What happens when you put together a group of super achievers who are accustomed to being the best into a new environment called a Ph.D. program? Scott Turow’s One L provides a window into that environment at Harvard Law School, one that mirrors many of the trials and tribulations that many graduate students face across multiple fields.

U.S. survey data in prior published research indicates that about 14.9% of Ph.D. students in economics and 10 to 13.5% of Ph.D. students in political science have received mental health treatment. However, because it is not possible to randomly assign people to a Ph.D. program and then follow them over time, it is also unclear whether these students who sought out mental health treatment already had issues to begin with prior to entering the programs.

Now, a new working paper by Sanna Bergvall, Clara Fernstrom, Eva Ranehill, and Anna Sandberg at Lund University using Swedish population-wide and longitudinal administrative records tries to estimate whether this higher incidence of mental health uptake among Ph.D. students is due to selection or perhaps due to doing a Ph.D. itself. They do this by showing that prior to entering the Ph.D., prospective students have similar reported mental health issues as a matched sample of master’s degree students in the same field. However, by following both groups of students past the onset of the Ph.D. program starting, the authors document that there is a significant increase in the use of psychiatric medication among the Ph.D. students.

This finding generally holds across fields, with variation, such as a notable exception for the medical and health sciences. Overall, groups that were most susceptible to obtaining psychiatric medication during their Ph.D. were older people, women, and those with a previous history of using psychiatric medications.

The authors of the new study note that in 2016, 13.5% of their sample of active Ph.D. students received psychiatric medication. This is quite similar to the studies in economics and political science showing between 10 to 14.9% of Ph.D. students received mental health treatment. Additionally, the authors of this new study argue that because they are recording diagnosed mental health problems, the percentage reporting may be an underestimate.

The authors conclude: “If PhD studies negatively impact mental health, this likely decrease both academic productivity and causes a selection of researchers not only based on academic aptitude, but also mental resilience.”