. (Linking to the point above, I believe in the sciences supervisors with poor outcomes do suffer repetitional damage – not so in the humanities.)

I’d also add that the UK’s Viva system, which I believe is unique globally, is a recipe for disaster – years of work evaluated over the course of just a couple of hours by examiners who, again, are not held accountable in any way.

I wrote my experience up here: https://medium.com/the-faculty/i-had-a-brutal-phd-viva-followed-by-two-years-of-corrections-here-is-what-i-learned-about-vivas-5e81175aa5d

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PhD students’ mental health is poor and the pandemic made it worse – but there are coping strategies that can help

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A pre-pandemic study on PhD students’ mental health showed that they often struggle with such issues. Financial insecurity and feelings of isolation can be among the factors affecting students’ wellbeing.

The pandemic made the situation worse. We carried out research that looked into the impact of the pandemic on PhD students, surveying 1,780 students in summer 2020. We asked them about their mental health, the methods they used to cope and their satisfaction with their progress in their doctoral study.

Unsurprisingly, the lockdown in summer 2020 affected the ability to study for many. We found that 86% of the UK PhD students we surveyed reported a negative impact on their research progress.

But, alarmingly, 75% reported experiencing moderate to severe depression. This is a rate significantly higher than that observed in the general population and pre-pandemic PhD student cohorts .

Risk of depression

Our findings suggested an increased risk of depression among those in the research-heavy stage of their PhD – for example during data collection or laboratory experiments. This was in contrast to those in the initial stages, or who were nearing the end of their PhD and writing up their research. The data collection stage was more likely to have been disrupted by the pandemic.

Our research also showed that PhD students with caring responsibilities faced a greatly increased risk of depression. In our our study , we found that PhD students with childcare responsibilities were 14 times more likely to develop depressive symptoms than PhD students without children.

This does align with findings on people in the general UK population with childcare responsibilities during the pandemic. Adults with childcare responsibilities were 1.4 times more likely to develop depression or anxiety compared to their counterparts without children or childcare duties.

It was also interesting to find that PhD students facing the disruption caused by the pandemic who did not receive an extension – extra financial support and time beyond the expected funding period – or were uncertain about whether they would receive an extension at the time of our study, were 5.4 times more likely to experience significant depression.

Our research also used a questionnaire designed to measure effective and ineffective ways to cope with stressful life events. We used this to look at which coping skills – strategies to deal with challenges and difficult situations — used by PhD students were associated with lower depression levels. These “good” strategies included “getting comfort and understanding from someone” and “taking action to try to make the situation better”.

Interestingly, female PhD students, who were slightly less likely than men to experience significant depression, showed a greater tendency to use good coping approaches compared to their counterparts. Specifically, they favoured the above two coping strategies that are associated with lower levels of depression.

On the other hand, certain coping strategies were associated with higher depression levels. Prominent among these were self-critical tendencies and the use of substances like alcohol or drugs to cope with challenging situations.

A supportive environment

Creating a supportive environment is not solely the responsibility of individual students or academic advisors. Universities and funding bodies must play a proactive role in mitigating the challenges faced by PhD students.

By taking proactive steps, universities could create a more supportive environment for their students and help to ensure their success.

Training in coping skills could be extremely beneficial for PhD students. For instance, the University of Cambridge includes this training as part of its building resilience course .

A focus on good strategies or positive reframing – focusing on positive aspects and potential opportunities – could be crucial. Additionally, encouraging PhD students to seek emotional support may also help reduce the risk of depression.

Another example is the establishment of PhD wellbeing support groups , an intervention funded by the Office for Students and Research England Catalyst Fund .

Groups like this serve as a platform for productive discussions and meaningful interactions among students, facilitated by the presence of a dedicated mental health advisor.

Our research showed how much financial insecurity and caring responsibilities had an effect on mental health. More practical examples of a supportive environment offered by universities could include funded extensions to PhD study and the availability of flexible childcare options.

By creating supportive environments, universities can invest in the success and wellbeing of the next generation of researchers.

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Open Access

Peer-reviewed

Research Article

Research disruption during PhD studies and its impact on mental health: Implications for research and university policy

Contributed equally to this work with: Maria Aristeidou, Angela Aristidou

Roles Conceptualization, Data curation, Formal analysis, Methodology, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Institute for Educational Technology, The Open University, Milton Keynes, Buckinghamshire, United Kingdom

Roles Conceptualization, Investigation, Resources, Writing – original draft, Writing – review & editing

Affiliation UCL School of Management, London, United Kingdom

• Maria Aristeidou, 
• Angela Aristidou

• Published: October 18, 2023
• https://doi.org/10.1371/journal.pone.0291555
• Reader Comments

Research policy observers are increasingly concerned about the impact of the disruption caused by the Covid-19 pandemic on university research. Yet we know little about the effect of this disruption, specifically on PhD students, their mental health, and their research progress. This study drew from survey responses of UK PhD students during the Covid-19 pandemic. We explored evidence of depression and coping behaviour (N = 1780) , and assessed factors relating to demographics, PhD characteristics, Covid-19-associated personal circumstances, and significant life events that could explain PhD student depression during the research disruption (N = 1433) . The majority of the study population (86%) reported a negative effect on their research progress during the pandemic. Results based on eight mental health symptoms (PHQ-8) showed that three in four PhD students experienced significant depression. Live-in children and lack of funding were among the most significant factors associated with developing depression. Engaging in approach coping behaviours (i.e., those alleviating the problem directly) related to lower levels of depression. By assessing the impact of research disruption on the UK PhD researcher community, our findings indicate policies to manage short-term risks but also build resilience in academic communities against current and future disruptions.

Citation: Aristeidou M, Aristidou A (2023) Research disruption during PhD studies and its impact on mental health: Implications for research and university policy. PLoS ONE 18(10): e0291555. https://doi.org/10.1371/journal.pone.0291555

Editor: Yadeta Alemayehu, Mettu University, ETHIOPIA

Received: January 23, 2023; Accepted: August 31, 2023; Published: October 18, 2023

Copyright: © 2023 Aristeidou, Aristidou. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The raw dataset on PhD students' patient health questionnaire scale and coping mechanisms is available from the Open Research Data Online (ORDO) database: https://doi.org/10.21954/ou.rd.22794203 .

Funding: This work was supported by the Institute of Educational Technology at The Open University (MA) and the University College London (UCL) School of Management (AA). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The abrupt outbreak in January 2020 and the global proliferation of a novel virus (Covid-19) has created a crisis for many sectors, including the international higher education (HE) sector [ 1 ] that continues during the ‘post-pandemic’ period. A point of particular alarm for HE leaders, policy observers, and governments is the disruption to the typical flow and pace of university research activity. While research related to Covid-19 is still in overdrive, other research was slowed or stopped due to worldwide physical distancing measures to contain the virus’ spread (e.g., sudden campus and laboratory closures, mobility restrictions, stay-at-home orders) [ 2 ]. The resulting ‘drop in research work’ is suggested to have a detrimental impact on the HE sector on the ‘research and innovation pipeline’ [ 3 ], and on ‘research capacity, innovation and research impact’ [ 4 ].

As research and university policies internationally are being (re)shaped at a rapid pace in efforts to meet the challenge of university research disruption [ 5 ], we contribute to academic and policy conversations by examining the effect of the research disruption on the mental health of PhD students. A considerable body of research acknowledges the role of PhD students in the innovation process, in knowledge creation and diffusion (e.g., [ 6 ]) and further posits that the period of one’s PhD program is key to early career success and research productivity (e.g., [ 7 ]). These outcomes, which matter to research policy, have been linked to PhD student mental health [ 8 – 10 ]. In those times of relative stability, research had additionally demonstrated the higher prevalence of mental health issues amongst the PhD student population across research disciplines, as compared to other students within academia [ 9 ] and the general population [ 9 , 11 , 12 ]. In the period since Covid-19 disrupted our social and economic lives, depression levels in the general population have been exacerbated globally [ 13 , 14 ]. These trends suggested that the already high prevalence of poor mental health in PhD students is likely to be further exacerbated during the pandemic. Indeed, as reported in early studies on research students’ experience of the Covid-19 pandemic (e.g., [ 15 ]) and the post-pandemic period (e.g., [ 16 ]) the impact on students’ mental wellbeing has been significant, with students suggesting a number of support measures at institutional and national level.

Ignoring, at this critical moment, the increased likelihood of poor mental health in PhD students may jeopardize research capacity and HE competitiveness for years to come. Therefore, there is a pressing need to identify–within the PhD student population–those whose mental health is more affected by the research disruption, so that policies and assistance can be timelier and more targeted. Additionally, by understanding more clearly the factors that may contribute to poor mental health, and their interrelationships (presented in Methods), policymakers and HE leaders may be better placed to tackle, and ultimately overcome, this and future research disruptions.

Motivated by the current lack of an empirical basis for insights into PhD students’ mental health during the pandemic-induced disruption, we collected survey data contemporaneously during July 2020. Our 1780 survey respondents are PhD students in 94 UK Universities, across the natural and social sciences and across PhD stages. Our study has three objectives: first, to explore mental health prevalence (depression) and coping behaviour in a large-scale representative sample of PhD students in the UK (O1); second, to evaluate the relationships among mental health prevalence and coping behaviour (O2); third, to identify factors that increase the likelihood of poor PhD student mental health during the period of research disruption (O3). Our study extends previous research on mental health in the HE sector by considering the dynamics of severe disruption, as opposed to the dynamics of relative stability, on PhD students’ mental health, performance satisfaction, and coping behaviours.

Background and literature review

Uk phd students’ mental health in times of disruption.

In the UK, there are approximately 100,000 postgraduate students completing doctoral research [ 17 ]. Since 2018, significant government funding has been targeted at developing insights into supporting UK PhD students’ mental health [ 18 ]. Still, with the exception of Byrom et al. [ 11 ], published research on PhD students’ mental health in the UK exhibits the same limitations as the international research: It reflects discipline- or institution-related specificity (e.g., [ 19 ]) or utilizes samples of early career researchers in general (e.g., [ 20 ]).

Early findings on postgraduate research students’ wellbeing during the pandemic showed that only a small proportion of them are in good mental health wellbeing (28%) while the rest demonstrate possible or probable depression or anxiety [ 15 ]. Goldstone and Zhang [ 15 ] further highlight the differences among student groups with, for example, students with disabilities or caring responsibilities or female students having lower levels of mental wellbeing. The post-pandemic findings have been more promising, as only about one in four students were at risk of experiencing mental health issues [ 16 ].

In response to the Covid-19 research disruption, substantive actions have been taken by the HE sector and the UK Government to disseminate approaches deployed by UK universities to support student mental health (e.g., [ 18 ]) and to update mental health frameworks for UK universities (e.g., [ 4 ]), but so far, mitigation activities have been targeting mental health for UK university students broadly, not UK PhD students specifically.

Overcoming the paucity of evidence on UK PhD students’ mental health during the pandemic is a crucial first step to drawing strong conclusions on the prevalence and determinants of mental health issues and ways to mitigate them specific to the PhD population. For example, policy recommendations by UK postgraduate respondents during the pandemic [ 15 ] focused mainly on financial support, such as extensions to their funded period of study and tuition and visa fee support (including waivers to fees). To develop an overarching framework specific to the Objectives of our study, we synthesize insights from the international literature on PhD student mental health conducted in the period before the research disruption.

International research on PhD student mental health in times of relative stability

In the international literature examining mental health specifically for PhD students (see the systematic review in [ 21 ], the issue of mental health for PhD students is acknowledged to be multidimensional and complex [ 10 ]. In this growing research area, some address mental health as an aspect of the broader ‘health’ of the PhD students (e.g., [ 22 ]), some focus on psychological distress [ 23 ], while others take depression as a specific manifestation of distress [ 9 , 24 ]. The latter is particularly interesting because depression within the PhD population in these studies is often assessed with standardised questionnaires (e.g., PHQ, see below) that allow for developing comparative insights. It is also the approach adopted by the only global survey of PhD students’ mental health by Evans et al. [ 12 ], showing that 39% of PhD students report moderate-to-severe depression, significantly more than the general population.

Literature on PhD student’s mental health determinants in times of relative stability

Past literature on PhD students’ mental health offers insights into the determinants of PhD students’ mental health in times of stability, which may help understand the relationships we want to examine between PhD mental health, performance satisfaction and coping in times of research disruption.

First, past studies evidence the influence of PhD students’ personal lives on poor mental health. PhD students with children or with partners are less likely to have or develop psychological distress [ 9 ]. The normalcy of family roles is a much-needed antidote to the known pressures of a PhD program [ 25 ] and might even protect against mental health problems [ 22 , 26 ]. Other aspects of PhD students’ personal lives, such as significant life events (e.g., severe problems in personal relationships or severe illness of the student or someone close to them), have been linked to dissatisfaction with their research progress [ 24 ]. Research progress is defined as students’ perception of their progress in the completion of their degree [ 27 ] and is linked to their mental health. Dissatisfaction is tied to negative outcomes, such as attrition and delay [ 28 ], but also to lower productivity and mental health problems, such as worry, anxiety, exhaustion, and stress [ 29 ]. Related to this, Levecque and colleagues [ 9 ] observed that PhD students expressing a high interest in an academic career are in better mental health than those with no or little interest in remaining in academia.

Second, gender was the key personal factor that emerged as a determinant for mental health in past studies: PhD students who self-identify as female report greater clinical [ 9 , 30 ] and non-clinical problems with their mental health [ 23 , 31 ]. This is explained through the additional pressure women report on their professional and personal lives [ 23 ].

Third, past studies argue that each PhD phase presents PhD students with specific sets of challenges and should thus be explored discreetly in relation to mental health [ 32 ]. Still, the evidence on the link between the PhD phase (or the year of study as a proxy for the PhD phase) and mental health is inconclusive. Barry et al.’s [ 33 ] survey reports no connection between the PhD phase and depression levels in an Australian PhD population. However, Levecque et al. [ 9 ] report high degrees of depression in the early PhD stage of students in Belgium, and a global survey of PhD students across countries and disciplines shows that depression likelihood increases as the PhD program progresses [ 32 ].

Fourth, past research offers strong evidence that financial concerns impact PhD students’ mental health negatively. In a study by El-Ghoroury et al. [ 34 ], 63.9% of PhD students cited debt or financial issues as a cause for poor wellbeing and cited financial constraints as the major barrier to improving their wellness (through social interactions, outside-PhD activities, etc). Even uncertainty about funding was shown to predict poor mental health [ 9 ]. To this end, Geven et al. [ 35 ] explored packages of reforms in a pre-pandemic graduate school programme, including an extension of the grant period, and indicated that such policies can increase students’ completion rates to up to 20%.

Finally, age is not shown to be associated with mental health [ 9 ], but numerous studies found that having children, particularly for female PhD students and in Science-Technology-Engineering-Maths (STEM) disciplines [ 36 ], consistently corresponds with heightened stress [ 37 ]. However, a specific examination of the relationship between children and mental health indicates that PhD students with one or more children in the household showed significantly lower odds of having or developing a common psychiatric disorder [ 9 ]. Further, parenting and, in particular, motherhood during doctorate studies contribute to the development of students’ coping mechanisms that allows them to succeed in a balance in both worlds [ 38 ].

Past research insights into PhD mental health and coping

Past research explored how PhD students may “cope” with stressors and thus mitigate poor mental health [ 39 ]. Studies identify the importance of social interactions (e.g., [ 22 ]); balancing life demands (e.g., [ 16 ]), reaching out for social support (e.g., [ 40 ]) sometimes through peer relationships (e.g., [ 10 , 39 ]); and ‘planning’ (e.g., [ 22 ]); As invaluable as these insights are, drawing comparisons between these findings is difficult because often the identification of coping styles or strategies was not the focus of these studies, making it difficult to draw fine-grained conclusions as to their effect on PhD students’ mental health.

