Relationship between socio-linguistic factors and symptoms of depression, anxiety and psychosis in the general population

F on ie s in Psychology 01 on ie sin.o g TYPE O iginal Resea ch PUBLISHED 20 Feb ua y 2026 DOI 10.3389/ psyg.2026.1690424 OPEN ACCESS EDITED BY Daniel H. Robinson, The Uni e si y o Texas a A ling on College o Educa ion, Uni ed S a es REVIEWED BY Inmaculada Méndez, Uni e si y o Mu cia, Spain Ca los Fe ás Sex o, Uni e si y o San iago de Compos ela, Spain *CORRESPONDENCE Lei e E ko eka lei e.e ko ekagonzalez@ osakide za.eus RECEIVED 21 Augus 2025 REVISED 26 Janua y 2026 ACCEPTED 26 Janua y 2026 PUBLISHED 20 Feb ua y 2026 CITATION Ozamiz-E xeba ia N, E ko eka L and Mancini S (2026) Rela ionship be ween socio-linguis ic ac o s and symp oms o dep ession, anxie y and psychosis in he gene al popula ion. F on . Psychol. 17:1690424. doi: 10.3389/ psyg.2026.1690424 COPYRIGHT © 2026 Ozamiz-E xeba ia, E ko eka and Mancini. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion License (CC BY). The use, dis ibu ion o ep oduc ion in o he o ums is pe mi ed, p o ided he o iginal au ho (s) and he copy igh owne (s) a e c edi ed and ha he o iginal publica ion in his jou nal is ci ed, in acco dance wi h accep ed academic p ac ice. No use, dis ibu ion o ep oduc ion is pe mi ed which does no comply wi h hese e ms. Rela ionship be ween socio-linguis ic ac o s and symp oms o dep ession, anxie y and psychosis in he gene al popula ion Naia aOzamiz-E xeba ia 1, Lei eE ko eka 1,2,3,4* and SimonaMancini 5,6 1Uni e si y o he Basque Coun y UPV-EHU, Leioa, Spain, 2Galdakao-Usansolo Uni e si y Hospi al, Osakide za Basque Heal h Se ice, Galdakao, Spain, 3BioBizkaia Heal h Resea ch Ins i u e, Ba akaldo, Spain, 4CIBERSAM ISCII, Mad id, Spain, 5Basque Cen e on Cogni ion, B ain and Language, Donos ia-San Sebas ian, Spain, 6Ike basque, Basque Founda ion o Science, Bilbao, Spain In oduc ion: O e he las decade, and especially since he COVID-19 pandemic, psychological dis ess has inc eased signi ican ly in he gene al popula ion, wi h a pa icula ly s ong impac on young people. This si ua ion has in ensi ied in e es in iden i ying isk and p o ec i e ac o s associa ed wi h men al heal h. Wi hin his amewo k, he p esen s udy aimed o analyze he ela ionship be ween sociode- mog aphic and linguis ic a iables and di e en indica o s o men al heal h in a bilingual popula ion om he Basque Coun y. Me hods: A o al o 521 bilingual indi iduals (Basque/Spanish) om he gene al popula ion pa icipa ed in he s udy. Pa icipan s comple ed alida ed ques ion- nai es assessing anxie y (GAD-7), dep ession (PHQ-9), and p od omal psycho ic symp oms (PQ-B), along wi h a sociodemog aphic ques ionnai e and a mea- su e o linguis ic compe ence. Uni a ia e analyses and linea eg ession models we e conduc ed o examine associa ions be ween men al heal h indica o s and sociodemog aphic a iables (age, gende , educa ional le el, employmen s a us, ma i al s a us, and o sp ing), as well as linguis ic a iables (sel -pe cei ed p o i- ciency in local languages and o eign language ce i ica ion). Resul s: The esul s indica e ha highe educa ional a ainmen is consis en ly associa ed wi h lowe le els o dep essi e symp oms and p od omal psycho ic symp oms. Addi ionally, be e sel -pe cei ed compe ence in he usual languages o communica ion (Basque and Spanish) is ela ed o lowe sco es on p od omal psycho ic symp oms. Ha ing child en is associa ed wi h lowe le els o dep es- si e symp oms. In con as , a iables such as gende , ma i al s a us, and employ- men s a us did no show signi ican associa ions wi h men al heal h indica o s in his p edominan ly young sample. Discussion: O e all, hese indings highligh he ele ance o educa ional le el and sociolinguis ic con