Skip to main content
SpringerLink
Log in

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

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Adewuya AO, Ola BA, Aloba OO, Mapayi BM, Oginni OO (2006) Depression amongst Nigerian university students: prevalence and sociodemographic correlates. Soc Psychiatr Psychiatr Epidemiol 41:674–678

    Article  Google Scholar 

  2. Allgood-Merten B, Lewinsohn PM, Hops H (1990) Sex differences and adolescent depression. J Abnorm Psychol 99:55–63

    Article  PubMed  CAS  Google Scholar 

  3. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh WA (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl:21–27

  4. Avison WR, McAlpine DD (1992) Gender differences in symptoms of depression among adolescents. J Health Soc Behav 33:77–96

    Article  PubMed  CAS  Google Scholar 

  5. Beck AT, Steer RA, Ball R, Ranieri W (1996) Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. J Pers Assess 67:588–597

    Article  PubMed  CAS  Google Scholar 

  6. Bland RC (1997) Epidemiology of affective disorders: a review. Can J Psychiatr 42:367–377

    CAS  Google Scholar 

  7. Bobak M, Pikhart H, Pajak A, Kubinova R, Malyutina S, Sebakova H, Topor-Madry R, Nikitin Y, Marmot M (2006) Depressive symptoms in urban population samples in Russia, Poland and the Czech Republic. Br J Psychiatr 188:359–365

    Article  Google Scholar 

  8. Bostanci M, Ozdel O, Oguzhanoglu NK, Ozdel L, Ergin A, Ergin N, Atesci F, Karadag F (2005) Depressive symptomatology among university students in Denizli, Turkey: prevalence and sociodemographic correlates. Croat Med J 46:96–100

    PubMed  Google Scholar 

  9. Cairney J, Wade TJ (2002) The influence of age on gender differences in depression: further population-based evidence on the relationship between menopause and the sex difference in depression. Soc Psychiatr Psychiatr Epidemiol 37:401–408

    Article  Google Scholar 

  10. Coyne JC (1994) Self-reported distress: analog or Ersatz depression? Psychol Bull 116:29–45

    Article  PubMed  CAS  Google Scholar 

  11. Cross-National Collaborative Group (1992) The changing rate of major depression. Cross-national comparisons. JAMA 268:3098–3105

    Article  Google Scholar 

  12. Czapinski S (1999) Non-clinical indicators of mental health of society. Report. Warsaw

  13. Dolea C, Nolte E, McKee M (2002) Changing life expectancy in Romania after the transition. J Epidemiol Community Health 56:444–449

    Article  PubMed  CAS  Google Scholar 

  14. El Ansari W, Maxwell AE, Mikolajczyk RT, Stock C, Naydenova V, Kraemer A (2007) Promoting public health: benefits and challenges of a European wide research consortium on student health. Cent Eur J Public Health 15:58–65

    PubMed  Google Scholar 

  15. Eller T, Aluoja A, Vasar V, Veldi M (2006) Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety 23:250–256

    Article  PubMed  Google Scholar 

  16. Erginoz E, Alikasifoglu M, Ercan O, Uysal O, Ercan G, Albayrak Kaymak D, Ilter O (2004) Perceived health status in a Turkish adolescent sample: risk and protective factors. Eur J Pediatr 163:485–494

    Article  PubMed  Google Scholar 

  17. Franko DL, Striegel-Moore RH, Bean J, Barton BA, Biro F, Kraemer HC, Schreiber GB, Crawford PB, Daniels SR (2005) Self-reported symptoms of depression in late adolescence to early adulthood: a comparison of African-American and Caucasian females. J Adolesc Health 37:526–529

    Article  PubMed  Google Scholar 

  18. Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE (1998) Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 107:128–140