There is, however, a long tradition of research on coping for physiological wellbeing that provides standardised measures for individuals’ coping and their link to mental health [ 41 ]. The most widely used measurement instrument in the literature reviewed is the COPE Inventory, which allows researchers to assess how people cope in a variety of stressful situations, including in HE for students [ 42 – 44 ], making it particularly relevant to the context and sample under investigation in our study of PhD students. Additionally, COPE allows for the identification of consistent ways of coping, which provides predictive validity across a range of situations. Predictive validity is desired when examining the role of coping in relation to mental health. Indeed, multiple studies have linked the COPE measurement to mental health outcomes (e.g., [ 45 , 46 ]), including depression [ 43 ], which is a focus of our study.

Data and methods

Participants.

For the current study, we recruited participants that were active PhD students from March to July 2020 at any stage of their research to take part in an online survey. The survey ran between the 31st of July and the 23rd of August 2020, with the aim of capturing the potential impact of the Covid-19 disruption during the first lockdown on their research progress and mental health. The use of online surveys to assess the scope of mental health problems is particularly appropriate during the Covid-19 outbreak [ 47 ]. The current study has been reviewed by, and received a favourable opinion, from The Open University Human Research Ethics Committee (reference number: HREC/3605/Aristeidou), http://www.open.ac.uk/research/ethics/ . For the recruitment of a diverse audience, we followed a snowball sampling method, forwarding our invitation to PhD student groups in a number of UK-based universities, but also exploited the reach of PhD social media channels and online PhD groups, and we invited academics and respondents to recruit other participants. Vouchers were provided as an incentive for participation to the first 300 respondents. Before completing the survey, the respondents were provided with an online information sheet and were asked to provide their written consent through a digital consent form. They reported their email addresses to be identifiable and contactable for validation, consent issues, potential withdrawal, and incentive processing. The dataset was anonymized on the 30th of August 2020, prior to initiating data analysis.

Exclusion criteria included survey respondents who ‘straight-lined’ (chose the same answer option repeatedly), gave inconsistent responses to similar questions, or did not use their institution emails (rendering them unidentifiable). Finally, there were 1790 PhD students in the study from 94 different HE institutions across all four UK nations (England, Scotland, Northern Ireland and Wales). The majority of the study population (86%) reported that their research progress had been impacted in a negative way. The dataset [ 48 ] included 44.4% male and 55.4% female participants, while the doctoral students in the UK consist of 51% male and 49% female students [ 17 ]. Weighting adjustments were made to correct the sample representativeness. The majority of the survey respondents were 25–34 years old (80.4%), with live-in children (71%). Most respondents (86.7%) were conducting their PhDs full-time, and almost two-thirds (64.4%) were funded by a research council or a charitable body in the UK. At the time of the survey, a large proportion of the survey respondents were in the ‘executing’ phase of their research (i.e., data collection/analysis). Finally, a natural science-related PhD was being pursued by slightly over two-thirds of the respondents (68.8%). According to data sourced from HESA [ 17 ], the likelihood of individuals embarking on a research postgraduate degree at a younger age (such as 18–20) appears to be relatively low. This is evident from the fact that only 90–130 students within this age group register for such programs each year. More details on the demographics and characteristics of the sample can be found in Table 1 and below.

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https://doi.org/10.1371/journal.pone.0291555.t001

Variables and instruments

Brief cope inventory (bci)..

The BCI [ 49 ] is a 28-item self-report questionnaire designed to measure effective and ineffective ways to cope with a stressful life event, and it is the abbreviated version of the original 60-item COPE inventory developed by [ 42 ]. The BCI has a 4-point Likert scale with options on each item ranging from 0 (I usually do not do this at all) to 3 (I usually do this a lot). Coping in this study is categorised in two overarching coping behaviours, as per Eisenberg et al. [ 50 ]: (a) the approach behaviours that attempt to reduce stress by alleviating the problem directly, which include 12 items related to active coping, positive reframing, planning, acceptance, seeking emotional support, and seeking informational support; and (b) the avoidant coping behaviours that attempt to reduce stress by distancing oneself from the problem, which include 12 items related to denial, substance use, venting, behavioural disengagement, self-distraction, and self-blame. Items that belong to neither overarching behaviour are coping related to humour and religion. These were included in the overall coping score but excluded from the analysis based on the two overarching behaviours. A higher score indicates frequent use of that coping behaviour. Cronbach’s alpha for the BCI was .88. Further, both the approach and avoidant scales have shown very good internal consistency in this sample, with Cronbach’s alpha equal to 0.83 and 0.80, respectively.

Patient health questionnaire eight-item depression scale (PHQ-8).

PHQ-8 [ 57 ] is an eight-item version of the Patient Health Questionnaire (PHQ-9). PHQ is a popular measure for assessing depression and is frequently used for PhD mental health (e.g., [ 12 , 51 ]), making it an ideal choice for our study. PHQ-9 has been validated as both a diagnostic and severity measure [ 52 , 53 ] in population-based settings [ 54 ] and self-administered modes [ 55 , 56 ], and it was recently used in a global survey of PhD students’ depression prevalence [ 12 ]. PHQ-8 omits the ninth question that assesses suicidal or self-injurious thoughts, and it was deemed more appropriate for our research because researchers in web-based interviews/surveys are unable to provide adequate interventions remotely. The PHQ-8 items employ a 4-point Likert scale with options on each item ranging from 0 (not at all) to 3 (nearly every day). Then, the scores are summed to give a total score between 0 and 24 points, where 0–4 represent no significant depressive symptoms, 5–9 mild depressive symptoms, 10–13 moderate, 15–19 moderately severe, and 20–24 severe [ 55 ]. Evidence from a large-scale validation study [ 57 ] indicates that a PHQ-8 score ≥ 10 represents clinically significant depression. In this study, Cronbach’s alpha for the PHQ-8 was 0.71, indicating a good internal consistency.

Performance satisfaction.

Performance satisfaction is an 8-item self-report scale designed to measure the students’ self-perceived progress in their PhD research, their confidence in being able to finish on time, and their satisfaction. The scale was successfully used in a PhD student well-being study at the university of Groningen [ 24 ] prior to the Covid-19 pandemic. The performance satisfaction 5-point Likert scale responses range from 1 (completely disagree) to 5 (completely agree). The score for each respondent equals the mean score of the 8-item responses. A reliability analysis was carried out on the performance satisfaction scale. Cronbach’s alpha showed the scale to reach acceptable reliability, α = 0.86.

Significant life events Significant Life events is a questionnaire designed to capture whether PhD students had experienced any significant life events in the 12 months prior to the survey. This was successfully used in studying PhD students’ mental health at the university of Groningen [ 24 ] prior to the Covid-19 pandemic research disruption. Events include the death of someone close, severe problems in personal relationships, financial problems, severe illness of oneself or someone close, being in the process of buying a house, getting married, expecting a child, none of these events, and prefer not to say. Significant life events were used as an incident control variable in this study.

Statistical analyses

SPSS (Version 25) was used for statistical analysis. In the first phase, descriptive statistics were used to describe the PHQ-8 Depression and coping behaviours of the sample and the distribution of these three variables among demographics, PhD characteristics, and Covid-19-related circumstances (O1). We used a weighting adjustment for gender to correct the survey representativeness for descriptive analysis; females were given a ‘corrective’ weight of 0.88 and males of 1.15.

In relation to O2, Spearman rank correlations were used to examine the degree of association between all of the 28 coping behaviours and PHQ-8 Depression scores. This finding contributed to our understanding of how individual coping behaviours could relate to lower or higher depressive symptoms.

To assess whether the behaviours significant to our study (i.e., those with a negative or the strongest positive PHQ-8 Depression association) were used more frequently by students of a particular demographic group (O2), we used independent-samples t-test and ANOVA. Before assessing the relationship between our variables, outliers, and groups with a sample size smaller than 15 for each group were removed from the tests (e.g., Gender = other; Funding = partially funded; Likelihood in HE = already employed in academia).

In relation to O3, a binary logistic regression analysis was performed to examine whether Covid-19-related circumstances explain significant depression in PhD students, while controlling for demographics, PhD characteristics, and external incidents. Prior to performing the regression analysis, PHQ-8 Depression score outliers, as well as groups with fewer than 10 events per variable (e.g., gender = other; age = 55–64; Impact reason = mental health), were detected and excluded from the dataset. The dichotomous dependent variable was calculated based on PHQ-8 Depression scores smaller than 10 for non-significant depression, and equal or larger than 10 for significant depression. Associations between Depression in PhD students and the independent variables in our dependency model were estimated using odds ratios (ORs) as produced by the logistic regression procedure in SPSS (Version 25). The ORs were used to explain the strength of the presence or absence of significant depression. Wald tests were used to assess the significance of each predictor. A test of the full model against a constant only model was statistically significant, indicating that the predictors as a set reliably distinguished between PhD students who are having or developing significant depression and those who are not ( Χ 2 (25)  =  405.258, p <  . 001 ). A Nagelkerke R 2 of .798 indicated a good to substantial relationship between prediction and grouping (68% of variance explained by the proposed model in completion rates). Table 2 presents response percentages about the categorical variables entered in the model, including the two dependent variables (significant depression and non-significant depression).

https://doi.org/10.1371/journal.pone.0291555.t002

Exploring depression prevalence and coping behaviours

The average PHQ-8 Depression score was 10.13 ( SD = 3.23) on a scale of 0–24 (weighted cases). Importantly, this highlights that the majority of survey respondents are facing moderate depression symptoms ( Fig 1 ). The PHQ-8 item with the highest score, in a range of 0–4, was ‘having trouble to concentrate on things, such as reading the newspaper or watching television’ ( M = 1.45; SD = 0.84), and the item with the lowest score was ‘moving or speaking so slowly that other people could have noticed; or the opposite–being so fidgety or restless that have been moving around a lot more than usual’ ( M = 1.10; SD = 0.75). Of the study population, 75% self-reported significant depression (moderate, moderately severe, or severe major).

https://doi.org/10.1371/journal.pone.0291555.g001

The coping behaviours that the majority of PhD students used in a medium or large amount to overcome the Covid-19 disruption were “accepting the reality of the fact that it has happened” (84%), followed by “thinking hard about what steps to make” (76%) ( Fig 2 ). Both are approaching coping behaviours. Other coping behaviours used to a great extent were “praying or meditating” (73%) , “blaming myself for things that happened” (avoidant) (71%) , and “expressing my negative feelings” (avoidant) (69%). On the other hand, coping behaviours that were used the least were all avoidant ones: “giving up attempting to cope” ( 13%) , “refusing to believe that it has happened” (15%) , “using alcohol or other drugs to make myself feel better” (17%) , and “giving up trying to deal with it” (17%) . Overall, approach coping behaviours were used to a greater extent ( M = 26.43, SD = 5.15) than avoidant coping behaviours ( M = 23.97, SD = 4.90).

https://doi.org/10.1371/journal.pone.0291555.g002

The Spearman correlations between coping behaviours and PHQ-8 scores ( Table 3 ), which included outliers, suggested that only two items have significant negative (very weak) associations with depression: Item 15, “getting comfort and understanding from someone” ( r s (1780) = -.107, p < .01); and Item 7, “taking action to try to make the situation better” ( r s (1762) = -.077, p < .01). The majority of the coping behaviours had a significant positive relationship with higher scores in depressive symptoms. The coping behaviours with the largest effect and a moderate to strong association were Item 13, “criticizing myself” ( r s (1762) = .452, p < .01), followed by Item 11 “using alcohol or other drugs to help me go through it” ( r s (1762) = .387, p < .01).

https://doi.org/10.1371/journal.pone.0291555.t003

Table 4 shows the relationship among approach and avoidant coping behaviours, and demographics. Our analyses indicated that both approach and avoidant coping behaviours had been significantly used to a greater extent by the female over male PhD students, by students without a live-in partner than those with a live-in partner, and by those without live-in children than those with live-in children. There is no evidence that the students of a particular age group were using avoidant coping more than those of another age group. However, students aged 25–34 were using approach coping behaviours less than other groups, and those aged 45–54 more ( Table 5 ).

https://doi.org/10.1371/journal.pone.0291555.t004

https://doi.org/10.1371/journal.pone.0291555.t005

Our analyses indicated that female PhD students, who had significantly lower PHQ-8 Depression scores, were using Table 3 ‘s Items 15 ( t [1778] = 14.61, p < .001) and Item 7 ( t [480] = 15.11, p < .001) significantly more than male students. Also, those without live-in partners were getting comfort and understanding from someone to a significantly greater extent than those without ( t [702] = 20.09, p < .001). PhD students without live-in children were taking action to try to make the situation better significantly more than those who have them ( t [894] = 25.21, p < .001).

Predictors of depression and relative influence

Covid-19-related circumstances (receiving an extension, impact reasons, and impact results), performance satisfaction, and coping behaviours (approach and avoidant) were entered together as predictors of depression. Demographics (gender, age, live-in partner, and live-in children), PhD characteristics (discipline, PhD phase, PhD mode, funding, interest in HE, and likelihood in HE) and external incidents were used as control variables. Table 6 reports the findings of the analyses.

https://doi.org/10.1371/journal.pone.0291555.t006

Prediction success overall was 95.3% (83.1% for not significant depression and 98.0% for significant depression). The Wald criterion demonstrated that not having an extension ( p = .014), having caring responsibilities ( p < .001), and using approach ( p < .001) or avoidant ( p < .001) coping behaviours made significant contributions to prediction. The OR value indicated that in the case that PhD students were not receiving an extension amid the Covid-19 disruption, or they did not know whether they were receiving one yet, they were 5.4 times more likely to experience significant depression. For the impact reason, our findings showed that–compared to those who experienced personal illness–PhD students who had caring responsibilities (e.g., childcare or other) showed slightly lower depressive symptoms (OR = 0.10). The OR for approach and avoidant coping behaviours were 0.13 and 43.73, respectively. This finding indicates that when approach coping is raised by one unit (e.g., +1 to the score), we see evidence for better mental health, while when avoidant coping is raised by one unit, a PhD student is very likely (44 times) to experience significant depression.

Turning to our control variables, PhD students with children in the household and with live-in partners showed significantly higher odds (about 14 and 7 times more, respectively) of having or developing depressive symptoms than those without. The latter can be explained by the fact that 88% of the participants with live-in partners also reported having live-in children. Also, male students were slightly more likely than female students to experience significant depression (with a borderline p-value), but this might be explained by the significantly increased use of coping approaches by female students. This gender-related finding that shows nearly no difference between the two categories slightly differs from Goldstone and Zhang’s model [ 15 ] which highlights a difference between female and male participants’ mental wellbeing. This difference can be explained by the fact that the research instruments used in the two studies were different, as well as the survey period.

Some PhD characteristics that made significant contributions to prediction were the discipline of PhD studies and the interest of students to remain in academia after finishing their PhD projects. The risk of experiencing significant depression in PhD students in social sciences (OR = 9.68) was lower than in students conducting a PhD in natural sciences. In contrast to findings by Levecque et al. [ 9 ], we observed that PhD students expressing a high interest in an academic career were 3.5 times more likely to develop depressive symptoms than those with no or only little interest in remaining in academia. Further, those considering having a high likelihood of remaining in academia were slightly more depressed (OR = 3.73), as well as those who were in the executing phase of their PhD research (OR = 3.33). No differences between funded and self-funded students were detected. Finally, the OR for the external incident variable was 6.13, indicating that for each incident unit (e.g., one more incident), we see evidence for depressive symptoms that are six times worse.

Our study contributes new empirical data and new insights needed to develop knowledge on the effect of university research disruption on the PhD student population. In turn, new knowledge may provide the evidence base for university and research policy.

Exploring mental health and coping behaviours

Our first contribution is to provide empirical estimates for the performance satisfaction, prevalence of mental health problems, and coping behaviours of PhD students during the pandemic-induced research disruption, on the basis of representative data across disciplines and across universities in the UK.

Our findings show that most UK PhD students across universities and disciplines report that their research progress has been affected negatively (86%). By contrast, in pre-pandemic periods, 79% of UK PhD students across Universities and disciplines had indicated excellent research progress [ 11 ]. This shift within the same population is important to reveal because of its potential implications for PhDs’ careers and university research capacity and innovation, as we know that dissatisfaction about the PhD trajectory is tied to negative outcomes such as attrition and delay [ 24 , 28 ], but also to lower productivity [ 58 ].