ex as impo an ac o s in men al heal h. They unde - sco e he need o inco po a e educa ional and linguis ic dimensions in o he design o p e en ion and in e en ion s a egies, pa icula ly hose a ge ing young popula ions in bilingual and mul ilingual con ex s. KEYWORDS bilingual, educa ion, language p o iciency, men al heal h, sociocul u al con ex Ozamiz-E xeba ia e al. 10.3389/ psyg.2026.1690424 F on ie s in Psychology 02 on ie sin.o g In oduc ion Wo ldwide, he e has been a ma ked inc ease in psychological dis ess in ecen yea s (Keyes and Pla , 2024). While his up u n had al eady been eco ded p io o he COVID-19 pandemic, he heal h c isis signi ican ly exace ba ed men al heal h p oblems in a ious popula ions (B i o e al., 2022; Daniali e al., 2023; Zhang e al., 2022). The WHO (Wo ld Heal h O ganiza ion, 2022a) epo ed a 25% ise in he global p e alence o dep ession and anxie y diso de s du ing he i s yea o he pandemic. This inc ease is due o ac o s such as occupa ional s ess, lack o suppo ne wo ks and economic unce - ain y, all o which may inc ease psychological ulne abili y. S udies in a ious pa s o he wo ld ha e ound he younge popula ion o be mos a ec ed, wi h a signi ican ise in he incidence o mood and anxie y diso de s (Ma elli e al., 2021; Qiu e al., 2020; Solomou and Cons an inidou, 2020). I has been sugges ed ha his ulne abili y in young people may be ela ed o ac o s such as employmen insecu i y, o e use o social media and lack o coping skills (Ozamiz-E xeba ia e al., 2023). In many egions, s uc u al ac o s, such as lack o access o men al heal h se ices and he s igma associa ed wi h men al dis- o de s, ha e also con ibu ed o he men al heal h c isis (Wo ld Heal h O ganiza ion, 2022b). Gende - ela ed di e ences in men al illness ha e also been ex en- si ely documen ed, in s udies showing ha women ha e highe a es o anxie y, dep ession and ea ing diso de s, while men ha e a highe p e alence o addic ion, a en ion de ici hype ac i i y diso de , psy- chosis, schizoph enia and au ism spec um diso de s. These di e - ences canno be explained by biological ac o s alone; a he , hey appea o be p o oundly in luenced by gende inequali ies in socie y. Women, o example, expe ience highe le els o s ess due o he bu den o unpaid wo k, job insecu i y and gende -based iolence, which all con ibu e o hei g ea e emo ional ulne abili y (Hu en e al., 2021). In addi ion, he e is a eal issue wi h he medicaliza ion o emale men al heal h, wi h a g ea e endency o diagnose dep es- sion and anxie y among women and o p esc ibe psycho opic d ugs mo e equen ly han among men, e en when hey p esen wi h simi- la symp oms (A azcoz e al., 2018). Se e al s udies ha e also shown a ela ionship be ween employ - men and men al heal h. Di e en dimensions o p eca ious employ- men such as job insecu i y and seasonali y a e associa ed wi h men al heal h p oblems (Rönnblad e al., 2019; U ze e al., 2020). In addi ion, unemploymen is associa ed wi h impai ed men al heal h (Paul and Mose , 2009), wi h men he mos a ec ed (Mu phy and A hanasou, 1999; Vi golino e al., 2022). Ma i al s a us has also been obse ed o play an impo an ole in men al heal h (Ch is ensen e al., 2022). One s udy ound ha ma ied people sco ed highe o psychological well-being due o he social suppo and economic esou ces associa ed wi h ma iage (Si a Kuma e al., 2019). O he s udies ound an associa ion be ween being single and indica o s o men al illness (Si a Kuma e al., 2019). Ma i al s a us (in his case, being ma ied) would he e o e appea o be a p o ec i e ac o in men al heal h (Roh e e al., 2005). None heless, a sepa a e s udy ound ha he ela ionship be ween ma i al s a us and dep ession a ies by age and gende , wi h a lowe isk among single, widowed and sepa a ed women