    Article  PubMed  CAS  Google Scholar 

  19. Kadison R (2006) College psychiatry 2006: challenges and opportunities. J Am Coll Health 54:338–340

    Article  PubMed  Google Scholar 

  20. Khawaja NG, Bryden KJ (2006) The development and psychometric investigation of the university student depression inventory. J Affect Disord 96:21–29

    Article  PubMed  Google Scholar 

  21. Knurowski T, van Dijk JP, Geckova AM, Brzyski P, Tobiasz-Adamczyk B, van den Heuvel WJ (2005) Socio-economic health differences among the elderly population in Krakow, Poland. Soz Praventivmed 50:177–185

    Article  PubMed  Google Scholar 

  22. Koster A, Bosma H, Kempen GI, Penninx BW, Beekman AT, Deeg DJ, van Eijk JT (2006) Socioeconomic differences in incident depression in older adults: the role of psychosocial factors, physical health status, and behavioral factors. J Psychosom Res 61:619–627

    Article  PubMed  Google Scholar 

  23. Kubik MY, Lytle LA, Birnbaum AS, Murray DM, Perry CL (2003) Prevalence and correlates of depressive symptoms in young adolescents. Am J Health Behav 27:546–553

    PubMed  Google Scholar 

  24. Littell RC (1996) SAS system for mixed models. SAS Inst, Cary

    Google Scholar 

  25. Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M (2003) Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157:98–112

    Article  PubMed  CAS  Google Scholar 

  26. Makinen IH (2000) Eastern European transition and suicide mortality. Soc Sci Med 51:1405–1420

    Article  PubMed  CAS  Google Scholar 

  27. Nicholson A, Pikhart H, Pajak A, Malyutina S, Kubinova R, Peasey A, Topor-Madry R, Nikitin Y, Capkova N, Marmot M, Bobak M (2007) Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe. J Affect Disord [Epub ahead of print]

  28. Olsen LR, Mortensen EL, Bech P (2004) Prevalence of major depression and stress indicators in the Danish general population. Acta Psychiatr Scand 109:96–103

    Article  PubMed  CAS  Google Scholar 

  29. Ovuga E, Boardman J, Wasserman D (2006) Undergraduate student mental health at Makerere University, Uganda. World Psychiatr 5:51–52

    Google Scholar 

  30. Piko BF, Fitzpatrick KM (2003) Depressive symptomatology among Hungarian youth: a risk and protective factors approach. Am J Orthopsychiatr 73:44–54

    Article  Google Scholar 

  31. Richter P, Werner J, Heerlein A, Kraus A, Sauer H (1998) On the validity of the Beck Depression Inventory. A review. Psychopathology 31:160–168

    Article  PubMed  CAS  Google Scholar 

  32. Roberts RE, Lewinsohn PM, Seeley JR (1991) Screening for adolescent depression: a comparison of depression scales. J Am Acad Child Adolesc Psychiatr 30:58–66

    Article  CAS  Google Scholar 

  33. Sacco WP (1981) Invalid use of the Beck Depression Inventory to identify depressed college-student subjects: a methodological comment. Cognitive Ther Res 5:143–147

    Article  Google Scholar 

  34. Schmitt M, Altstöter-Gleich C, Hinz A, Maes J, Brähler E (2006) Normwerte für das Vereinfachte Beck-Depressions-Inventar (BDI-V) in der Allgemeinbevölkerung. Diagnostica 52:51–59

    Article  Google Scholar 

  35. Schmitt M, Beckmann M, Dusi D, Maes J, Schiller A, Schonauer K (2003) Messgüte des vereinfachten Beck-Depressions-Inventars (BDI-V). Diagnostica 49:147–156

    Article  Google Scholar 

  36. Schmitt M, Maes J (2000) Vorschlag zur Vereinfachung des Beck-Depressions-Inventars (BDI). Diagnostica 46:38–46

    Article  Google Scholar 

  37. Steptoe A, Wardle J (2001) Health behaviour, risk awareness and emotional well-being in students from Eastern Europe and Western Europe. