Background: Effective targeting of services requires that we establish which undergraduates are at increased risk of mental health problems at university. We aimed to conduct a systematic review and meta-analysis of the prevalence and risk factors for mental health problems in undergraduates.

Methods: We searched MEDLINE, PsycInfo, EMBASE and the Cochrane Central Register. Eligible studies were assessed using the Quality of Prognostic Studies checklist and narratively synthesised. Pooled prevalence of depression and suicide-related outcomes, and associated risk factors (odds ratios) were estimated using random-effects meta-analyses.

Results: Sixty-six eligible studies of varying quality were included in a narrative synthesis. The pooled prevalence of depression (eight studies; 13,790 participants) was 25% (95% CI 17%, 35%) and the pooled prevalence of suicide-related outcomes (four studies; 2,586 participants) was 14% (95% CI 0%, 44%). Thirteen studies contributed to meta-analytic syntheses of 12 depression-related and four suicide-related risk factors. Presenting with a current mental health problem, negative rumination, parent separation, experiences of sexual harassment and parental depression significantly predicted depression outcomes. Childhood adversity, baseline mental health problems and financial difficulties significantly predicted suicide-related outcomes.

Limitations: Student mental health is a heterogeneous research area and is hampered by the use of imprecise terms, both for describing risk factors and mental health outcomes. These inconsistencies limit the extent to which datasets can be meaningfully synthesised.

Conclusions: This review evidences the importance of a range of risk factors for poor undergraduate mental health. Interventions should be developed to target modifiable risk factors and prevent poor mental health outcomes.

Systematic review registration: PROSPERO registration CRD42019144927

背景：有效定位服务要求我们确定哪些大学生在大学中面临精神健康问题的风险增加。我们旨在对大学生心理健康问题的患病率和危险因素进行系统的回顾和荟萃分析。

方法：我们搜索了MEDLINE，PsycInfo，EMBASE和Cochrane中央寄存器。使用“预后研究质量”清单评估合格的研究，并进行叙述性综合。抑郁症和自杀相关结果的汇总患病率，以及相关的危险因素（比值比）使用随机效应荟萃分析进行估算。

结果：六十六篇不同质量的合格研究被纳入叙述性综合研究。合并的抑郁症患病率（八项研究； 13,790名参与者）为25％（95％CI为17％，35％），与自杀有关的结果的合并症患病率（四项研究； 2,586名参与者）为14％（95％CI为0％） ，占44％）。十三项研究有助于对12个与抑郁相关的危险因素和四个与自杀相关的危险因素进行荟萃分析。面对当前的心理健康问题，反刍，父母分离，性骚扰和父母抑郁的经历显着预测了抑郁的预后。童年的逆境，基本的心理健康问题和经济困难极大地预测了自杀相关的后果。

局限性：学生的心理健康是一个多元化的研究领域，并且由于使用了不准确的术语来描述危险因素和心理健康结果，因此妨碍了学生的心理健康。这些不一致限制了可以有意义地合成数据集的程度。

结论：这篇综述证明了一系列不良因素对大学生心理健康状况的重要性。应制定干预措施以针对可改变的危险因素并预防不良的心理健康结果。

系统审查注册： PROSPERO注册CRD42019144927