and he isk inc easing wi h age among single men (Bulloch e al., 2017). Wi h ega d o educa ional le el, esea ch has shown ha a highe le el o educa ion may be associa ed wi h a lowe a e o men al illness (Li e al., 2023; Xu and Chen, 2024). Thus, he p e alence o men al diso de s is g ea e among hose wi h lowe educa ional le els, sug- ges ing ha highe le els o educa ion a e associa ed wi h be e men al heal h ou comes. In addi ion, one s udy obse ed ha people wi h a high le el o educa ion gene ally u ilize men al heal h se ices mo e and ely less exclusi ely on medica ion; his could be in e p e ed as a mo e comp ehensi e managemen o hei men al heal h (Halme e al., 2023). Finally, lea ning new languages could be iden i ied as a possible p o ec i e ac o . Language lea ning has been desc ibed as being a he apeu ic ac i i y ha can imp o e men al heal h (de Diego Alonso and Isiegas, 2007). O he indings show ha anxie y is in e sely ela ed o he numbe o languages lea ned (Thompson and Lee, 2013) and ha pe cei ed language p o iciency is posi i ely ela ed o se e al aspec s o psychological well-being (Luo e al., 2019), al hough his associa ion has no been explo ed o any g ea deg ee. Mo eo e , men al heal h issues can make i di icul o lea n new languages (Wu, 2024). In any case, s udies in his a ea a e sca ce and he e is much ye o be explo ed. Conside ing he ele ance o hese a iables, his s udy seeks o analyze he ela ionship be ween sociodemog aphic and linguis ic ac- o s and men al heal h, p o iding empi ical e idence on he in luence o gende , ma i al s a us, cohabi a ion, o sp ing, employmen s a us, educa ional le el, and knowledge and sel -pe cep ion o language p o- iciency on anxie y, dep ession and psycho ic symp oms. Ma e ials and me hods Pa icipan s and p ocedu es The s udy sample consis ed o 521 bilingual (Basque/Spanish) adul s om he gene al popula ion who pa icipa ed in a b oade esea ch p ojec (E ko eka e al., 2025). Among hem, 383 pa icipan s (73.5%) iden i ied as emale, 131 (25.1%) as male, and 7 (1.3%) as non-bina y. The mean age o he sample was 26.58 yea s (SD = 7.67), mos pa icipan s we e single (68.9%), and he majo i y we e wo king o s udying a he ime o da a collec ion (83.7%). Pa icipan s li ed in households wi h a mean o 3.37 cohabi an s (SD = 1.18). Educa ional a ainmen was gene ally high, wi h 73.7% ha ing comple ed uni e - si y s udies, 25.5% high school o oca ional aining, and less han 1% p ima y educa ion. A mino i y o pa icipan s (11.9%) epo ed ha ing o sp ing. F om a linguis ic pe spec i e, pa icipan s epo ed high sel -pe cei ed p o iciency in Basque and Spanish (mean = 73.32, SD = 5.86), and 67% held an o icial quali ica ion in a leas one o - eign language (Table 1). Pa icipan s we e eligible i hey we e 18 yea s o age o olde , esided in he Basque Coun y, we e bilingual in Basque and Spanish, and p o ided in o med consen . Indi iduals we e excluded i hey did no comple e he ques ionnai es, p o ided inconsis en esponses, o did no mee he bilingualism c i e ia. Rec ui men was ca ied ou be ween No embe 2019 and Janua y 2021 h ough con enience sampling, mainly ia uni e si y mailing lis s, he BCBL olun ee da abase, and wo d o mou h. Those in e es ed accessed he online o ms ia Google Fo ms, i s ag eeing o he in o med consen o m and hen comple ing he sociodemo- g aphic ques ionnai e and he clinical and linguis ic assessmen s. All measu es we e comple ed in a single session, wi h an es ima ed du a- ion o 20–30 min, and da a we e collec ed anonymously. Ozamiz-E xeba ia e al. 10.3389/ psyg.2026.1690424 F on ie s in Psychology 03 on ie sin.o g The s udy employed a c oss-sec ional, obse a ional, and co ela- ional design, which was conside ed app op ia e o examining asso- cia ions be ween sociodemog aphic and linguis ic a iables and men al heal h indica o s in a non-clinical popula ion. Al hough causal in e ences canno be made, his design allows he iden i ica ion o po en ial isk and p o ec i e ac o s ele an o p e en ion and in e - en ion s a egies. Measu es and ins umen s Gene alized Anxie y Diso de Scale-7 (GAD-7, Pa el e al., 2019): This is a sel -adminis e ed ques ionnai e designed o assess he p es- ence and in ensi y o gene alized anxie y diso de (GAD) symp oms o e he p e ious 2 weeks, ollowing he diagnos ic c i e ia es ablished in he DSM-IV-TR. I includes 7 i ems, each a ed on a 4-poin Like scale. A h eshold sco e o 10 o highe has been sugges ed o de ec - ing p obable cases o GAD. Sco es o 5, 10, and 15 a e commonly used o ca ego ize anxie y as mild, mode a e, and se e e, espec i ely. The measu e has demons a ed s ong psychome ic p ope ies ac oss di e se languages and popula ions (Lee e al., 2022; V uble ska e al., 2022), including excellen in e nal consis ency, wi h C onbach’s alpha anging om 0.85 o 0.95. Pa ien Heal h Ques ionnai e-9 (PHQ-9, K oenke e al., 2001): This sel -adminis e ed ool comp ises 9 i ems, each co esponding o one o he DSM-IV c i e ia o dep essi e diso de s, a ed on a 4-poin Like scale. An addi ional i em assesses he deg ee o unc ional impai men caused by he symp oms. A o al sco e o 10 o abo e is ypically used as a cu -o o sugges he p esence o a po en ial dep es- si e diso de . The ins umen has been alida ed ac oss mul iple lan- guages and cul u al se ings (Fonseca-Ped e o e al., 2018; Gómez-Gómez e al., 2023; Jomli e al., 2020; Lamela e al., 2020), consis en ly demons a ing solid in e nal eliabili y, wi h C onbach’s alpha coe icien s anging om 0.79 o 0.89. P od omal Ques ionnai e-B ie Ve sion (PQ-B, Loewy e al., 2011): This sc eening ool o psychosis isk is a sel - epo ques ion- nai e comp ising 21 dicho omous (yes/no) i ems and is based on symp om equency. The PQ-B is a sho ened e sion de i ed om he o iginal 92-i em P od omal Ques ionnai e (Loewy e al., 2011). When a esponden answe s “yes” o an i em, a ollow-up ques ion is p esen ed o assess bo h he equency and le el o dis ess o unc- ional impac associa ed wi h he expe ience, on a 5-poin Like - ype scale. Va ious s udies ha e p oposed di e en cu -o sco es o he equency and dis ess subscales, depending on he popula ion unde s udy (Kaligis e al., 2018; Okewole e al., 2015; Pelizza e al., 2018). In he case o he Spanish popula ion, alida ion s udies ha e ecom- mended a h eshold sco e o 9 o o e on he equency scale (Fonseca-Ped e o e al., 2018) and 29 o o e on he dis ess scale (Fonseca-Ped e o e al., 2016). These alida ions also epo s ong in e nal consis ency (C onbach’s alpha be ween 0.83 and 0.89) and suppo a unidimensional ac o s uc u e o he ins umen . TABLE 1 Desc ip ion o he sample. Va iables Va iables Mean ± SD To al (N = 521) Male (N = 131) Female (N = 383) Non-bina y (N = 7) Age*26.58 ± 7.67 25.55 ± 7.6 25.98 ± 7.6 22.29 ± 1.1 Numbe o cohabi an s 3.37 ± 1.18 3.25 ± 1.13 3.40 ± 1.20 3.71 ± 1.11 P o iciency in local languages 73.32 ± 5.86 72.36 ± 6.66 73.68 ± 5.55 71.57 ± 4.92 GAD-7 6.48 ± 3.84 5.89 ± 3.95 6.67 ± 3.77 7.00 ± 4.47 PHQ-9 7.07 ± 5.10 5.57 ± 4.86 7.23 ± 5.17 7.86 ± 5.92 PQB 3.13 ± 3.35 2.88 ± 3.32 3.20 ± 3.36 4.06 ± 1.52 N(%) O sp ing (yes) 62(11.9) 20 (15.3) 42 (11.0) 0 (0) Ma i al s a us Single 359 (68.9) 88 (67.2) 266 (69.6) 5(71.4) Ma ied/pa ne 106 (20.3) 29 (22.1) 77 (20.2) 0 (0) Di o ced 3(0.6) 1 (0.8) 2 (0.5) 0 (0) O he s 53 (10.2) 13 (9.9) 37 (9.7) 2 (28.6) Occupa ion No wo king 85 (16.3) 15 (11.5) 69 (18) 1 (14.3) Wo king/S udying 436 (83.7) 116 (88.5) 314 (82) 6 (85.7) Educa ion P ima y 4(0.8) 1 (0.8) 3 (0.8) 0 High school/ Voca ional 133 (25.5) 32 (24.4) 99 (25.8) 2 (28.6) Uni e si y 384 (73.7) 98 (74.8) 281 (73.4) 5 (71.4) Fo eign language quali ica ion (yes) 349 (67) 90(68.7) 256 (66.8) 3(42.9) GAD-7, Gene alized Anxie y Diso de Scale-7; PHQ-9, Pa ien Heal h Ques ionnai e-9; PQB, P od omal Ques ionnai e-B ie Ve sion. *S a is ically signi ican esul s we e obse ed be ween males’ and emales’ sco es, wi h no di e ences ega ding non-bina y people. Ozamiz-E xeba ia e al. 10.3389/ psyg.2026.1690424 F on ie s in Psychology 04 on ie sin.o g BCBL language compe ence ques ionnai e: This ques ionnai e was de eloped by he Basque Cen e on Cogni ion, B ain and Language as a ool o making a comp ehensi e linguis ic assessmen o an indi idual. Among o he a iables, i collec s in o ma ion on he languages spoken by he pe son, hei exposu e, sel -es ima ed p o i- ciency in each language, and whe he hey ha e o icial quali ica ions in any o he languages hey know. This s udy conside ed sel -es i- ma ed p o iciency in local languages (Basque and Spanish) as a sum o he wo sco es anging om 40 o 80 and whe he he indi idual has any o icial quali ica ion in a o eign language (E ko eka e al., 2025). Da a analysis We i s pe o med uni a ia e analyses o s udy he associa- ions be ween sociodemog aphic and linguis ic a iables and he sco es on he h ee scales. We used Pea son’s co ela ion o s udy he ela ionship be ween quan i a i e a iables and S uden ’s es o quali a i e a iables. Secondly, we c ea ed h ee linea eg es- sion models, in which he dependen a iable was he sco e on he scale s udied (GAD7, PHQ-9 and PQ-B) and he independen a iables we e hose sociodemog aphic and linguis ic a iables which had shown a signi ican (p < 0.1) associa ion in he uni a i- a e analyses. We used IBM SPSS S a is ics 29.0 o he s a is ical analyses. Resul s Table 2 shows he esul s ob ained in he 3 linea eg ession models. Wi h ega d o symp oms o anxie y, he only a iables o show an associa ion in he uni a ia e analyses we e sociodemog aphic (o sp ing, age and educa ional le el), bu none o hese su i ed when included join ly in he eg ession model. A end can be seen in educa- ion le el, sugges ing ha he highe he educa ion le el, he less he anxie y expe ienced, bu wi hou a aining he es ablished le el o s a- is ical signi icance. Wi h ega d o clinical dep ession, mul iple sociodemog aphic a iables (o sp ing, job, educa ional le el, age) and linguis ic a iables ( o eign language ce i ica ion, p o iciency in local languages) showed a ela ionship wi h he PHQ-9 sco e in uni a ia e analyses. When, in a p elimina y s ep, all he a iables a e inco po a ed in o he eg es- sion model, i is e iden ha only he educa ion le el con inues o show a signi ican associa ion, and a end can be obse ed in ha ing o sp ing. In he second s ep, we emo ed he a iables o which he associa ion did no endu e, showing ha educa ional le el and o - sp ing we e signi ican ly ela ed o dep essi e symp oma ology, such ha a highe educa ional le el and ha ing child en we e associa ed wi h lowe sco es o dep ession. These wo a iables explain 4.5% o he a iabili y o he PHQ-9 sco e. Finally, wi h ega d o he s udy o psycho ic symp oms, he e was again ound o be a ela ionship be ween bo h sociodemog aphic and linguis ic a iables (age, le el o educa ion, o sp ing, o eign language quali ica ion and p o iciency) and he PQ-B sco e. Inco po a ing all o hese in o he eg ession model, we obse ed ha he signi ican e ec o educa ional le el, p o iciency and age su i es he con ol o mul iple a iables, wi h he model explaining 7.4% o he a iabili y in he PQ-B sco e. Highe educa ional le el, g ea e language p o iciency in local languages and olde age a e associa ed wi h lowe sco es o psycho ic symp oma ology. Discussion This s udy analyzed he ela ionship be ween se e al