We found that during the period of severe research disruption caused by the Covid-19 pandemic, 75% of the UK students surveyed from 94 universities and across disciplines self-reported in the moderate-severe range for depression. This is at least three times more compared to the reported prevalence of depression among the general population internationally during the Covid-19 outbreak (16–28%, [ 59 ]). Our findings are also in line with findings in Goldstone and Zhang’s study [ 15 ] on UK postgraduate students’ mental wellbeing during the pandemic, in which 72% of the surveyed students were found to demonstrate possible or probable depression or anxiety.

By adopting widely used standardised questionnaires, our findings provide an accessible benchmark for the comparison with studies that took place among PhD student populations in periods of HE stability (pre-2020), thereby providing the empirical basis to accurately estimate the issue of poor mental health among PhD students during a period of research disruption. Using the same questionnaire as in our survey (PHQ-9) and drawing on a sample of PhD students from multiple universities and across research disciplines, a pre-pandemic global survey reported that 39% of PhD students scored in the moderate-severe range for depression [ 12 ]. Pre-pandemic national surveys of PhD students across institutions and disciplines report similar rates of depression, between 32% (in Belgium, Levecque et al. [ 9 ] and 38% (in the Netherlands, Van der Weijden et al. [ 60 ]. In a pre-pandemic (2018–2019) survey of UK PhD students across 48 universities and disciplines, only 25% reported levels that would indicate probable depression or anxiety [ 11 ]. These comparisons indicate that the prevalence of depression among the UK PhD student population of our study during the pandemic-induced period of research disruption is two-to-three times more than that which was reported in periods of stability for the UK PhD student population, for PhD student populations of other countries, and the global PhD population.

Our findings on PhD students’ mental health and PhD students’ coping advance past literature [ 22 , 23 , 34 ] in two significant ways. First, by using a highly reliable coping measure (COPE), we are able to demonstrate the relationship between coping styles and mental health outcomes in PhD students in a way that allows for comparisons and to build further research in this area. Second, we identify specific coping behaviours amongst the UK PhD students that are associated with lower depression scores and some that have a negative association with depression (i.e., getting comfort and understanding from someone and taking action to try to make the situation better ). Both are ‘coping approach’ behaviours (i.e., attempts to reduce stress by alleviating the problem directly; [ 50 ]). Studies using COPE in other populations have also linked coping-approach behaviours to fewer symptoms of psychological distress [ 45 ], more physical and psychological well-being at work [ 46 ], and an absence of anxiety and depression [ 61 ].

Factors explaining PhD students’ depression

Our second contribution is to explain–within the UK PhD population–whose mental health is more affected by the pandemic-induced research disruption. We find that several factors have a significant impact on PhD students to have or develop mental health issues during a period of research disruption.

Consistent with past research on PhD students’ mental health, our findings reveal the significant influence of their personal lives on poor mental health. The relationships we observed during a period of research disruption, however, differ from those suggested in studies conducted in periods of stability (e.g., [ 9 , 22 , 25 , 26 , 62 ]). We found that PhD students with live-in children or with a live-in partner and PhDs with caring responsibilities are more likely to have or develop significant depression compared to those without. This difference can be explained by the closure of schools that resulted in parents home-schooling their children, a greater demand for devices and the internet in households, and parents going through emotional hardship [ 63 ]. We additionally find six times worse depressive symptoms for each ‘external life incident’ (e.g., childbirth, moving home) that occurred in the PhD students’ lives. A larger number of external incidents were found to be associated with students with live-in partners and students with live-in children, which may explain these as reinforcing negative effects. These new insights explain that–although most of these realities in PhD students’ personal lives existed besides the research disruption—when combined with the research disruption, their mental health can spiral downward.

Our findings also address the role of structural PhD characteristics (PhD discipline and PhD phase) in predicting whether a student might present mental health issues in times of research disruption. We find that in a period of research disruption, the risk of significant depression is higher in the execution phase of the PhD compared to the beginning or extension phases, contrary to Levecque and colleagues’ findings [ 9 ]. Because there is very limited research on the PhD stage and mental health, our findings contribute insights to a broader community of scholars who advocate for the further study of the challenges in each PhD stage discreetly (e.g., [ 32 ]). Furthermore, we find that the risk of experiencing significant depression in PhD students in social sciences was lower than students conducting a PhD in natural sciences. Our survey respondents offered explanations on the role of PhD discipline in mental health during the pandemic in the open text responses. These converge on the fact that natural sciences often require being physically in a laboratory, which is probably unfeasible when university facilities are closed.

In tune with past research on finances and mental health in PhD students [ 9 , 64 ], we found those without funded extensions are more likely to have or develop significant depression (moderate, moderately severe, and severe) compared to those with them. We reveal the size of this association (about 5.5 times more) and link PhD funding extensions to standardized assessments of depression prevalence, thus uniquely providing new evidence for policy scholars.

Implications for research and higher education policy

Our findings show an alarming increase in self-reported depression levels among the UK PhD student population. The long-term mental health impact of Covid-19 may take years to become fully apparent, and managing this impact requires concerted effort not just from the healthcare system at large [ 59 ] but also from the HE sector specifically. With mental illness a cause for PhD student attrition, loss of research capacity and productivity, data from our survey should prompt consideration of immediate intervention strategies.

For research and education policy scholars, our findings contribute directly to the development of evidence-based research and university policies on support for targeted groups of PhD students in times of disruption. Specifically, our findings show that institutional and funder support should not only be in the form of PhD-funded extensions–which are nevertheless shown in our study and other studies (e.g., [ 15 ]) to be very significant. But also, in the form of providing expedited alternatives to the changes evoked by the pandemic for PhD students, such as new and adjusted policies that explicitly consider those PhDs with caring responsibilities, since 77% of our respondents reported that childcare and other caring responsibilities are the reason for dissatisfaction with their PhD progress. If not, the Covid-19 research disruption could erase decades of progress towards equality in academia [ 65 ].

Our main contribution is that we offer insights into how to mitigate mental health consequences for PhD students in times of research disruption. Individual-driven coping behaviours are suggested to be of equal importance to those promoted by the PhD students’ institutions [ 66 ]. In this study, approach coping behaviours were found to associate with lower depression levels, which may eventually contribute to PhD completion. The importance of developing coping mechanisms has also been highlighted in pre-pandemic studies, with, for instance, mothers finding ways to combine academic work and family responsibilities and succeed in both roles [ 38 ]. Still, institutions may play a crucial role in offering training for PhD students on coping and wellbeing through, for instance, a virtual platform to comply with social distancing policies. Such efforts may include mental health support and coping behaviour guidance, so that students are guided on how to successfully deal with disruptions (for example, to avoid avoidant coping behaviours that may lead them to higher levels of depression). Pre-pandemic reforms have previously shown that a well-structured programme and well-timed financial support can facilitate and uphold PhD completion, alongside student efforts [ 35 ]. As the future generation of academics, PhD students would be better equipped to handle the current and future disruptions and better cope with other disruptions in their academic journeys.

Limitations and implications for further research

Although our study has gone some way towards enhancing our understanding of Covid-19-related effects on UK PhD students’ mental health, it is plausible that a number of limitations could have influenced the results obtained. First, while our research attracted a representative number of students from different age groups, PhD modes, phases and funding, there was a very strong presence of students in natural sciences [ 17 ]. Second, as this was a cross-sectional study, we did not follow the UK PhD population longitudinally, and we may not offer insights into the trajectory of the relationships we articulate in our findings. Nevertheless, our adoption of standardized questionnaires allows for a platform for comparisons with past and future research efforts. Third, findings in this survey are based on self-report and may be subject to unconscious biases (e.g., PhD students assessing themselves or the situation inaccurately). Fifth, the research undertaken employed the PHQ-8 with a specific emphasis on assessing aspects related to depression. It is important to acknowledge that while these questionnaires offer valuable insights into depression, they may not comprehensively encompass the broader spectrum of general mental health. Therefore, the findings of the study should be interpreted within the context of its targeted focus on depression, recognizing the potential existence of other dimensions of mental health that were not directly addressed within this research framework. Finally, despite the high percentage of prediction in our findings (80%), additional factors may likely explain variabilities in our study outcomes, such as leadership factors or supervision styles in the 94 UK Universities whose PhD students participated in our survey.

As our study strongly demonstrates, juxtaposing findings from studies conducted during periods of relative HE stability with those conducted during periods of disruption is a fruitful approach for advancing research and university policy. By identifying which insights that would have been invaluable during periods of stability are less so during a period of disruption, scholars can provide significant advancements to existing research and new insights for policy, research and HE leadership.

Conclusions

Our study extends previous research on mental health in the HE sector by considering the dynamics of a severe disruption as opposed to the dynamics of relative stability in PhD mental health and coping behaviours. Drawing on our insights into these interrelationships, we suggest extensions to the literature on PhD students’ mental health, research and university policy. With our findings, HE leaders and policymakers may be better placed to tackle and ultimately overcome this and future research disruptions.

Acknowledgments

The authors would like to thank all the PhD students who committed time for taking part in this study and their responses informed the writing of this paper.

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Depression and anxiety ‘the norm’ for UK PhD students

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Nearly half of PhD students consider developing a mental health problem ‘normal’

A new study led by the University of Westminster in collaboration with researchers from the University of Sussex and Brighton and Sussex Medical School shows that 42% of PhD students consider developing a mental health problem a ‘normal’ part of the PhD process.

The researchers also found that more than a third (35.8%) of doctoral researchers considered ending or taking a break from their studies due to poor mental health, while just over 14% of doctoral researchers had formally suspended their studies due to mental health problems. 

They discovered that compared to working professionals, PhD students are particularly vulnerable to mental health problems, and found initial evidence that PhD studies might be causative of this. 

The study, published in Humanities & Social Sciences Communications and funded by Office for Students and Research England, investigated depression and anxiety levels through a nationwide survey of PhD students in the UK to ask them questions about their mental health. Over 3,000 PhD students completed the survey, as well as a matched control group of 1,168 working professionals. 

PhD students reported significant anxiety and depression levels, a difference which was not explained by a higher rate of pre-existing mental health problems.  The new collaborative research, which is the biggest ever controlled study on PhD student mental health and the first of its kind based in the UK, examined the mental health of PhD students and some factors that might increase their risk or protect against poor mental health. It comes after a recent international survey conducted by Nature, which found that 36% of current doctoral researchers reported seeking help for anxiety and/or depression.

These new findings provide an evidence-based mandate for universities and funders to reflect upon practices related to doctoral researcher training and mental health. Attention should now be directed towards understanding what factors may explain heightened anxiety and depression among PhD students to inform preventative measures and interventions. To help achieve this, the researchers are currently analysing data looking at viable, specific risk factors associated with poor mental health amongst PhD students with the goal of developing policies, strategies and interventions to improve and protect PhD students’ mental health.

Talking about the research, lead author of the study Dr Cassie Hazell , Lecturer in Psychology at the University of Westminster, said: “PhD students are a key part of the university community and are the future of research. Our findings demonstrate that a worrying proportion of PhD students are experiencing clinically significant levels of poor mental health that exceed those seen in other working professionals. It seems clear to us that there is something about the PhD process that is triggering mental health problems, and that a paradigm shift is needed. Without this change, PhD students, academia, and society as a whole will suffer.”

Professor Jeremy E. Niven, Dean of the Doctoral School at the University of Sussex, added: “Doctoral researchers are a key part of universities, they're future thinkers, innovators and leaders that are vital in building and sustaining our economy. Our research shows that they are particularly susceptible to some mental health difficulties that may be linked to the PhD itself. Universities and funding agencies really need to reconsider what is expected of a PhD Thesis or changes in the acceptable length of time over which funding is provided.”

Read the full paper in the Humanities & Social Sciences Communications journal .

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• v.20(3); Fall 2021

PhDepression: Examining How Graduate Research and Teaching Affect Depression in Life Sciences PhD Students

Logan e. gin.

† Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ 85281

Nicholas J. Wiesenthal

§ Department of Biology, University of Central Florida, Orlando, FL 32816

Katelyn M. Cooper

Graduate students are more than six times as likely to experience depression compared with the general population. However, few studies have examined how graduate school specifically affects depression. In this qualitative interview study of 50 life sciences PhD students from 28 institutions, we examined how research and teaching affect depression in PhD students and how depression in turn affects students’ experiences teaching and researching. Using inductive coding, we identified factors that either positively or negatively affected student depression. Graduate students more commonly mentioned factors related to research that negatively affected their depression and factors related to teaching that positively affected their depression. We identified four overarching aspects of graduate school that influenced student depression: the amount of structure in teaching and research, positive and negative reinforcement, success and failure, and social support and isolation. Graduate students reported that depression had an exclusively negative effect on their research, primarily hindering their motivation and self-confidence, but that it helped them to be more compassionate teachers. This work pinpoints specific aspects of graduate school that PhD programs can target to improve mental health among life sciences graduate students.

INTRODUCTION

In 2018, researchers found that graduate students were more than six times as likely to report experiencing depression and anxiety compared with the general population and subsequently declared a “graduate student mental health crisis” ( Evans et al. , 2018 ; Flaherty, 2018 ). Calls to identify which factors exacerbate graduate student mental health problems followed (“The Mental Health of PhD Researchers,” 2019; Woolston, 2019a ). However, few studies have taken an inductive approach to identifying what aspects of graduate school in particular affect student mental health. More commonly, large quantitative studies propose a limited number of factors that may affect student mental health that participants select from, few of which directly relate to graduate research or teaching ( Peluso et al. , 2011 ; Levecque et al. , 2017 ; Evans et al. , 2018 ; Liu et al. , 2019 ). In this interview study, we focus on depression in life sciences PhD students and examine which specific aspects of research and teaching graduate students report as affecting their depression. We also explore how depression affects students’ experiences in graduate school.

The American Psychiatric Association defines depression as a common and serious medical illness that negatively affects how one feels, the way one thinks, and how one acts ( American Psychiatric Association, 2020 ). Depression is characterized by nine symptoms: depressed mood; markedly diminished interest or pleasure in activities; reduced ability to think or concentrate, or indecisiveness; feelings of worthlessness, or excessive or inappropriate guilt; recurrent thoughts of death or suicidal ideation, or suicide attempts or plans; insomnia or hypersomnia; significant change in appetite or weight; psychomotor agitation or retardation; and fatigue or loss of energy ( American Psychiatric Association, 2013 ; Schmidt and Tolentino, 2018 ). For depression to be diagnosed, the presence of at least five of the symptoms is required most of the day, nearly every day, for at least 2 weeks in addition to the occurrence of either depressed mood or diminished interest or pleasure ( American Psychiatric Association, 2013 ). In the general U.S. population, depression affects approximately 6.7% of individuals and is estimated to affect 16.6% of individuals at some point in their lifetime.

Graduate students are far more likely to report experiencing depression compared with the general population ( Evans et al. , 2018 ; Barreira et al. , 2020 ). Specifically, a recent study of master’s and PhD students in programs across the world, spanning a variety of disciplines, found that 39% of graduate students reported having moderate to severe depression ( Evans et al. , 2018 ). Similar studies have demonstrated high rates of depression in graduate students in specific disciplines such as economics ( Barreira et al. , 2020 ), biochemistry ( Helmers et al. , 1997 ), pharmacology ( Helmers et al. , 1997 ), and physiology ( Helmers et al. , 1997 ). Depression rates have surged in recent years among graduate students ( American College Health Association, 2014 , 2019 ). Talking about depression has become more socially acceptable, particularly among younger adults ( Anxiety and Depression Association of America, 2015 ; Lipson et al. , 2019 ), which may have contributed to the number of students willing to reveal that they are struggling with mental health. Additionally, depression is highly related to burnout, defined as a work-related chronic stress syndrome involving emotional exhaustion, depersonalization, and reduced personal accomplishment ( Maslach et al. , 2001 ; Bianchi et al. , 2014 ). Graduate work environments appear to be increasingly characterized as stressful and demanding ( American College Health Association, 2014 , 2019 ; Woolston, 2017 ), which may also be contributing to the increase in graduate depression rates.

Increasingly, scientists, psychologists, and education researchers are recognizing graduate student mental health as a concern and calling for further investigation of graduate student mental health in hopes of identifying interventions to improve graduate student quality of life (“The Mental Health of PhD Researchers,” 2019; Woolston, 2019a , b ). For example, in 2019, Nature added a question to its annual survey of PhD students asking students from around the world whether they had sought help for anxiety or depression, and more than one-third (36%) confirmed they had ( Woolston, 2019b ). Additionally, notable publication outlets such as Nature (“The Mental Health of PhD Researchers,” 2019), Scientific American ( Puri, 2019 ), and Science ( Pain, 2018 ) have published blogs or editorials spotlighting the need to improve graduate student mental health.

Some recent studies have sought to uncover the factors affecting depression in graduate students. Primarily, survey studies with predetermined factors that researchers hypothesized impact student mental health have identified poor mentor–mentee relationships ( Peluso et al. , 2011 ; Evans et al. , 2018 ; Hish et al. , 2019 ; Liu et al. , 2019 ; Charles et al. , 2021 ), financial stress ( Hish et al. , 2019 ; Jones-White et al. , 2020 ; Charles et al. , 2021 ), and lack of work–life balance ( Evans et al. , 2018 ; Liu et al. , 2019 ) to be associated with depression or depressive symptoms among graduate students in various disciplines. Other variables shown to be predictive of depression include low research self-efficacy, defined as low confidence in one’s ability to do research ( Liu et al. , 2019 ), difficulty publishing papers ( Liu et al. , 2019 ), hours worked per week ( Peluso et al. , 2011 ), and perceived institutional discrimination ( Charles et al. , 2021 ). Factors that appear to be protective of depressive symptoms include social support ( Charles et al. , 2021 ), mastery, defined as the extent to which individuals perceive themselves to be in control of the forces that impact their lives ( Hish et al. , 2019 ), positive departmental social climate ( Charles et al. , 2021 ), optimism about career prospects ( Charles et al. , 2021 ), and sense of belonging to one’s graduate program ( Jones-White et al. , 2020 ). While these studies have identified some depression-related factors associated with graduate school broadly and emphasize the importance of positive mentor–mentee relationships, few studies have explored factors specifically associated with research and teaching, the two activities that graduate students engage in most frequently during their time in a program. Additionally, the extant literature has primarily focused on surface causes of graduate student depression, yet understanding the underlying causes may be key to developing meaningful interventions. For example, while it is well established that student perception of poor mentorship is related to student depression ( Evans et al. , 2018 ; Hish et al. , 2019 ; Liu et al. , 2019 ; Charles et al. , 2021 ), it is less well understood what specific behaviors mentors exhibit and how such behaviors negatively affect the cognitive and behavioral underpinnings of graduate student depression. Without this knowledge, it is difficult to develop strategies to help mentors be more inclusive of students.

Theories of depression seek to explain the causes of depression. No theoretical model is widely accepted as an overarching framework for depression within the psychological and psychiatric communities ( Mcleod, 2015 ; Ramnerö et al. , 2016 ); instead, there are a number of models addressing how different aspects of depression are associated with the disorder. Arguably, the three most prominent models are cognitive ( Beck et al. , 1979 ), behavioral ( Martell et al. , 2001 ), and psychodynamic ( Busch et al. , 2016 ). In brief, cognitive theories focus on an individual’s beliefs and propose that changes in thinking precede depressive symptoms; for example, negative views of oneself, the world, and the future are thought to be common for individuals with depression ( Beck et al. , 1979 ; Leahy, 2002 ). Behavioral theories emphasize that depression is a result of one’s interaction with the environment; depressive symptoms are thought to be the result of decreased reward, lack of positive reinforcement, encouragement of depressive or passive behaviors, and discouragement of healthy behaviors ( Lewinsohn, 1974 ; Martell et al. , 2001 ; Carvalho et al. , 2011 ). Psychodynamic theories of depression consider the role of feelings and behaviors in the etiology and persistence of depressive symptoms; these theories often focus on 1) one’s biology and temperamental vulnerabilities, 2) earliest attachment relationships, and 3) childhood experiences associated with frustration, helplessness, loss, guilty, or loneliness ( Busch et al. , 2016 ). While each group of theories has been critiqued and no one theory fully explains one’s experience with depression ( Mcleod, 2015 ; Ramnerö et al. , 2016 ), we propose that each may be helpful in understanding how aspects of graduate school may affect depression among PhD students.

The thoughts and behaviors associated with depression may in turn affect students’ experiences in graduate school, particularly their experiences with research and teaching. While no studies have examined how depression explicitly affects graduate students’ research experiences, studies have identified ways in which depression can affect students’ experiences in undergraduate research ( Cooper et al. , 2020a , b ). Undergraduate researchers report that their depression negatively affected their motivation, ability to concentrate and remember, intellectual engagement, and creativity in research ( Cooper et al. , 2020b ). Undergraduates described that their depression also caused them to be overly self-critical, less social, and ultimately negatively affected their research productivity. Additionally, undergraduates have been reluctant to share their depression with others in the lab, because they fear that they will be judged ( Cooper et al. , 2020b ). While these studies provide some insight into how depression may affect graduate students’ experience in research, there is much less information about how depression may affect graduate teaching.

In this study, we interviewed 50 PhD students in the life sciences who self-identified with having depression with the intent of answering two research questions that address gaps in the literature: 1) What specific aspects of graduate research and teaching affect PhD student depression? 2) How does PhD students’ depression affect their experience in research and teaching?

Student Interviews

This study was done under an approved Arizona State University Institutional Review Board protocol (no. 00011040).

In Fall 2019, we surveyed graduate students by sending an email out to program administrators of all life sciences graduate programs in the United States that are listed in U.S. News & World Report (2019) . Of the 259 graduate programs that we contacted, 75 (29.0%) program administrators agreed to forward our survey to students enrolled in their graduate programs. Of the 840 graduate students who participated in the survey, 459 (54.6%) self-identified as having depression based on general demographic questions on the survey. Of the 459 students who identified as having depression, 327 (71.2%) agreed to be contacted for a follow-up interview. In Summer 2020, we sent a recruitment email out to the 327 students who identified as having depression, asking to interview them about their experiences with depression in a PhD program. We specifically did not require that students be diagnosed with depression in order to participate in the interview study. We did not want to bias our sample, as mental health care is disproportionately unavailable to Black and Latinx individuals, as well as to those who come from low socioeconomic backgrounds ( Howell and McFeeters, 2008 ; Kataoka et al. , 2002 ; Santiago et al. , 2013 ). Of the students who were contacted, 50 PhD students (15.3%) enrolled across 28 life sciences PhD programs completed an interview.

The interview script was based on a previous interview script that we had developed, which successfully elicited what aspects of research affect depression in undergraduates and how depression affects their research ( Cooper et al. , 2020a ). Our previous work has shown that research experiences do not exclusively worsen depression, but that aspects of research can also help students manage their depression ( Cooper et al. , 2020a ). As such, our interview questions explored what aspects of research helped students manage their depression (positively affecting depression), and what aspects worsened students’ depression (negatively affecting depression). Additionally, we hypothesized that other prominent aspects of graduate school, such as teaching, would also affect PhD student depression and revised the interview script to include questions focused on examining the relationship between depression and teaching. We asked students what aspects of graduate research and teaching made their depression worse and what aspects helped them manage their depression. Participants were invited to come up with as many aspects as possible. We also asked how students perceived their depression affected their research and teaching. With the knowledge that we would be conducting interviews during summer of 2020 in the midst of the COVID-19 pandemic, and that the pandemic had likely exacerbated graduate student depression ( Chirikov et al. , 2020 ), we directed students to not reference aspects of research and teaching that were uniquely related to the pandemic (e.g., teaching remotely or halted research) when discussing the relationship between research, teaching, and depression. We were specifically interested in aspects of teaching and research that affected student depression before the pandemic and would presumably affect student depression afterward. We conducted think-aloud interviews with four graduate students who identified as having depression to ensure that our questions would not offend anyone with depression and to establish cognitive validity of the interview script by ensuring that each student understood what each question was asking. The interview script was iteratively revised after each think-aloud interview ( Trenor et al. , 2011 ). A final copy of the interview script can be found in the Supplemental Material.

All interviews were conducted using Zoom by one of two researchers (L.E.G. or K.M.C.). The average interview time was about 45 minutes. After the interview, all participants were sent a short survey to collect their demographics and additional information about their depression (a copy of the survey can be found in the Supplemental Material). Participants were provided a small monetary gift card in exchange for their time. All interviews were deidentified and transcribed before analysis.

Interview Analysis

Three researchers (L.E.G., N.J.W., and K.M.C.) independently reviewed 12 of the same randomly selected interviews to explore each idea that a participant expressed and to identify recurring themes ( Charmaz, 2006 ). Each researcher took detailed analytic notes during the review. After, the three researchers met to discuss their notes and to identify an initial set of recurring themes that occurred throughout the interviews ( Saldaña, 2015 ). The authors created an initial codebook outlining each theme and the related description. Together, the authors then reviewed the same set of five additional interviews to validate the themes outlined in the codebook and to identify any themes that may have been missed during the initial review. The researchers used constant comparison methods to compare quotes from the interviews to each theme and to establish whether any quotes were different enough from a particular theme to warrant an additional code ( Glesne and Peshkin, 1992 ). Together, the three researchers revised the codebook until they were confident that it captured the most common themes and that no new themes were emerging. A final copy of the codebook can be found in the Supplemental Material. Two authors (L.E.G. and N.J.W.) used the final codebook to code five randomly selected interviews (10% of all interviews) and their Cohen’s κ interrater score was at an acceptable level (κ = 0.94; Landis and Koch, 1977 ). Then, one researcher (N.J.W.) coded the remaining 45 interviews. In the text, we present themes mentioned by at least 10% of interviewees and use quotes to highlight themes. Some quotes were lightly edited for clarity.

Author Positionality

Some of the authors identify as having depression and some do not. One author had completed a PhD program (K.M.C.), one author was in the process of completing a PhD program (L.E.G.), and two authors were undergraduates (N.J.W. and I.F.) at the time when the interviews and analyses took place.

Interview Participants

Fifty PhD students agreed to participate in the study. Students were primarily women (58%), white (74%), and continuing-generation college students (78%). Twelve percent of students were international students, and the average age of the participants was 28 years old. While 20% of students were unsure of their career goals, 32% of students planned to pursue a career in academia, and 24% were planning to pursue a career in industry. Students reported how severe they perceived their depression to be, on average, during the time they had spent in their PhD programs. Most students reported their depression as either moderate (50%) or severe (28%). Eighty percent of students reported being diagnosed with depression, and 74% reported receiving treatment for depression. Participants were at different stages in their PhD programs ranging from first year to sixth year or more. Three students had graduated between the time they completed the initial survey and when they participated in the interview in Summer 2020. Students self-reported their main research areas and represented a broad range, with ecology and evolutionary biology (26%), animal science (14%), molecular biology (14%), and neurobiology (10%) being the most common. Eighty-six percent of students had experience teaching undergraduates, primarily as teaching assistants (TAs), at the time of the interviews. All student demographics are summarized in Table 1 .

Participant demographics

The Effect of Research on Graduate Student Depression

Students more commonly identified ways that research negatively affected their depression than ways research positively affected their depression. Considering all factors that students listed and not just those that were most common, students on average listed two ways in which an aspect of research negatively affected their depression and one way in which an aspect of research positively affected their depression.

The most commonly reported aspect of research that worsened students’ depression was experiencing failures, obstacles, or setbacks in research. Specifically, students cited that failed experiments, failed research projects, and the rejection of manuscripts and grants was particularly difficult for their depression. Conversely, students highlighted that their depression was positively affected when they were able to make substantial progress on their research projects; for example, if they wrote part of a manuscript or if an experiment worked. Students also explained that accomplishing smaller or mundane research tasks was helpful for their depression, both because they felt as though they were checking off a box and also because it allowed them to focus on something other than the negative thoughts often associated with depression.

Students also highlighted that the unstructured nature of graduate research worsened their depression. Specifically, students described that, in graduate research, there are often no clear directions, sets of guidelines, or deadlines to help structure their day-to-day activities. Without this structure, students need to rely on their own motivation to outline goals, accomplish tasks, or seek help, which participants described can be difficult when one is experiencing a depressive episode. However, students also felt as though the unstructured nature of research benefited their depression, because it allowed for flexibility. Those who did not have frequent deadlines or strict schedules were able to not conduct research on days when they needed to recover from a depressive episode or schedule research around therapy or other activities that had a positive impact on their depression. Finally, students highlighted that their passion for their research was protective against depression. Their love for the subject of their research or thinking about how their work may have a positive impact on others could positively affect their motivation or mood.

Students described that their relationships with others in the lab also affected their depression. Specifically, if their mentors or others in their lab had unreasonable or overwhelming expectations of them, it could make them feel as though they would never be able to meet such expectations. Research also provides an environment for students to constantly compare themselves with others, both those in supervisory roles as well as peers. Notably, when students mentioned comparing themselves with others, this comparison never made them feel good about themselves, but was exclusively detrimental to their depression; they felt as though they would never be able to accomplish what others had already accomplished. Students’ relationships with their mentors also seemed to have a notable impact on their depression. Having a positive relationship with their mentors or a mentor who provided psychosocial support positively affected their depression, whereas perceiving a negative relationship with their mentors, particularly a mentor who provided consistently harsh or negative feedback, was detrimental. Students who had absent mentors or mentors who provided infrequent technical support and guidance also felt as though this situation worsened their depression, because it prevented or prolonged their success in research. Finally, students highlighted that conducting graduate research can be isolating, because you are often working on something different from those in the lab or because those outside graduate school cannot relate to the stress and struggles associated with research. However, in instances in which students were able to collaborate with others, this could be protective against depression, because it gave students a sense of comradery or validated their feelings about specific aspects of research. The most common research-related factors that students reported negatively and positively affected their depression and example student quotes of each factor are reported in Tables 2 and ​ and3, 3 , respectively.

Research-related factors that PhD students reported negatively affected their depression

Research-related factors that PhD students reported positively affected their depression

The Effect of Teaching on Graduate Student Depression

We asked all graduate students who had teaching experience ( n = 43) how teaching affected their depression. Graduate students more commonly identified ways that teaching positively affected their depression than ways teaching negatively affected their depression. On average, considering all factors that graduate students listed and not just those that were most common, participants listed two ways in which teaching positively affected their depression and one way in which teaching negatively affected their depression.

Graduate students most commonly highlighted that teaching provided positive reinforcement from undergraduates, which helped them manage their depression. This positive reinforcement came in multiple forms ranging from formal teaching evaluations to positive verbal comments from undergraduates about how good a graduate student was at teaching to watching undergraduates accomplish academic goals or grasp complex concepts. A subset of graduate students highlighted that teaching was good for their depression, because it was something they were passionate about or that they genuinely enjoyed. As such, it was a source of happiness, as was being able to collaborate and form friendships with other TAs or instructors. Some graduate students also acknowledged that they felt confident teaching, often because they had mastered content that undergraduates had not. However, this was not always the case; some graduate students highlighted that a lack of teaching training and preparation negatively affected their self-efficacy as instructors, which in turn exacerbated their depression. This was further exacerbated by the pressure that graduate students put on themselves to perform well as instructors. The potential to have a negative impact on undergraduates and their learning experiences could worsen students’ depression by increasing the stress surrounding their performance as a teacher. Additionally, some graduate students received negative reinforcement from undergraduates, in the form of negative comments on formal teaching evaluations or disrespectful behavior from undergraduates such as groans or eye rolls, which graduate students explained negatively affected their self-efficacy, further worsening their depression.

Students also highlighted that teaching could negatively affect their depression because it interfered with the time they felt they needed to be spending on research or added to the large number of responsibilities they had as graduate students. However, some students welcomed time away from research; teaching sometimes served as a distraction from research-related stressors. Students also highlighted that teaching is structured, which positively affected their depression. That is, there are concrete tasks, such as grading, that need to be accomplished or places that the graduate student needs to be during a specific time. This structure helped motivate them to accomplish teaching goals, even if they were feeling a lack of motivation because of their depression. The most common teaching-related factors that graduate students reported negatively and positively affected their depression and example student quotes for each factor are reported in Tables 4 and ​ and5, 5 , respectively.

Teaching-related factors that PhD students reported negatively affected their depression

a Forty-three out of the 50 students who participated in the study had experience teaching undergraduates either as a TA or as an instructor of record. We only considered the responses from the TAs with teaching experiences when calculating the percent of students who reported each factor.

Teaching-related factors that PhD students reported positively affected their depression

The Effect of Depression on Graduate Research

In the interviews, we asked graduate students how their depression affected their graduate research, if at all. They identified three primary ways in which depression could affect research, all of which were negative. The most common way depression affected research was interfering with students’ motivation, which in turn affected their productivity. Students described that their productivity was affected immediately, for example, struggling to execute daily tasks like collecting or analyzing data. However, graduate students described that their lack of motivation ultimately resulted in larger consequences, such as delays in getting papers submitted and published. In fact, some graduate students explicitly stated that they felt as though they would have been able to graduate earlier if they had not had depression. The second way in which depression affected graduate students’ research is that it interfered with their ability to focus or concentrate. Students primarily explained that the lack of focus did not delay their research but caused their research to be less enjoyable or made them frustrated because they had to expend additional mental energy to execute tasks. Depression also caused students to be less confident or overly critical of themselves. Specifically, if an experiment did not go right or they experienced rejection of a manuscript, they tended to internalize it and blame themselves. This lack of confidence often inhibited students’ abilities to make decisions about research or take risks in research. They described frequently second-guessing themselves, which made decisions and taking risks in research more difficult. The most common ways students reported that their depression affected their research and example student quotes are reported in Table 6 .

Self-reported ways that depression affected PhD students’ research or the student as a researcher

The Effect of Depression on Teaching

Graduate students described one positive way and two negative ways that depression affected their teaching. Students explained that, because they had experienced depression, they were more compassionate and empathetic toward the undergraduates in their courses. Specifically, they felt they could better understand some of the struggles that undergraduates experience and were sometimes more likely to be flexible or lenient about course requirements and deadlines if an undergraduate was struggling. However, graduate students reported that depression also negatively affected their teaching. Specifically, depression could cause graduate students to feel disconnected or disengaged from undergraduates. It could also cause graduate students to feel as though they had a lack of energy or felt down when teaching. The common self-reported ways that depression affected PhD students’ teaching and example quotes are reported in Table 7 .

Self-reported ways that depression affected PhD students’ teaching or the graduate student as an instructor

a Forty-three out of the 50 students who participated in the study had experience teaching undergraduates either as a TA or as an instructor of record. We only considered the responses from the TAs with teaching experiences when calculating the percent of students who reported each theme.

Despite the increasing concern about graduate student mental health among those in the scientific community ( Pain, 2018 ; “The Mental Health of PhD Researchers,” 2019; Puri, 2019 ), there is a lack of information about how specific aspects of science PhD programs affect students with depression. This is the first study to explicitly investigate which particular aspects of research and teaching affect depression among life sciences PhD students and how depression, in turn, affects graduate students’ experiences in research and teaching. Overall, graduate students highlighted factors related to teaching and research that both alleviated and exacerbated their symptoms of depression. Graduate students more commonly brought up ways that research negatively affected their depression, than ways that it positively affected their depression. Conversely, graduate students more commonly mentioned ways that teaching had a positive effect on their depression compared with a negative effect. The requirement and opportunity to teach differs among life sciences graduate programs ( Schussler et al. , 2015 ; Shortlidge and Eddy, 2018 ). As such, future research should investigate whether the amount of teaching one engages in during graduate school is related to levels of graduate student depression. Despite differences in how teaching and research affect student depression, this study unveiled factors that protect against or worsen depressive symptoms. Specifically, four overarching factors affecting graduate student depression emerged from the interviews: 1) Structure; 2) Positive and Negative Reinforcement; 3) Failure and Success; 4) Social Support and Isolation. We discuss here how each of these factors may positively and negatively affect graduate student depression.

One stark contrast between research and teaching is the amount of structure in each activity. That is, students expressed that research goals are often amorphous, that there are not concrete instructions for what needs to be accomplished, and that there is often no set schedule for when particular tasks need to be accomplished. Conversely, with teaching, graduate students often knew what the goals were (e.g., to help students learn), exactly what they needed to accomplish each week (e.g., what to grade, what to teach), and when and where they needed to show up to teach (e.g., a class meets at a particular time). Graduate students highlighted that a lack of structure, particularly in research, was detrimental for their depression. Their depression often made it difficult for them to feel motivated when there was not a concrete task to accomplish. Major depression can interfere with executive function and cognition, making goal setting and goal achievement particularly difficult ( Elliott, 1998 ; Watkins and Brown, 2002 ). In fact, research has documented that individuals with depression generate less specific goals and less specific explanations for approaching a goal than individuals who do not have depression ( Dickson and Moberly, 2013 ). As such, it may be particularly helpful for students with depression when an activity is structured, relieving the student from the need to articulate specific goals and steps to achieve goals. Students noted that the lack of structure or the flexibility in research was helpful for their depression in one way: It allowed them to better treat their depression. Specifically, students highlighted that they were able to take time to go to therapy or to not go into the lab or to avoid stressful tasks, which may be important for successful recovery from a depressive episode ( Judd et al. , 2000 ).

Compared with conducting research, many participants reported that the concrete tasks associated with teaching undergraduates were helpful for their depression. This is supported by literature that illustrates that concrete thinking, as opposed to abstract thinking, can reduce difficulty making decisions in individuals with depression ( Dey et al. , 2018 ), presuming that teaching often requires more concrete thinking compared with research, which can be more abstract. Additionally, cognitive-behavioral treatments for depression have demonstrated that developing concrete goals for completing tasks is helpful for individuals with depression ( Detweiler-Bedell and Whisman, 2005 ), which aligns with graduate students’ perceptions that having concrete goals for completing teaching tasks was particularly helpful for their depression.

Positive and Negative Reinforcement

Graduate students reported that the negative reinforcement experienced in research and teaching had a significant negative effect on their depression, while the positive reinforcement students experienced only in teaching had a positive effect. Notably, students did not mention how positive reinforcement affected their depression in the context of research. Based on student interviews, we predict that this is not because they were unaffected by positive reinforcement in research, but because they experienced it so infrequently. Drawing from behavioral theories of depression, the concept of response-contingent positive reinforcement (RCPR; Lewinsohn, 1974 ; Kanter et al. , 2004 ) helps explain this finding. As summarized by Kanter and colleagues (2004) , RCPR describes someone seeking a response and being positively reinforced; for example, graduate students seeking feedback on their research are told that what they have accomplished is impressive. Infrequent RCPR may lead to cognitive symptoms of depression, such as low self-esteem or guilt, resulting in somatic symptoms of depression, such as fatigue and dysphoria ( Lewinsohn, 1974 ; Martell et al. , 2001 ; Manos et al. , 2010 ). RCPR is determined by three factors. 1) How many potential events may be positively reinforcing to an individual. For example, some people may find an undergraduate scoring highly on an exam in a class they are teaching to be reinforcing and others may find that they only feel reinforced when an undergraduate explicitly compliments their teaching. 2) The availability of reinforcing events in the environment. If graduate students’ mentors have the ability to provide them with RCPR but are never able to meet with them, these reinforcing events are unavailable to them. 3) The instrumental behavior of an individual. Does the individual exhibit the behavior required to obtain RCPR? If graduate students do not accomplish their research-related tasks on time, they may not receive RCPR from their mentor. If individuals are not positively reinforced for a particular behavior, they may stop exhibiting it, further exacerbating the depressive cycle ( Manos et al. , 2010 ). Therefore, the lack of positive reinforcement in research may be particularly damaging to graduate students, because it may discourage them from completing tasks, leading to additional depressive symptoms. Conversely, teaching presents many opportunities for positive reinforcement. Every time graduate students teach, they have the opportunity to receive positive reinforcement from their students or to witness a student’s academic accomplishment, such as an undergraduate expressing excitement when they understand a concept. As such, it is not surprising that positive reinforcement was the primary teaching-related factor that graduate students reported helped with their depression. Despite the positive reinforcement of teaching for graduate students with depression, we are not suggesting that graduate students should take on additional teaching loads or that teaching should be viewed as the sole respite for graduate students with depression. Overwhelming students with increased responsibilities may counteract any positive impact that teaching could have on students’ depression.

Failure and Success

Failure and success affected student depression, but only in the context of research; contrary to research, students rarely mentioned concrete metrics for success and failure in teaching. While graduate students highlighted receiving positive or negative reinforcement from undergraduates, they did not relate this to being a “successful” instructor. It is unsurprising that graduate students did not mention failing or succeeding at teaching, given that experts in teaching agree that it is difficult to objectively evaluate quality teaching ( d’Apollonia and Abrami, 1997 ; Kember et al. , 2002 ; Gormally et al. , 2014 ). In fact, the lack of teacher training and knowledge about how to teach effectively negatively affected student depression, because it could cause students to feel unprepared as an instructor. Integrating teacher training into graduate programs has been championed for decades ( Torvi, 1994 ; Tanner and Allen, 2006 ; Schussler et al. , 2015 ); however, the potential for such training to bolster graduate student mental health is new and should be considered in future research. With regard to graduate students’ research, the concept of success and failure was far more concrete; students mentioned failing in terms of failed experiments, research projects, and rejected manuscripts and grant proposals. Successes included accepted manuscripts, funded grant proposals, and concrete progress on significant tasks, such as writing or conducting an experiment that yielded usable data. Failure has been shown to negatively affect depression among undergraduate researchers ( Cooper et al. , 2020a ), who are hypothesized to be inadequately prepared to experience failure in science ( Henry et al. , 2019 ). However, it is less clear how well prepared graduate students are to experience failure ( Simpson and Maltese, 2017 ). Drawing from cognitive theories of depression, depression is associated with dysfunctional cognitive schemas or dysfunctional thinking that can lead individuals with depression to have negative thoughts about the world, themselves, and the future and to interpret information more negatively than is actually the case (called negative information-processing biases; Beck, 1967 ; Beck et al. , 1979 ; Gotlib and Krasnoperova, 1998 ; Maj et al. , 2020 ). Related to failure, individuals with dysfunctional cognitive schemas may harbor beliefs such as if something fails at work (or in graduate research), they are a failure as a person or that a small failure can be as detrimental as a larger failure ( Weissman, 1979 ; Miranda and Persons, 1988 ). As such, setbacks in research may be particularly difficult for PhD students with depression. Graduate students in our study also mentioned how failing in research was often out of their control, particularly failure related to experiments and research projects. The extent to which one feels they can control their environment is important for mental health, and lower estimates of control have been hypothesized to be an important factor for depression ( Grahek et al. , 2019 ). Therefore, this feeling of being unable to control success in research may further exacerbate student depression, but this would need to be tested. Importantly, these findings do not imply that individuals with depression are unable to cope with failure; they only suggest that individuals perceive that failure in science can exacerbate their depression.

Social Support and Isolation

Graduate students reported that feelings of isolation in research could worsen their depression. Specifically, they highlighted that it can be difficult for their mental health when their friends outside graduate school cannot relate to their struggles in research and when others in their research group are not working on similar projects. One study of more than 1400 graduate students at a single university found that feeling isolated from fellow graduate students and faculty positively predicted imposter phenomenon ( Cohen and McConnell, 2019 ), defined as the worry that they were fooling others about their abilities and that their fraudulence would be exposed ( Clance and Imes, 1978 ), which is positively correlated with depression among college students ( McGregor et al. , 2008 ). Developing a positive lab environment, where undergraduates, graduate students, and postgraduates develop positive relationships, has been shown to positively affect undergraduates ( Cooper et al. , 2019 ) and may also positively affect graduate students who experience such feelings of isolation. Graduate students in this study described that both teaching and research had the potential to be a source for relationship development and social support. Students who described positive collaborative relationships in research and teaching felt this had a positive impact on their depression, which aligns with a review of studies in psychiatry concluding that being connected to a large number of people and having individuals who are able to provide emotional support by listening or giving advice is protective against depression ( Santini et al. , 2015 ), as well as a study that found that social support is protective against depression, specifically among the graduate population ( Charles et al. , 2021 ).

These four factors provide clear targets for graduate programs looking to improve the experiences of students with depression. For example, increasing structure in research could be particularly helpful for graduate students with depression. Ensuring that students have concrete plans to accomplish each week may not only positively impact depression by increasing structure, but ultimately by increasing a student’s success in research. Research mentors can also emphasize the role of failure in science, helping students realize that failure is more common than they may perceive. Increasing opportunities for positive reinforcement in teaching and research may be another avenue to improving student mental health. Providing students with appropriate teacher training is a first step to enhancing their teaching skills and potential for positive reinforcement from undergraduate students ( Schussler et al. , 2015 ). Additionally, teaching evaluations, a common form of both positive and negative reinforcement, are known to be biased and disadvantage women, People of Color, and those with non–English speaking backgrounds ( Fan et al. , 2019 ; Chávez and Mitchell, 2020 ) and arguably should not be used to assess teaching. In research, mentors can make an effort to provide positive feedback or praise in meetings in addition to critiques. Finally, to provide social support to graduate students with depression, graduate programs could consider creating specific initiatives that are related to supporting the mental health of graduate students in their departments, such as a support group for students to meet and discuss their experiences in graduate school and how those experience pertain to their mental health.

Limitations and Directions for Future Research

In this study, we chose to only interview students with the identity of interest (depression), as is common with exploratory studies of individuals with underserved, underrepresented, or marginalized identities (e.g. Carlone and Johnson, 2007 ; Cooper and Brownell, 2016 ; Barnes et al. , 2017 , 2021 ; Downing et al. , 2020 ; Gin et al. , 2021 ; Pfeifer et al. , 2021 ). However, in future studies, it would be beneficial to also examine the experiences of individuals who do not have depression. This would provide information about the extent to which specific aspects of graduate research and teaching are disproportionately beneficial or challenging for students with depression. In this study, we did not explicitly examine whether there was a relationship between students’ identities and depression because of the small number of students in particular demographic groups. However, a theme that occurred rather infrequently (but is included in the Supplemental Material) is that discrimination or prejudice in the lab or academia could affect depression, which was reported exclusively by women and People of Color. As such, disaggregating whether gender and race/ethnicity predicts unique factors that exacerbate student depression is an important next step in understanding how to create more equitable and inclusive research and teaching environments for graduate students. Moreover, our sample included a significant number of students from ecology and evolutionary biology PhD programs, which may limit the generalizability of some findings. It is important to acknowledge potential subdisciplinary differences when considering how research may affect depression. Additionally, some of the factors that affect student depression, such as lack of teaching training and confidence in teaching, may be correlated with time spent in a graduate program. Future quantitative studies would benefit from examining whether the factors that affect student depression depend on the student’s subdiscipline and time spent in the graduate program. The primary focus of this study was the relationship between depression and graduate teaching/research. Many of the factors that emerged from the interviews are also associated with burnout ( Bianchi et al. , 2014 ; Maslach et al. , 2001 ). Burnout and depression are known to be highly related and often difficult to disaggregate ( Bianchi et al. , 2014 ). It was beyond the scope and design of this study to disaggregate which factors relate exclusively to the condition of burnout. Additionally, the interviews in this study were collected at a single time point. Thus, we are unable to differentiate between students who had depression before starting graduate school and students who experienced depression after starting graduate school. Future longitudinal studies could explore the effects of students’ experiences in research and teaching on their depression over time as well as on long-term outcomes such as persistence in graduate programs, length of time for degree completion, and career trajectory. This study identified a number of factors that graduate programs can address to benefit graduate student mental health, and we hope that future studies design and test interventions designed to improve the experiences of graduate students in teaching and research.

In this interview study of 50 life sciences PhD students with depression, we examined how graduate research and teaching affect students’ depressive symptoms. We also explored how depression affected graduate students’ teaching and research. We found that graduate students more commonly highlighted ways that research negatively affected their depression and ways that teaching positively affected their depression. Four overarching factors, three of which were related to both teaching and research, were commonly associated with student depression, including the amount of structure provided in research and teaching, failure and success, positive and negative reinforcement, and social connections and isolation. Additionally, graduate students identified depression as having an exclusively negative effect on their research, often hindering motivation, concentration, and self-esteem. However, they did note that depression made them more compassionate teachers, but also could cause them to have low energy or feel disconnected when teaching. This study provides concrete factors that graduate programs can target in hopes of improving the experiences of life sciences PhD students with depression.

