Lifestyles, psychological well-being, and mental health: A cross-sectional study in a higher education sample

Abstract

The transition to higher education represents a critical developmental stage during which lifestyle behaviours and psychosocial factors interact to influence well-being and mental health. Understanding these dynamics is essential to prevent adverse health outcomes and support academic success. This study aimed to (i) describe lifestyle patterns among Portuguese higher education students, (ii) examine their associations with well-being and mental health, and (iii) assess the influence of sociodemographic and contextual variables. A cross-sectional study was conducted with 1,159 students from the Polytechnic of Porto, Portugal. Participants completed the FANTASTICO Lifestyle Questionnaire, the Depression, Anxiety and Stress Scale (DASS-21), and the CORE-18 to assess lifestyle behaviours and mental health indicators. Descriptive analyses were performed, and one-way ANOVA and independent Student’s t-tests were used to compare lifestyle and psychological variables across sociodemographic groups. Pearson’s correlation coefficients were calculated to examine associations with age, body mass index (BMI), and self-rated health. A multiple linear regression model using a stepwise method identified explanatory variables of lifestyle scores. The mean age of the sample was 21.51 (± 2.65) years; most participants were women (69.70%) and lived with their families (71.00%). Students reported overall favourable lifestyle profiles and relatively low psychological distress. However, mild symptoms of depression, anxiety, and stress were present, approaching the threshold for moderate severity. Higher self-rated health, absence of depressive symptoms, lower stress levels, lower BMI, female gender, younger age, and enrolment in the School of Health Sciences were significantly associated with healthier lifestyle scores. Fourth-year students also reported better lifestyle and mental health indicators than those in earlier years. An unexpected positive association emerged between the CORE-18 problems/symptoms subscale and lifestyle scores, possibly reflecting compensatory health behaviours among students more aware of psychological symptoms. These findings highlight the complex interplay between psychological well-being, lifestyle, and sociodemographic factors in higher education students. Future research should include more diverse samples, consider additional factors such as social support, economic pressures, and physical context, and adopt longitudinal designs with objective measures to better capture the relationships between lifestyle and mental health.