sociolinguis- ic ac o s and men al heal h, p o iding e idence o hei impac on he symp oms s udied. To begin wi h, he esul s ob ained in he uni a ia e analyses indi- ca e ha gende is no signi ican ly associa ed wi h he men al heal h indica o s assessed by PHQ-9, GAD-7 and PQ-B. These indings con- as wi h hose o p e ious s udies ha ha e iden i ied gende di e - ences (Hu en e al., 2021; Eugene e al., 2025) in he p e alence o men al illness. One possible explana ion is ha because hey measu e gene al symp oms o men al heal h, he ools used in his s udy may no cap u e gende -speci ic nuances, such as di e en ways o exp ess- ing o mani es ing psychological dis ess, which migh limi he de ec- ion o di e ences among he popula ion e alua ed. Occupa ion and ma i al s a us ha e no been ound o in luence symp oma ology ei he . This inding con as s wi h hose o p e ious s ud- ies (Begum, 2025; Compe nolle and Zheng, 2025; Mu phy and A hanasou, 1999; Paul and Mose , 2009; Vi golino e al., 2022). Howe e , wi h ega d o ma i al s a us, i may be due o he ac ha he mean age o ou popula- ion was qui e young (26.58 yea s), and as al eady no ed in p e ious s ud- ies (Bulloch e al., 2017; Solomou and Cons an inidou, 2020), he in luence o his ac o appea s o inc ease wi h age. As o he in luence o occupa- ion, one possible explana ion migh be ha he young people in his sample ha e jobs wi h mo e a o able o less demanding condi ions, which ha e a subsequen ly educed impac on hei well-being. Wi h ega d o age, an in e se associa ion wi h all indica o s o he symp oma ology was obse ed in he uni a ia e analyses, bu his ela- ionship emained signi ican only in he model adjus ed o psycho ic symp oma ology. This inding is consis en wi h ecen s udies ha indica e an inc eased ulne abili y o subclinical psycho ic expe i- ences among he younge popula ion (Fonseca-Ped e o e al., 2009; Lemos-Gi áldez e al., 2011; Ozdemi e al., 2025). O all he i ems s udied, educa ional le el appea s o be he mos de e minan o he h ee spec a o symp oms. In he pos -hoc s udy ca ied ou a e he uni a ia e analysis, we ound ha he di e ence was mainly be ween he high school/VT g oup and uni e si y s u- den s o all h ee ques ionnai es, wi h a U-shaped pa e n, al hough he eg ession models indica e ha he highe he le el o s udies, he lowe he a e o symp oms obse ed. Se e al s udies ha e shown ha a highe educa ional le el is associa ed wi h be e men al heal h (B acke e al., 2014; Ga iépy e al., 2022; Kondi olli and Sunde , 2022; Ses i e al., 2022; Spe andei e al., 2023; Xu and Chen, 2024). This sug- ges s ha educa ion may ac as a p o ec i e ac o agains men al dis- o de s by p omo ing he de elopmen o pe sonal, p o essional and social esou ces ha con ibu e o psychological well-being. In ou s udy, p o iciency in an addi ional hi d o ou h language was no ound o be signi ican ly ela ed o educed symp oma ology, as desc ibed in p e ious esea ch highligh ing he cogni i e and emo- ional bene i s o language lea ning (de Diego Alonso and Isiegas, 2007; Thompson and Lee, 2013). Howe e , he e was an in e se ela ionship be ween sel -pe cep ion o p o iciency in local languages (Basque and Spanish) and PQ-B, indica ing ha he be e he pe cep ion o p o i- ciency in hei habi ual languages o communica ion, he lowe he a e Ozamiz-E xeba ia e al. 10.3389/ psyg.2026.1690424 F on ie s in Psychology 05 on ie sin.o g o psycho ic symp oma ology. This would be an impo an inding o his s udy, ein o cing and expanding upon aspec s desc ibed in o he p e ious s udies ha ound ha language p o iciency was posi i ely ela ed o se e al aspec s o psychological well-being and men al heal h (Luo e al., 2019; Mon emi o e al., 2021). As a inal sociodemog aphic a iable o in e es , we ound ha ha ing child en appea