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Objectives. Students are reported to have more symptoms of mental health problems than other young people. Disordered eating and self-harm are common but evidence on comorbidity, especially in community samples, is limited. This study aimed to examine their co-occurrence, onset timing, and the help-seeking of UK university students.

Methods. Two surveys were administered to undergraduate students at a single UK university. One was administered electronically (UNIversity Quality of Life and Learning survey) and completed by 5,045 students. The second, questionnaire-based, was completed by 805 students (Student Well-Being study). Both surveys included questions about disordered eating, self-harm thoughts and behaviours, and psychological well-being.

Results. A strong relationship was found between reports of disordered eating and self-harm, with co-occurrence observed in 4.5 and 4.9% of students in the two surveys. Disordered eating and self-harm often pre-dated university entrance and there was no evidence of increasing levels of pathology by university year group. A younger age of onset of disordered eating behaviours was reported in those with co-occurring disordered eating and self-harm. Help-seeking rates were low.

Conclusions. The risk of co-occurrence and earlier onset-timing of disordered eating are consistent with a limited clinical literature. Information on co-occurrence of mental health problems, their history, and low rates of help-seeking identifies some of the challenge to universities and practitioners. These results suggest the value of access to screening resources and the involvement of service-users in shaping the support provided.