Emerging adulthood is a peak period for the onset of most mental health problems. This period – in which many young people go to college – is also marked by a shift in multiple lifestyle behaviors, including increased time spent in sedentary behavior and physical inactivity, poorer dietary habits, sleep quality, and increased substance use. Evidence in the general population previously showed associations between such lifestyle behaviors and increased risk for incident mental health problems. However, the role of (changes in) lifestyle behaviors on mental health trajectories in emerging adulthood remains unclear.

The present project portrays an international prospective, multicenter cohort in 70 study sites from 27 countries sites over five continents. The present study aims to evaluate associations between diverse lifestyle factors (diet, physical activity, substance use, stress management, social support, restorative sleep, and exposure to green environment) and mental health trajectories (symptoms of depression, anxiety, mania, sleep problems, substance abuse, inattention/hyperactivity and obsessive/compulsive thoughts/behaviors and suicidal ideation) during college years.

More specifically, we anticipate that a healthier lifestyle behavior and changes towards a healthier behavior (over all lifestyle behaviors), will be associated with a reduced growth (risk of development) of any mental health problem in the cohort (depressive, anxiety, manic, obsessive-compulsive, psychotic, or attention deficit/hyperactivity symptoms, substance abuse, or suicidal ideation) compared to an overall unhealthier lifestyle behavior. We further expect that independent behaviors and changes in these behaviors will be associated with a reduced growth in each mental health problem.

At least 300 students per study site starting their academic course will be recruited through email lists, podcasts, advertisement and social media posts. Participants will be assessed via the platform Redcap at baseline and follow-up measurements 1, 2 and 3,5 years after the baseline assessments. Lifestyle factors and mental health problems will be assessed via validated questionnaires. Hypotheses will be tested using analyses of latent growth curve models (LGCMs). The study will provide evidence on sensible periods for lifestyle and mental health interventions, defining evidence-based targets for mental health prevention.

Study participation
From winter semester 2023 on