s o ha e a p o ec i e e ec agains symp oms o dep ession. This is especially ele an gi en ha mos p e ious s udies ha e ocused on analyzing how dep ession in luences he p obabili y o ha ing child en, gene ally iden i ying a nega i e asso- cia ion be ween he wo (Golo ina e al., 2023; Kailaheimo-Lönnq is e al., 2024). Ou s udy he e o e o e s a complemen a y pe spec i e, and al hough he c oss-sec ional design does no allow us o es ablish causali y, i does poin o a no el and in e es ing associa ion be ween pa en hood and g ea e psychological well-being. This s udy has some limi a ions ha mus be aken in o accoun . To begin wi h, pa icipa ion in his s udy is highe among women and he numbe o non-bina y indi iduals is negligible. None heless, i is impo an o no e ha he e a e no signi ican di e ences among he h ee g oups ac oss he dep essi e, anxious and psycho ic symp om- a ology, as add essed by hese widely used ins umen s. The ac ha he e a e mo e women han men in he samples is qui e common in many s udies (Ganguli e al., 1998), and e en mo e so in s udies on psychology, educa ion, and men al heal h. The opics o many men al heal h s udies end o a ouse g ea e in e es o iden i ica ion among women, which inc eases hei pa icipa ion (P oye and Häusle , 2007). Cul u al and social ac o s also play a ole, as women may eel mo e com o able o less s igma ized when alking abou emo ions and psy- chological well-being (Deng e al., 2016). Finally, ec ui men o sam- pling me hods h ough uni e si ies, associa ions o social ne wo ks may a o he ec ui men o women, as hese a e a eas whe e hey a e mo e p esen . The e a e no o icial igu es on he p e alence o people who iden i y as non-bina y in ou se ing, so we canno en u e o de e mine whe he hey a e o e - o unde ep esen ed in ou sample. Ano he limi a ion o his s udy is he age ange o he pa ici- pan s. The sample included young people and young adul s, mainly anging om 18 o 33 yea s o age. The e o e, in he con ex o his s udy, pa icipan s who all in o he ca ego y o ‘young adul s’ acco d- ing o he WHO classi ica ion (2023) a e included. Fo his eason, he conclusions o his s udy mus be limi ed o ha age ange. I is also impo an o men ion ha despi e mos da a was col- lec ed be o e he COVID-19 pandemic, he ec ui men pe iod was ex ended un il 2021, and we know ha young people’s men al heal h has wo sened du ing he pandemic (Idoiaga e al., 2022; Ozamiz- E xeba ia e al., 2023). The e o e, and al hough dispe sion o he sco es on he PHQ-9 and GAD-7, which assess symp oms ha may ha e inc eased due o he pandemic, is wi hin he usual ange o hese ins umen s, we canno ule ou ha hey may be o e sized in he mon hs ollowing he pandemic. Finally, he way in which he s udy has been dissemina ed, mainly h ough mailing lis s, may a o sel -selec ion bias ( hose who a e mo e engaged, ha e mo e ee ime, o eel mo e s ongly abou a opic may be o e ep esen ed). The use o sel -adminis e ed ques ionnai es may also be associa ed wi h biases such as social desi abili y, ecall bias, o ex eme esponse bias. Howe e , we mus bea in mind ha he ools used, mainly he PHQ-9 and he GAD-7, a e s ongly sup- po ed and a e, in ac , he main assessmen ins umen s used in men al heal h esea ch. Conclusion In conclusion, his s udy p o ides e idence ha educa ional le el may play a cen al ole in men al heal h, ac ing as a p o ec i e ac o agains symp oms o dep ession, anxie y, and psychosis. Highe educa ion appea s o con ibu e o psychological well- being, likely h ough he de elopmen o pe sonal, social, and p o es- sional esou ces. Addi ionally, ha ing o sp ing was associa ed wi h lowe dep es- si e symp oma ology, sugges ing ha pa en hood may o e emo ional bene i s, al hough his inding should be in e p e ed cau iously due o he c