Social Psychiatry and Psychiatric Epidemiology

, Volume 43, Issue 2, pp 105-112

First online:

Prevalence of depressive symptoms in university students from Germany, Denmark, Poland and Bulgaria

  • Rafael T. MikolajczykAffiliated withDept. of Public Health Medicine, School of Public Health, University of Bielefeld
  • , Annette E. MaxwellAffiliated withSchool of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles Email author 
  • , Walid El AnsariAffiliated withFaculty of Sport, Health & Social Care, University of Gloucestershire
  • , Vihra NaydenovaAffiliated withDept. of Public Health Medicine, School of Public Health, University of Bielefeld
  • , Christiane StockAffiliated withUnit for Health Promotion Research, University of Southern Denmark
  • , Snezhana IlievaAffiliated withDept. of Social, Work and Educational Psychology, Faculty of Philosophy, Sofia University “St. Kl. Ohridski”
  • , Urszula DudziakAffiliated withInstitute of Family Sciencies, Catholic University of Lublin
  • , Iveta NagyovaAffiliated withInstitute for Society and Health – KISH, PJ Safarik University Kosice

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Previous research indicated a higher prevalence of depressive symptoms among students from Eastern European countries than students from Western European countries. This difference was thought to be linked to political and economic instabilities resulting from political changes in the early 1990s. We investigated whether these differences persist 15 years later.


Using data from a general health survey among first year students (N = 2,651) from two Western (Germany and Denmark) and two Eastern European countries (Poland and Bulgaria), our analysis was restricted to 2,146 students below 23 years of age. Depressive symptoms were measured using the Modified Beck Depression Inventory (M-BDI). The recommended cut-off point of the M-BDI for depression screening in the general population is a score of ≥35. Perceived income sufficiency was measured on a four-point scale from “totally sufficient” to “not sufficient at all”. Analysis of variance and logistic regression were performed to assess the differences in depressive symptoms between countries adjusting for income sufficiency.


Depressive symptoms were more prevalent in Eastern European than Western European countries (M-BDI scores of ≥35 in Germany 26.7%/22.8%, in Denmark 24.9%/12.1%, in Poland 45.5%/27.3%, in Bulgaria 42.9%/33.8% for female and male students, respectively). There was an association between income perceived as insufficient and higher levels of depressive symptoms, but it did not differ across the countries. Adjusting for perceived income sufficiency had little effect on differences in the prevalence of depressive symptoms across countries.


The difference in prevalence of depressive symptoms in university students from Eastern and Western European countries persists 15 years after political changes have taken place and cannot be explained by differences in perceived sufficiency of income.

Key words

depressive symptoms students international differences Beck Depression Inventory (BDI)