Mental Health of Pharmaceutical Sciences Students: A Repeated Cross-Sectional Study (2018-2025)

University students enrolled in pharmaceutical sciences programs are increasingly vulnerable to mental health issues, yet temporal data on symptom patterns and psychological constructs remain scarce. This study aimed to estimate the prevalence and severity of depressive, anxiety, and stress symptoms, psychological distress, loneliness, and mood state among pharmaceutical sciences students; assess associations between these symptoms and demographic characteristics; identify central symptoms within the symptom networks; and analyze trends from 2018 to 2025.

This repeated cross-sectional study analyzed data from 11 independent survey waves conducted between 2018 and 2025 among pharmacy students at a public university in Southeast Brazil. Data were collected using self-administered questionnaires (DASS‑21, IES‑R, BRUMS, and UCLA‑3). Prevalence and mean scores were estimated with 95% confidence intervals. Associations were examined using multiple logistic regression, with adjusted odds ratios pooled across waves using meta-analysis. Network analysis identified central symptoms, and joinpoint regression evaluated temporal trends.

Participants were predominantly women (64.0%-77.8%), and 30.1%-41.3% reported a lifetime diagnosis of mental disorder. Depressive symptoms increased by 20.6% and stress by 7.9% over the study period, with a modest post-pandemic decline. Anxiety remained consistently high, with a 1.25% average increase across waves. Although loneliness and psychological distress declined slightly, prevalence remained elevated. In multiple logistic regression analyses, female students (pooled ORs ≥ 1.56) and those with a lifetime mental disorder diagnosis (pooled ORs ≥ 1.98) showed higher odds of anxiety, stress, and psychological distress, whereas no statistically significant associations were observed for age. Network analysis identified stress, tension, and hyperarousal as central nodes.

Mental health-related symptoms were highly prevalent and were increasing before the pandemic among pharmaceutical sciences students. Loneliness persisted post-pandemic, and social determinants played a key role in shaping mental health-related symptoms. Universities should implement sustained, targeted prevention and intervention strategies, particularly for vulnerable groups.