oss-sec ional na u e o he s udy. In e ms o psycho ic symp- oms, olde age and highe sel -pe cei ed p o iciency in local lan- guages (Basque and Spanish) we e linked o lowe symp om a es, highligh ing a no el po en ial p o ec i e ole o language p o iciency in habi ual communica ion. No signi ican associa ions we e ound wi h gende , ma i al s a us, o employmen , which may be ela ed o he p edominan ly young, educa ed, and uni e si y-based na u e o he sample. O e all, hese esul s unde sco e he impo ance o ocusing on he men al heal h o young adul s and sugges ha in e en ions aiming o imp o e psychological well-being could bene i om p o- mo ing access o highe educa ion, suppo ing pa en hood, and enhancing language p o iciency. Fu u e esea ch should examine hese associa ions longi udinally, explo e unde lying mechanisms, and TABLE 2 Reg ession models. Models Va iables β pAdjus ed R2 GAD-7 (1) Cons an 9.977 <0.001 0.014 Educa ion −0.077 −1.727 0.085 Age −0.052 −0.958 0.339 O sp ing −0.065 −1.217 0.224 PHQ-9 (1) Cons an 5.405 <0.001 0.048 Educa ion −0.150 −3.355 <0.001 Age −0.044 −0.805 0.421 O sp ing −0.095 −1.813 0.070 P o iciency −0.065 −1.463 0.144 Occupa ion −0.043 −0.990 0.323 Fo eign qual. −0.056 −1.244 −214 PHQ-9 (2) Cons an 12.530 <0.001 0.045 Educa ion −0.176 −4.088 <0.001 O sp ing −0.120 −2.795 0.005 PQB (1) Cons an 6.196 <0.001 0.074 Educa ion −0.175 −3.983 <0.001 O sp ing 0.018 0.347 0.729 P o iciency −0.105 −2.406 0.016 Fo eign qual. −0.065 −1.482 0.139 Age −0.145 −2.718 0.007 GAD-7, Gene alized Anxie y Diso de Scale-7; PHQ-9, Pa ien Heal h Ques ionnai e-9; PQB, P od omal Ques ionnai e-B ie Ve sion. Ozamiz-E xeba ia e al. 10.3389/ psyg.2026.1690424 F on ie s in Psychology 06 on ie sin.o g in es iga e whe he hese indings gene alize o b oade and mo e di e se popula ions. Da a a ailabili y s a emen The da a ha suppo he indings o his s udy a e a ailable om he co esponding au ho upon easonable eques . E hics s a emen The p esen s udy was app o ed by he Basque E hics Commi ee (code: PI2019052). The s udies we e conduc ed in acco dance wi h he local legisla ion and ins i u ional equi emen s. All pa icipan s p o- ided hei in o med consen o pa icipa e in his s udy. Au ho con ibu ions NO-E: W i ing– o iginal d a , W i ing– e iew & edi ing. LE: W i ing– o iginal d a , W i ing– e iew & edi ing. SM: W i ing – e iew & edi ing. Funding The au ho (s) decla ed ha inancial suppo was ecei ed o his wo k and/o i s publica ion. This p ojec was unded by he Heal h Depa men o he Basque Go e nmen . Edi ing o his pape was unded by he Resea ch Uni o Galdakao-Usansolo Uni e si y Hospi al. Acknowledgmen s The au ho s would like o hank he pa icipan s o hei in ol e- men in his s udy. Con lic o in e es The au ho (s) decla ed ha his wo k was conduc ed in he absence o any comme cial o inancial ela ionships ha could be cons ued as a po en ial con lic o in e es . Gene a i e AI s a emen The au ho (s) decla ed ha Gene a i e AI was no used in he c ea ion o his manusc ip . Any al e na i e ex (al ex ) p o ided alongside igu es in his a icle has been gene a ed by F on ie s wi h he suppo o a i icial in elligence and easonable e o s ha e been made o ensu e accu acy, including e iew by he au ho s whe e e possible. I you iden i y any issues, please con ac us. Publishe ’s no e All claims exp essed in his a icle a e solely hose o he au ho s and do no necessa ily ep esen hose o hei a ilia ed o ganiza ions, o hose o he publishe , he edi o s and he e iewe s. Any p oduc ha may be e alua ed in his a icle, o claim ha may be made by i s manu ac u e , is no gua an eed o endo sed by he publishe . Re e ences A azcoz, L., Chile Rosell, E., Esca ín, P., and Fe nández Sánchez, A. (2018). 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