Important Note

There are resources available if you or someone you know is experiencing depression and want help. Colleges and universities often have crisis hotlines and counseling services designed to provide students, staff, and faculty with treatment for depression. These can often be found by searching the university website. Additionally, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (text “CONNECT” to 741741; Text Depression Hotline, 2019 ), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). If you would like to learn more about depression or depression help and resources near you, visit the Anxiety and Depression Association of American website: https://adaa.org ( Anxiety and Depression Association of America, 2019 ) and the Depression and Bipolar Support Alliance: http://dbsalliance.org ( Depression and Bipolar Support Alliance, 2019 ).

Acknowledgments

We are incredibly grateful to the 50 graduate students who were willing to share their personal experiences with us. We thank Sara Brownell, Tasneem Mohammed, Carly Busch, Maddie Ostwald, Lauren Neel, and Rachel Scott for their helpful feedback on earlier drafts of this work. L.E.G. was supported by an NSF Graduate Fellowship (DGE-1311230). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF.

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• Watkins, E., Brown, R. G. (2002). Rumination and executive function in depression: An experimental study . Journal of Neurology, Neurosurgery & Psychiatry , 72 ( 3 ), 400–402. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Weissman, A. (1979). Dysfunctional Attitude Scale (DAS) . Acceptance and Commitment Therapy. Measures Package , 54–56. http://www.integrativehealthpartners.org/downloads/ [ Google Scholar ]
• Woolston, C. (2017). Graduate survey: A love–hurt relationship . Nature , 550 ( 7677 ), 549–552. [ Google Scholar ]
• Woolston, C. (2019a, August 30). A better future for graduate-student mental health . Nature .  10.1038/d41586-019-02584-7 [ PubMed ] [ CrossRef ] [ Google Scholar ]
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Doctoral College

Depression, anxiety and my PhD

Trigger warning- please note that this blog post may contain topics which some people may find sensitive.

In November I successfully defended my PhD. I am now officially Dr Delafield. However, if we rewind to December 2019, I was sat on a bench on campus crying on the phone to my partner discussing whether or not I should leave my program.

I have suffered from anxiety and depression for over 10 years and knew the potential threat a PhD might pose to my mental health before I had even started. It’s no secret that the culture of overwork in academia, alongside experiences of bullying and discrimination, contributes to 86% of PhD students reporting marked levels of anxiety. [1]

I am telling you my story to help tackle the stigma around mental health. If you are struggling, I want you to know that you are not alone. Seeking help is a strength, not a weakness and you should never feel shame in doing so.

Since starting my PhD I have actively tried to protect my mental health. [2] I disclosed my history of anxiety and depression to the university and my supervisor. I took the annual leave I was entitled to. I avoided working on the evenings or weekends. When problems arose I would approach my supervisor to try to work through them.

Despite my efforts, by late 2018 I found myself struggling. I was living apart from my partner and had taken on teaching work which I didn’t yet feel particularly confident in doing. I often felt a strong sense of imposter syndrome. I did not feel like I belonged and I started having difficult discussions with my supervisor regarding the direction I wanted to take my research in. I spent weeks at my desk getting very little done as most of my energy was going into trying not to cry.

I tried to access counselling through the university and my GP but had no success. The university’s counselling service was so oversubscribed at the time they had closed the waiting list and the NHS could not offer me the type of therapy I needed. I ended up using the money I was making through my teaching work to pay for private therapy (the irony of this situation did not escape me…).

With the help of therapy, I started to prioritise what I wanted to get from my PhD experience and took the pressure off of myself to achieve the ‘perfect’ piece of research. I started to reap the benefits of disclosing my disability to the university by attending Health, Wellbeing and Support for Study (HWSS) meetings and asking to be assigned a wellbeing mentor. [3] Most importantly I learnt the power of saying no and setting clear boundaries in an environment which (sadly) encourages overworking. [4]

All of these measures helped me considerably. However due to a lack of sick pay, I never actually took time off to fully recharge. By December 2019, a series of events culminated in me sitting on that bench, in tears, deciding whether I should leave my PhD program. I took Christmas to gather myself and be with my family. A stroke of good fortune occurred in January 2020 when I saw a tweet highlighting that UKRI had updated their sick pay policy which meant I was now entitled to 13 weeks paid sick leave per year. By February, I had made the decision to interrupt my studies.

In total, I took 15 weeks off from my PhD. For many weeks, my to do list consisted simply of: eat, shower, take my antidepressants and do some mindfulness or yoga. Some days I felt fairly content, other days I was plagued by feelings of guilt and shame. I was lucky enough to have a strong support network around me who reminded me that taking an interruption from (or even quitting) your PhD is not a sign of weakness, it is a sign of great strength. At the end of the day looking after your mind and body is much more important than work. I started doing some volunteering which reminded me of the transferable skills I’d developed throughout my PhD.

Time away from the PhD allowed me to spend time looking after myself and put measures in place to ensure when I returned to my research I’d be better supported. I set out a clear plan for my remaining chapters, I brought onboard a new second supervisor, and arranged several HWSS meetings to check in on how I was doing. I started attending Shut Up & Write sessions with fellow PhD students to provide structure to my days. I felt empowered by my decision to put my health first and started campaigning to raise awareness of inclusivity issues within the university.

The final stages of my PhD were difficult, I cannot lie. I requested a 3 month COVID extension as lockdowns had heightened my sense of anxiety. In the last few months leading up to my deadline, I worked longer hours to ensure I finished on time. The physical symptoms of stress took their toll on me. Checking in with my wellbeing mentor every week however allowed me to note when I wasn’t taking good enough care of myself and put in place measures to manage my health. With the support of friends and family, I finally submitted my thesis. I celebrated by sleeping, sunbathing and listening to audiobooks for a solid 2 weeks.

I am proud of myself, not only for finishing my PhD, but for doing so whilst championing myself and my rights as a disabled individual.

I live in hope that the culture in academia will change. That more and more individuals will reject the expectation to overwork and fight for systematic change. That universities will work with the community to create an environment where everyone, no matter their disability, gender, race or sexuality, is supported to achieve what they are capable of.

Written by: Gemma Delafield (former PhD student in the Business School)

We realise that through reading this article you may find some of the information distressing and/or may identify with some of the issues and therefore may need some support. Below is a list of support available to all PGR students at Exeter:

Wellbeing Support

• Exeter based students- Speak to the University of Exeter’s Wellbeing team (available to all students on the Streatham and St Lukes campuses)
• Cornwall based students- Speak to Fxplus wellbeing services (available to all students based on the Penryn or Truro campuses)
• Speak to the PGR Education Welfare Advisor- [email protected]
• University Networks
• Call Spectrum Life (available to PGRs and staff)
• Speak to your GP
• Call the Samaritans on 116 123
• Details of all the support available to PGRs can be found on the Doctoral College website
• If there is an immediate emergency please call 999. Further details about urgent support available please see the Wellbeing website .

Policies to support PGRs

• UKRI’s sick pay policy
• The University of Exeter’s sick pay policy
• The University of Exeter’s Health Wellbeing and Support for study procedures (HWSSP)
• Doctoral College Parent and Carer webpage

[1] https://www.advance-he.ac.uk/news-and-views/postgraduate-researchers-are-positive-about-their- experience-despite-high-anxiety

[2] You can read my previous blog about work life balance here .

[3] You can find out more about HWSS meetings and Disability Support Allowance funded wellbeing mentors here and here .

[4] A useful TED talk about setting boundaries.

We have 40 depression PhD Projects, Programmes & Scholarships

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Mscr - astrocyte mechanisms in depression, phd research project.

PhD Research Projects are advertised opportunities to examine a pre-defined topic or answer a stated research question. Some projects may also provide scope for you to propose your own ideas and approaches.

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This project does not have funding attached. You will need to have your own means of paying fees and living costs and / or seek separate funding from student finance, charities or trusts.

Identification of depression and loneliness in early stages of dementia

Routine monitoring of depression and anxiety in patients with chronic kidney disease (ckd), the management of young people's mental health in primary care, modelling within-individual variability of clinical parameters and investigation of their effects on clinical decision-making, design for early detection of symptoms of anxiety and depression in university students, phd cognitive science: investigating the safety, tolerability, and feasibility of a stroboscopic intervention in mild to moderate forms of major depressive disorder, funded phd project (students worldwide).

This project has funding attached, subject to eligibility criteria. Applications for the project are welcome from all suitably qualified candidates, but its funding may be restricted to a limited set of nationalities. You should check the project and department details for more information.

The role of air-sea interactions in Indian monsoon depressions

Phd studentship - a digital health intervention for emotional wellbeing in midlife women, deciphering how nlrp3 inflammasome- and sting-driven inflammatory pathways are linked to mental health disorders, mscr - early-life stress, susceptibility to mental health disorders and glia: central immune response in a rat model of pre-term birth, mood and reward and mental health, unravelling the genetic & environmental basis of chronic pain, competition funded phd project (students worldwide).

This project is in competition for funding with other projects. Usually the project which receives the best applicant will be successful. Unsuccessful projects may still go ahead as self-funded opportunities. Applications for the project are welcome from all suitably qualified candidates, but potential funding may be restricted to a limited set of nationalities. You should check the project and department details for more information.

Investigating Neuropeptide Signalling From Synthesis to Survival

'a vernacular scientific imaginary' the origins and impacts of science fiction stories and strips in british comics in the first half of the 20c.

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Let's talk about post-graduate depression and anxiety

In the academic year of 2020/2021, a recorded 2.66 million students attended a UK higher education institution. Applicant numbers have only grown in recent years and, with the increase of university students, there has also been a surge in the amount of postgraduate students experiencing depression and anxiety, also commonly referred to as 'post-grad blues'. Once dismissed, post-graduate depression and anxiety is now recognised by many counsellors as a very real experience that some students go through after graduating from university.

What is post-graduate depression and anxiety?

Post-graduate depression and anxiety refers specifically to the presentation of depression and anxiety in an individual after completing an undergraduate or postgraduate degree. However, the term can also be applied to any individual completing higher education.

It is not uncommon for students to experience a form of anxiety and/or depression after completing their studies. There can be feelings of uncertainty regarding their future, pressures to secure work, difficulty adjusting to the transition from student life to the mainstream, as well as changing relationships as peers move on.

Additionally, according to research undertaken by the medical journal Addictive Behaviour Reports , manifestations of anxiety and depression may occur in higher education students due to the sheer amount of time they have spent within education – many have attended school in some capacity for a minimum of 15 years, making it a very real and very large part of their identity.

The transition from education to the mainstream can stir feelings of isolation, low self-esteem, general insecurity, irritability and low mood.

What are the symptoms of post-graduate depression and anxiety?

Symptoms of post-graduate depression and anxiety are similar to the common signs of clinical depression and an anxiety disorder. For example, individuals experiencing post-graduate depression and anxiety may present with psychological symptoms such as:

• sadness and/or continuous low mood
• low self-esteem
• irritability
• feelings of guilt
• general sense of failure
• decreased motivation

What are some tools to overcome post-graduate depression and anxiety?

The uncertainty surrounding transitioning from education to the mainstream can be very unsettling for some, however, there are several practices that you can put in place to help alleviate the symptoms of post-graduate depression and anxiety.

1. Adopt mindfulness

Allow yourself to experience the array of emotions that come up; be curious and non-judgemental in exploring your thoughts and feelings. In doing this, you may eventually be able to make better sense of them and overcome negative feelings stirred by your change in circumstance.

2. Make the most of the services available to you

Most schools and universities will have a careers service/department, where you can ask for support with job applications, upskilling, as well as putting in place a plan to create a more stable routine.

3. Remember that many other graduates are experiencing the same feelings as you

Lots of students leaving school and university find themself in the same position, which may stir up similar feelings of low mood and anxiousness. This is important to remember because it reaffirms that you are not isolated in your experience, and that how you are feeling will not last forever.

4. Reach out to someone

If you are struggling with low mood, or any psychological and/or physical symptoms related to depression and anxiety, speak to someone. You may choose to talk to your partner, friends, members of your family or even a counsellor .

Here at Hope Therapy, we offer UK-wide mental health and wellbeing support via coaching, counselling, cognitive behavioural therapy (CBT), EMDR and mindfulness. We understand how difficult a change in circumstance, in particular transitioning from education to the mainstream, can be. As such, we have access to counsellors in a variety of locations throughout England that can support you either face-to-face or virtually, depending on the support you are looking for.

To book a free 15-minute counselling consultation to discuss your needs, please visit hopefulminds.co.uk, or alternatively contact us via telephone on 07379 538411 between the hours of 9am till 9pm from Monday to Sunday.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team .

Ian Stockbridge is the founder and lead counsellor at Hope Therapy and Counselling Services.  As an experienced Counsellor, Ian recognised a huge societal need for therapeutic services that were often not being met. As such the 'Hope Agency'was born and its counselling team now offers counselling and therapeutic support throughout the UK.

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Professional Reference tools are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines, so you may find the language more technical than the  condition leaflets .

Please note that this questionnaire is not designed for people to complete without any input from their healthcare professional . Please contact your doctor if you are:

Concerned about your mood; or

Have completed this questionnaire and it indicates that you may be depressed.

If you are having any thoughts of self-harm, please read our leaflet on  Dealing with Suicidal Thoughts , which gives advice on all the help that is available .

This easy to use patient questionnaire is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. 1 The PHQ-9 is the depression module, which scores each of the nine DSM-IV criteria as "0" (not at all) to "3" (nearly every day). It has been validated for use in primary care. 2

It is not a screening tool for depression but it is used to monitor the severity of depression and response to treatment. However, it can be used to make a tentative diagnosis of depression in at-risk populations - eg, those with coronary heart disease or after stroke. 3 4

When screening for depression the Patient Health Questionnaire (PHQ-2) can be used first (it has a 97% sensitivity and a 67% specificity). 5 If this is positive, the PHQ-9 can then be used, which has 61% sensitivity and 94% specificity in adults.

Patient Health Questionnaire (PHQ-9)

Over the last two weeks, how often have you been bothered by any of the following problems?

Depression severity scale:

Validity has been assessed against an independent structured mental health professional (MHP) interview. PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88% for major depression. 1  It can even be used over the telephone. 6

Continue reading below

Note about credits

The copyright for the PHQ-9 was formerly held with Pfizer, who provided the educational grant for Drs Spitzer, Williams and Kroenke who originally designed it. 1 This is no longer the case and no permission is required to reproduce, translate, display or distribute the PHQ-9.

Further reading and references

• Kroenke K, Spitzer RL, Williams JB ; The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep 16(9):606-13.
• Cameron IM, Crawford JR, Lawton K, et al ; Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. Br J Gen Pract. 2008 Jan 58(546):32-6. doi: 10.3399/bjgp08X263794.
• Haddad M, Walters P, Phillips R, et al ; Detecting depression in patients with coronary heart disease: a diagnostic evaluation of the PHQ-9 and HADS-D in primary care, findings from the UPBEAT-UK study. PLoS One. 2013 Oct 10 8(10):e78493. doi: 10.1371/journal.pone.0078493.
• de Man-van Ginkel JM, Gooskens F, Schepers VP, et al ; Screening for post stroke depression using the patient health questionnaire. Nurs Res. 2012 Sep-Oct 61(5):333-41.
• Maurer DM ; Screening for depression. Am Fam Physician. 2012 Jan 15 85(2):139-44.
• Pinto-Meza A, Serrano-Blanco A, Penarrubia MT, et al ; Assessing depression in primary care with the PHQ-9: can it be carried out over the telephone? J Gen Intern Med. 2005 Aug 20(8):738-42.

Multiple moves during childhood can increase the risks of depression in later life

New research used population registers to examine the early-life experiences, and any subsequent depression diagnoses, of almost 1.1 million people.

Mr Alan Williams

Senior Media and Communications Officer 

Communication Services (Marketing and Communications)

People who experience a significant number of moves before the age of 15 are over 40% more likely to be diagnosed with depression in later life, a new study has shown. The research, published in the journal JAMA Psychiatry , analysed all residential locations of almost 1.1 million people born in Denmark between 1981 and 2001 and who stayed in the country during the first 15 years of their lives. It then tracked those same individuals into adulthood, and found at least 35,000 of those still living within Denmark had subsequently received a medical diagnosis of depression. As part of a detailed analysis, the study supported existing evidence by showing that individuals who live in income deprived neighbourhoods during childhood are more likely – by a factor of around 10% – to develop depression in adulthood. However, it for the first time showed that experiences of moving during childhood – whether between or within deprived or non-deprived neighbourhoods – is also associated with significantly higher rates of depression in adulthood. Specifically, children who move once between ages 10 to 15 are 41% more likely to be diagnosed with depression than those who don’t move. And if a child moves twice or more between the ages of 10 and 15, the risk rises to around 61%. This is a stronger effect than growing up in a deprived neighbourhood. It has led researchers behind the study to suggest a settled home environment – in terms of location – during childhood may be one way of protecting against future mental health issues. The study was carried out by researchers from Aarhus University (Denmark), the University of Plymouth (UK) and the University of Manchester (UK). Professor Clive Sabel , Professor of Big Data and Spatial Science at the University of Plymouth and former Director of the Big Data Centre for Environment and Health at Aarhus University, is the study’s lead author.

We know there are a number of factors which lead to a person being diagnosed with a mental illness. However, this is the first evidence to suggest that moving to a new neighbourhood during childhood is among them, and we believe the numbers we are seeing could be the tip of the iceberg. During those formative years, children are building their social networks through school, sports groups or other activities. Each time they have to adapt to something new it can be disruptive, so we potentially need to find new ways to help people overcome those challenges.

“This study emphasises the importance of global policies which enable and support settled childhoods, but ones that take into account regional and cultural identities. However, based on our findings, we also believe particular groups of young people may be at heightened risk. Young people in care often face multiple moves and are potentially being placed under additional pressures. Then there are military children, who move regularly depending on where their parents are stationed. This study would suggest they, and other such children, may need additional assistance to prevent the development of mental illness in later life.”

• The full study – Sabel et al: Changing neighborhood income deprivation over time, moving in childhood and adult risk of depression – is published in JAMA Psychiatry , DOI: 10.1001/jamapsychiatry.2024.1382.

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More news and updates

• Multiple moves during childhood can increase the risks of depression in later life 17 July 2024
• University shortlisted for two Green Gown Awards 17 July 2024
• Study explores what attracts people to watch live-streams of disasters and extreme weather 2 July 2024
• First transatlantic vessel-to-grid project aims to advance marine electrification 21 June 2024
• How soil health collaborations are changing agriculture 20 June 2024

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Longitudinal analysis of the UK COVID-19 Psychological Wellbeing Study: Trajectories of anxiety, depression and COVID-19-related stress symptomology

Affiliations.

• 1 Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, United Kingdom. Electronic address: [email protected].
• 2 Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, United Kingdom. Electronic address: [email protected].
• 3 Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, Queen's University Belfast, BT9 5BN, United Kingdom. Electronic address: [email protected].
• 4 Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, United Kingdom. Electronic address: [email protected].
• 5 Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, Queen's University Belfast, BT9 5BN, United Kingdom. Electronic address: [email protected].
• PMID: 34388511
• PMCID: PMC8424320
• DOI: 10.1016/j.psychres.2021.114138

COVID-19 has had a negative impact on the mental health of individuals. The aim of the COVID-19 Psychological Wellbeing Study was to identify trajectories of anxiety, depression and COVID-19-related traumatic stress (CV19TS) symptomology during the first UK national lockdown. We also sought to explore risk and protective factors. The study was a longitudinal, three-wave survey of UK adults conducted online. Analysis used growth mixture modelling and logistic regressions. Data was collected from 1958 adults. A robust 4-class model for anxiety, depression, and CV19TS symptomology distinguished participants in relation to the severity and stability of symptomology. Classes described low and stable and high and stable symptomology, and symptomology that improved or declined across the study period. Several risk and protection factors were identified as predicting membership of classes (e.g., mental health factors, sociodemographic factors and COVID-19 worries). This study reports trajectories describing a differential impact of COVID-19 on the mental health of UK adults. Some adults experienced psychological distress throughout, some were more vulnerable in the early weeks, and for others vulnerability was delayed. These findings emphasise the need for appropriate mental health support interventions to promote improved outcomes in the COVID-19 recovery phase and future pandemics.

Keywords: Anxiety; COVID-19; Depression; Mental health; Traumatic stress; longitudinal studies.

Copyright © 2021. Published by Elsevier B.V.

PubMed Disclaimer

Conflict of interest statement

Trajectories for depression, anxiety and…

Trajectories for depression, anxiety and CV19TS.

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• The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. Filippetti ML, Clarke ADF, Rigato S. Filippetti ML, et al. BMC Pregnancy Childbirth. 2022 Jan 26;22(1):68. doi: 10.1186/s12884-022-04387-7. BMC Pregnancy Childbirth. 2022. PMID: 35081906 Free PMC article.
• Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study. Jia R, Ayling K, Chalder T, Massey A, Broadbent E, Coupland C, Vedhara K. Jia R, et al. BMJ Open. 2020 Sep 15;10(9):e040620. doi: 10.1136/bmjopen-2020-040620. BMJ Open. 2020. PMID: 32933965 Free PMC article.
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Migraine, anxiety, depression: phd scholars at jamia allege harassment by guide, while a scholar accused the supervisor of sexual harassment, another left the course due to his alleged misconduct..

(Trigger Warning: Details of sexual harassment. The names of the complainants have been changed to protect their identity.)  

“I have gone through serious mental health issues, that have impacted my physical health. I have got migraines, which are getting more serious by the day.”  

“I suffered from retinal haemorrhage and depression, which are directly attributed to the prolonged emotional distress and pressure I have endured under his supervision.” 

“I was compelled to withdraw from the course after suffering from severe anxiety attacks and insomnia.”  

Three PhD scholars from the Delhi’s Jamia Millia Islamia have alleged that their supervisor, a senior faculty member, has been harassing them mentally and sexually over the last couple of years.

The three women have claimed that they have undergone serious mental trauma under his mentorship because of his "misogynistic, unprofessional and toxic attitude." While one of them has accused the supervisor of sexual harassment, another has left the course due to his alleged misconduct.  

The three claimed they submitted written complaints more than once – first in May, and then in July – to their department’s Director, the Dean and the varsity’s Registrar, demanding action against the said supervisor and a new mentor so that they can continue with their course work peacefully. But they claimed that their pleas have not been heeded so far.  

The Quint has reached out to all the concerned authorities at Jamia Millia Islamia for a response on the allegations. The Dean of Social Sciences Md Muslim Khan told The Quint on 16 July that "The professor (concerned) has been suspended."

‘Threw My Research Proposal, Made Fun of My Married Life’

On 9 May, in a written complaint to the Director of their centre, Ayesha* wrote that she had been experiencing “significant mental harassment” by her supervisor for the last one-and-a-half years. She claimed that her “earnest efforts and diligent presentation” of numerous research proposals, were “only met with indifference and mockery” from the supervisor. 

“His refusal to engage with my work and tendency to belittle my questions has left me feeling demoralised and insecure about my abilities as a researcher,” Ayesha* wrote in her complaint. 

Kavita* too accused the supervisor of not only rejecting her synopsis for two-and-a-half years, but also throwing it in front of another colleague, leaving her “embarrassed.” In her complaint to the university’s Registrar sent on 14 May, she accused the supervisor of making “fun of her married life” and “ridiculing” her because she was pregnant.  

“During my pregnancy, his toxic behaviour made me feel like ending my life...I corrected my synopsis 20 times, but he was still not satisfied and forced me to leave PhD,” Kavita* alleged. 

‘Made Me Sit in His Office for Hours, Google and Read Out His Feats’

Ayesha* alleged that every time she would go to his office to ask for his feedback, he would make her look him up online and read his introduction, make her read his book’s excerpts and abstracts but wouldn’t assess her work. Ayesha* said that she had done this exercise “more than 100 times.” 

This was also mentioned in the written complaints of the other two PhD scholars.

While Kavita said that he would make her sit “in his office for hours and asked me to google him,” Aditi alleged that when she refused to read out his achievements, he “behaved rudely and threatened to not help me with my research.”

Aditi* alleged that the supervisor rejected her proposals over minor issues such as spelling and typographical errors and even “insulted” her writing. 

“When I submitted the same work to Jamia International Conference on Education, not only did it get selected, the professors of Faculty of Education, Jamia Millia Islamia also published it in the form of a chapter in the book Changing Paradigms of Education ,” Aditi* told The Quint .  

However, she was allegedly “compelled” to withdraw from the course after suffering from “severe anxiety attacks and insomnia.”  

'Misogynistic, Racist, Inappropriate Comments'

“On my early proposal on a particular refugee community, the supervisor told me if I do research on the marginalised, I will become one of them one day,” Ayesha* alleged to The Quint . 

She added that when she changed her proposal to a study on women, the supervisor passed “misogynistic statements” during the discussion and “insulted” her. The supervisor’s attitude has caused a lot of emotional turmoil and anxiety, Ayesha* wrote in her complaint.  

She added that the supervisor also ventured into inappropriate topics during coursework in the classroom sessions by allegedly discussing methods to “enhance sexual drive.”  

“During a lecture, he randomly remarked, ‘Drumsticks (vegetables) are healthy as they boost sexual drive',” Ayesha* alleged in her complaint. 

Aditi wrote in her complaint that he would pass sexist remarks at female scholars and faculty members, including the Director of their department. Kavita too alleged that he would “constantly belittle criticise and question the academic integrity of other female faculty members of the university.” 

"He used to often say in the classroom - 'Women are now in every position; the director of your center (CJNS) is a woman and a boss here in the office, but she is a slave at home or becomes powerless. I might not be a boss here, but I am powerful at home, basically a boss," Ayesha* alleged.

‘He Would Call Late at Night, Comment on Sexual Needs’

Kavita* said that the supervisor would usually call her at night and begin the conversation by asking if “I was alone.” Recalling an incident of September 2022, after she had completed her course work, Kavita* alleged in her written complaint:  

“He told me to leave PhD and go to my husband’s place and satisfy his sexual needs well. He asked me if I don’t have any sexual needs. I was shivering at that time.”  

She claimed that she was “compelled to receive his calls,” otherwise he would behave very rudely in the next meeting and would not look at her academic work.  

Aditi* alleged that he would comment on her clothes and jewellery and would “pass lewd comments on whether I should make male friends or not.” 

Citing reports from AIIMS, Kavita* said she suffered from retinal haemorrhage and clinical depression in the last 18 months and is now taking medication daily for thyroid-related issues. She claimed her conditions “are directly attributed to the prolonged emotional distress and pressure I have endured under his supervision.” 

'Targets Women Scholars, Many Suffered Under Him’

Ayesha* and Aditi* both alleged that the supervisor mostly “picks women scholars” and that “most of them have discontinued” their research.    

The Quint spoke to an alumna, Pooja*, who claimed she faced “emotional abuse” under the said supervisor when she was pursuing her PhD from 2015 to 2022.  “He used to just look at us for hours while we would read out his achievements online in his office,” Pooja* alleged.

When she tried to raise a complaint against him, he allegedly told her that “no action will be taken against him” as he was in an important position at that time.    

She added that she could lodge a formal complaint only in September 2020, when he was no longer in that position. Pooja* claimed that his successor acknowledged her complaint and promptly changed her supervisor, after which she could complete her research. The Quint has reached out to the concerned in-charge and will update the story once he responds.

However, Pooja* had to withdraw her complaint. 

“When my grievances were heard by the Internal Complaints Committee (ICC), they said I wouldn’t get my degree until the proceedings continue. I had already spent seven years on my PhD and couldn’t afford to wait any longer. So, I withdrew my complaint,” Pooja* alleged to The Quint .  

‘Suffered Severe Anxiety, Withdrew from PhD’

Two months after she had submitted her first complaint, Ayesha* received an email on 6 July, which asked her to report to her supervisor and present her progress report. To this, she outrightly refused and wrote an email marking other professors in her department. It stated: 

“Meeting with my supervisor is now traumatic for me. No one understands the effort it takes to rebuild my self-worth and confidence after each meeting over the past two years. This caused me to suffer from severe migraines, anxiety, and depression. I was healthy before joining this center.” 

Kavita* and Aditi* too received the same communication but refused to report to him. The complainants sent the second set of emails, again detailing their grievances, to the concerned authorities on 7-8 July.

"Why are we being pushed to meet a habitual harasser?" Aditi* asked as Kavita pointed at a possible violation of Vishakha Guidelines against Sexual Harassment at Workplace, which state that the complainant and the respondent should not be brought face to face with each other.

In her first complaint, Aditi* had demanded a thorough investigation and appropriate action against the toxic culture perpetuated by the supervisor. After no update on her complaint for more than a month, Aditi* withdrew from her PhD position on 25 June. The Director allegedly accepted her application to withdraw the next day and asked her to go home.

"Ironically, I was pursuing my PhD on women's access to education. I feel now that my whole study was null and void, as the university system is not letting its female scholars access higher education," Aditi* lamented.

Meanwhile, Kavita* has demanded that the authorities sensitise the supervisor on gender issues and punish him for his misconduct towards her and her other women colleagues.  

“If I am married and have a child, it doesn’t mean I am not capable of pursuing PhD,” Kavita* said.  

(*Names have been changed to protect the identity of complainants)

( At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a membe r . Because the truth is worth it. )

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Yann McLatchie awarded G-research PhD grant

16 July 2024

Our first-year PhD student Yann McLatchie has been awarded a £1,285.00 grant from G-research to attend the 2024 ISBA World meeting this year in Venice, where he will present his work on light-weight model selection-induced bias estimation and correction!

Find out more here:  https://www.gresearch.com/news/g-research-may-2024-grant-winners/ ;  https://arxiv.org/abs/2309.03742 .

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• Published: 16 July 2024

Polygenic prediction of major depressive disorder and related traits in African ancestries UK Biobank participants

• S. C. Kanjira 1 , 2 ,
• M. J. Adams   ORCID: orcid.org/0000-0002-3599-6018 1 ,
• Y. Jiang 3 ,
• C. Tian 3 ,
• 23andMe Research Team ,
• C. M. Lewis   ORCID: orcid.org/0000-0002-8249-8476 4 ,
• K. Kuchenbaecker   ORCID: orcid.org/0000-0001-9726-603X 5 &
• A. M. McIntosh   ORCID: orcid.org/0000-0002-0198-4588 1 , 6  

Molecular Psychiatry ( 2024 ) Cite this article

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Genome-Wide Association Studies (GWAS) over-represent European ancestries, neglecting all other ancestry groups and low-income nations. Consequently, polygenic risk scores (PRS) more accurately predict complex traits in Europeans than African Ancestries groups. Very few studies have looked at the transferability of European-derived PRS for behavioural and mental health phenotypes to Africans. We assessed the comparative accuracy of depression PRS trained on European and African Ancestries GWAS studies to predict major depressive disorder (MDD) and related traits in African ancestry participants from the UK Biobank. UK Biobank participants were selected based on Principal component analysis clustering with an African genetic similarity reference population, MDD was assessed with the Composite International Diagnostic Interview (CIDI). PRS were computed using PRSice2 software using either European or African Ancestries GWAS summary statistics. PRS trained on European ancestry samples (246,363 cases) predicted case control status in Africans of the UK Biobank with similar accuracies (R2 = 2%, β = 0.32, empirical p-value = 0.002) to PRS trained on far much smaller samples of African Ancestries participants from 23andMe, Inc. (5045 cases, R² = 1.8%, β = 0.28, empirical p-value = 0.008). This suggests that prediction of MDD status from Africans to Africans had greater efficiency relative to discovery sample size than prediction of MDD from Europeans to Africans. Prediction of MDD status in African UK Biobank participants using GWAS findings of likely causal risk factors from European ancestries was non-significant. GWAS of MDD in European ancestries are inefficient for improving polygenic prediction in African samples; urgent MDD studies in Africa are needed.

Introduction

Depressive disorders are ranked as the third leading cause of disability, as measured by years lived with disability, with Major Depressive Disorder (MDD) being the most significant contributor to this burden. The World Health Organization estimates that more than 322 million individuals globally suffer from MDD, with at least 9% of these cases occurring in Africa [ 1 , 2 ]. While lower rates of MDD have been reported in Africa compared to Europe and North America, recent studies suggest that MDD is under-reported in Africa and that most affected individuals go undiagnosed [ 3 , 4 ].

MDD has a heritability of 30–40% [ 5 ] and better characterisation of its genetic architecture may provide both an improved mechanistic understanding and more accurate genetic prediction. So far, genome wide association studies (GWAS) have successfully identified over 243 variants to be associated with depression, focussing on participants of European ancestry [ 6 ]. Sirugo et al. showed that GWAS studies overrepresent European compared to other ancestry groups, with an approximately fivefold over-representation compared to their global population [ 7 , 8 , 9 ]. The overrepresentation of Europeans in genetics research means that the potential benefits of these studies will disproportionately apply to people of European ancestry and deprive other ancestries and low-income countries of new treatments and diagnostics [ 10 ].

Due to overrepresentation of Europeans in GWAS, polygenic risk scores (PRS) developed from these studies more accurately predict many complex traits in European than in African Ancestries samples [ 11 , 12 ]. The difference in prediction may be due to differences in the phenotypes themselves, their genetic architectures or because of gene-by-environment interactions [ 13 , 14 , 15 ]. Very few studies have looked at the transferability of European-derived PRS for behavioural and mental health phenotypes to non-Europeans generally and Africans specifically. Consequently, the predictive accuracy of European derived depression PRS to African samples remains uncertain. We looked at the transferability of MDD-PRS trained on European GWAS studies to African Ancestries participants from the UK Biobank within and across traits. Furthermore, we sought to compare the transferability of MDD-PRS trained in participants of African ancestries from 23andMe Inc., (mainly from North America), with the transferability of MDD-PRS trained on Europeans to the African-ancestry participants from the UK Biobank.

Methodology

The study focused on African participants in the UK Biobank who have a shared genetic similarity with 1000 Genomes Project’s African reference samples. The UK Biobank is a prospective cohort study of individuals of diverse ethnic backgrounds from across the United Kingdom [ 16 ]. We used Principal component analysis (PCA) to identify these participants of African ancestral background within the UK Biobank. Participants were initially selected based on self-report, individuals who self-reported as being Black or Black British (Caribbean, African, Any other Black background), White and Black Caribbean or Black African, and participants whose self-identity was not specifically categorised (responses “Other ethnic group”, “Any other mixed background”, “Do not know”, or “Prefer not to answer’) were selected. Using the genotypes provided by UK Biobank, we derived ancestry informative genetic principal components using the weights from the 1000 Genomes reference dataset to cluster the participants into their genetic similarity groupings. UK Biobank participants who clustered closely with the 1000 Genomes African (AFR) reference group were then selected for further analysis.

An online Mental Health Questionnaire that included a depression assessment was sent to UK Biobank participants by email and entitled ‘The thoughts and feelings questionnaire’ [ 17 ]. The questionnaire was offered to the 317,785 participants, out of the total 502,616 UK Biobank participants, who had agreed to email contact, and 157,396 completed the online questionnaires by June 2018, of these 1090 participants were of African ancestry. A depression phenotype was generated based on the CIDI-SF (Composite International Diagnostic Interview Short Form) [ 18 ]. Cases were defined as those participants who had at least one core symptom of depression (persistent sadness or loss of interest) for most of the day or all of the day. Symptoms had to be present for a period of over two weeks plus another four non-core depressive symptoms that represent a change from usual occurring over the same timescale, with some or a lot of impairment. Cases that self-reported another mood disorder were excluded. Controls were defined as participants who did not meet symptom criteria for MDD [ 17 , 19 ].

Polygenic risk scores

Polygenic risk scores were computed using PRSice-2 software [ 20 ]. PRSice2 software uses the clumping and thresholding method (C + T) to retain only SNPs that are weakly correlated with one another [ 20 ]. After clumping, SNPs with a p value larger than a specified level of significance were removed, PRS were then calculated by the sum of SNP allele effect sizes multiplied by the number of risk alleles. Both the base and target data sets were quality controlled (QC) by removing ambiguous and duplicate SNPs, SNPs with a minor allele frequency (MAF) of less than 1% and a genotype missingness greater than 2% were also removed. We report standardised effect sizes. Additionally, we provide empirical P values after specifying 10,000 permutations in PRSice-2.

Summary statistics

To compute polygenic risk scores in African-clustered participants of the UK Biobank, we used GWAS summary statistics of depression from global European studies (246,363 cases and 561,190 controls), a predominantly African American study from 23andMe (5045 cases, 102 098 controls), a secondary dataset comprising summary statistics from a meta-analysis of 12 African cohorts (36,313 cases, 160,775 control) and data from several traits that have been known to be associated with depression from European-clustered studies, in addition to height, which we used as a negative control. All summary statistics used in this study have been shown in Table  1 , for each set of summary statistics, SNP based heritability was calculated using linkage disequilibrium score regression as implemented in the LDSC software package [ 21 , 22 ]. To calculate heritability with LDSC, we employed LD Scores derived from UK Biobank data. Specifically, we used European LD Scores for European datasets and African LD Scores for African datasets, both sourced from the UK Biobank.

African-ancestries clustered participants in the UK Biobank

We utilised principal component analysis (PCA) to project the genetic data of UK Biobank participants onto the PCA space defined by the reference 1000 Genomes dataset. This approach enabled the identification of individuals from the UK Biobank whose genetic profiles closely resemble those of the African ancestry samples within the 1000 Genomes dataset Fig.  1 .

a A PCA plot showing the clustering of individuals of possible African ancestry (people who self-reported as being Black or Black British, other ethnic grouping, do not know, mixed, and prefer not to answer) in the UK Biobank with the reference 1000 Genomes dataset. Different colours represent the different ancestry groups in the reference 1000 Genomes dataset (AFR Africans, AMR Americans, EAS Asians, EUR Europeans, and SAS South Asians), while the grey colour indicates individuals of possible African ancestry based on self-report from the UK Biobank. b A PCA plot showing UK Biobank participants(grey) selected to be of African ancestry using PCA, alongside the reference 1000 Genomes participants.

UK Biobank participants of possible African ancestry that clustered within 6 standard deviations of the 1000 Genomes AFR cluster were selected to represent Africans in the UK Biobank. In total, 8543 participants in the UK Biobank clustered with the 1000 Genomes AFR reference group. Of these, 1090 participants completed the Mental Health Questionnaire, with 190 participants meeting the CIDI criteria for MDD cases and 671 participants meeting the criteria for controls.

Within ancestry within trait polygenic prediction of MDD from African datasets to African participants in the UK Biobank

Depression GWAS results of African participants from 23andMe (5045 cases and 102 098 controls) were used to predict MDD status in African participants of the UK Biobank (see Fig.  2 ). The summary statistics from 23andMe African ancestry significantly predicted MDD status in UK Biobank African participants across all P-value thresholds, with the most predictive P-value threshold being 0.2, explaining 1.8% of variation in MDD liability. The prediction was associated with a beta coefficient of 0.28(SE = 0.08, empirical P-value = 0.008). This PRS prediction of MDD from African sample to African sample is comparable in accuracy with prediction of PRS trained on European ancestry samples of over 800 K individuals (246,363 cases and 561,190 controls).

The y-axis displays the R2 values corresponding to the PRS predictions, while the x-axis illustrates the spectrum of p-value thresholds utilised in the PRS analysis. The p-values for the predictions are depicted atop the bars.

We also used a secondary set of summary statistics from a meta-analysed data of 12 African cohorts with 36,313 depression cases and 160 775 controls to predict MDD status in African participants of the UK Biobank. 99.6% of the cases in this meta-analysed dataset are multiple African American studies and 0.4% participants are from South Africa. In contrast, PRS trained on the meta-analysed African American dataset did not significantly predict MDD status in Africans of the UK Biobank, as shown in Fig.  3 .

Prediction of MDD status in African participants of UK Biobank using meta-analysed African MDD summary statistics from multiple African American (99%) and one Africa-based study.

Cross ancestry within trait prediction of MDD and other traits

European-based GWAS results for depression, BMI, Neuroticism, education attainment and height were used to predict within the same trait in UK Biobank African Ancestries participants. PRS trained on European GWAS results significantly predicted MDD, BMI, education attainment, and height within trait in African participants of the UK Biobank as illustrated in Fig.  4 .

The y-axis is showing the R 2 values for the PRS predictions while the x-axis is showing the most predictive bar for each trait with empirical P values for the prediction shown on top of the bars.

Specifically, the European based depression PRS explained a 2% variation in MDD risk among individuals of African Ancestries in the UK Biobank, with a beta coefficient of 0.32(SE = 0.09, empirical P-value = 0.002). The PRS associated with education attainment explained 0.7% of the variation in education attainment within the same cohort, this prediction had a beta coefficient equal 0.079 and a P-value = 0.0003 (Fig.  4 ). However, it is noteworthy that European-based Neuroticism PRS did not significantly predict Neuroticism in African Ancestries participants. Height PRS, a highly heritable trait used for comparison purposes, explained 3% of the variation in height among UK Biobank Africans.

Cross ancestry cross trait polygenic prediction of MDD

Cross ancestry cross trait polygenic prediction of MDD in Africans of the UK Biobank using PRS estimated from European based GWAS summary statistics for traits known to be associated with MDD (namely: Bipolar Disorder, BMI, Schizophrenia, Neuroticism, and education attainment) did not show any significant association (see Fig.  5 ). Height summary statistics were used for comparison purposes.

The y-axis displays the R 2 values for the PRS predictions, while the x-axis represents the most predictive bar associated with each trait, and the empirical P values for the predictions are presented atop these bars.

Polygenic risk scores trained on European GWAS studies of 246,363 depression cases predicted MDD case-control status in African Ancestries participants from UK Biobank at lower prediction accuracies (R 2  = 2%) than for European participants (R 2  = 3.2%). Polygenic risk scores trained on a much smaller single GWAS of 5045 depression cases from 23andMe Africans predicted depressed case-control status in African Ancestries participants from UK Biobank at a similar accuracy (R 2  = 1.8%), suggesting a much greater prediction accuracy relative to sample size from African than from European GWAS training datasets.

While we acknowledge that the 23andMe summary statistics used in our study indicated a negative heritability, the estimation of heritability in small sample sizes can be methodologically challenging. Large African population datasets and LD reference panels are scarce, and these findings further underpin the need for expanding research in underrepresented populations. Nevertheless, the observation that we were able to predict from the 23andMe African ancestry samples into an independent cohort suggests that MDD-relevant information is contained within these genetic associations.

Prediction of MDD status in African UK Biobank participants using European ancestry GWAS studies of other traits (known to predict MDD status in European populations) was non-significant. GWAS studies of depression from European samples are an inefficient means of improving polygenic prediction accuracy in African samples and genetic scores derived from European ancestry studies of known risk factors for depression may also be less useful for mechanistic studies.

In contrast to the findings made using 23andMe summary statistics, polygenic scores derived from a GWAS meta-analysis of several African ancestry studies within and outside of Africa, showed limited predictive ability for Major Depressive Disorder (MDD) in African Ancestries UK Biobank participants. The dataset combined 36,313 MDD cases and 160 775 controls, predominantly comprising African Americans, with a small representation (139 cases and 346 controls) from continental African populations (Drakenstein Child Health Study). Despite expectations of superior performance compared to the 23andMe dataset, various factors may have contributed to this underperformance. Firstly, while 23andMe used a single definition of MDD and a single genotyping quality-control pipeline, MDD phenotype definitions and methods varied across the included cohorts in the GWAS meta-analysis. Some studies employed stringent criteria while others used broader definitions. The inclusion of individuals with varying definitions of African Ancestries may also have increased genetic heterogeneity. The meta-analysed data primarily featured African Americans, who exhibit varying degrees of genetic admixture with other ancestral backgrounds, possibly influencing the accuracy of PRS predictions in UK Biobank. A recent study by Ding et al. in 2023 revealed that for highly polygenic traits, PRS predictive accuracy tends to diminish with increasing genetic distance between populations [ 23 ].

Several European ancestry studies have shown that various traits have a shared genetic liability with MDD, some of which may be causally associated but little is known about the shared genetic liability of MDD with other traits across ancestries [ 24 ]. We looked at cross ancestry cross trait prediction of MDD using height, BMI, bipolar disorder, schizophrenia, neuroticism, and education attainment in people of African Ancestries using European based GWAS results. Height was used as a highly heritable control trait with no known causal relationship with MDD. While our study did not yield successful predictions of MDD status in Africans of the UK Biobank using European GWAS results of various traits, it is worth noting that previous investigations conducted within European populations have demonstrated a shared genetic liability between MDD and traits such as Bipolar Disorder, BMI, and neuroticism [ 25 , 26 , 27 ]. To advance our understanding of shared genetic liability in African populations, future research endeavours could explore this aspect by training PRS using GWAS data derived specifically from African cohorts. This approach has the potential to uncover novel insights into the shared genetic components between MDD and other traits within the context of African ancestral backgrounds.

The predictive accuracy of MDD-PRS trained on predominantly African American data from 23andMe was broadly comparable to that of PRS trained on European data among individuals of African Ancestries, despite the African American PRS being based on a considerably smaller sample size compared to the European PRS. This observation aligns with findings from other studies focused on various traits, suggesting that PRS derived from African Ancestries data tends to exhibit superior performance when applied to African populations than PRS derived from European data.

Data availability

Access to UK Biobank data can be obtained by following the procedure described at http://www.ukbiobank.ac.uk/using-the-resource/ . European MDD summary statistics from Howard et al. [ 28 ] are available from https://doi.org/10.7488/ds/2458 . BMI and height summary statistics are available from the GIANT consortium. Schizophrenia, Bipolar disorder, depression and Neuroticism summary statistics are publicly available from the Psychiatric Genomics Consortium (PGC) https://pgc.unc.edu/for-researchers/download-results/ . The full GWAS summary statistics for the 23andMe data set are available to qualified researchers through 23andMe under an agreement. For more information and to apply for access, visit the 23andMe research website: https://research.23andme.com/collaborate/ .

Code availability

We used publicly available software PRSice-2 and its code is publicly available at https://github.com/choishingwan/PRSice . The tutorial for using PRSice2 is available at https://choishingwan.github.io/PRS-Tutorial/prsice/ .

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Acknowledgements

This work was supported by Wellcome Trust grants (223165/Z/21/Z [DepGenAfrica], 220857/Z/20/Z [WTIA]), UK Medical Research Council Grant (MR/S035818/1), the European Union H2020 Scheme (Grant agreement 847776) and by the US National Institutes of Health (1R01MH124873-01). We would particularly like to thank the African ancestries research participants of all studies included in the work presented here. We would also like to thank the research participants and employees of 23andMe, Inc. for making this work possible. Cathryn Lewis is part-funded by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.

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SCK performed data analysis and drafting of manuscript. MA, AM and KK supervised the research project, interpretation of results, critically revised and edited the manuscript. CML critically revised and edited the manuscript. CT, YJ and 23andMe Team contributed to data acquisition and edited the manuscript.

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YJ, CT are employed by and hold stock or stock options in 23andMe, Inc. All other authors declare no conflict of interest.

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The research involved human data in accordance with the Declaration of Helsinki. All participants provided written informed consent and the current study (application number 4844) was approved by the NHS National Research Ethics Service (approval letter dated 17th June 2011, Ref 11/NW/0382). All participants gave full informed written consent.

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Kanjira, S.C., Adams, M.J., Jiang, Y. et al. Polygenic prediction of major depressive disorder and related traits in African ancestries UK Biobank participants. Mol Psychiatry (2024). https://doi.org/10.1038/s41380-024-02662-x

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Received : 16 December 2023

Revised : 27 June 2024

Accepted : 03 July 2024

Published : 16 July 2024

DOI : https://doi.org/10.1038/s41380-024-02662-x

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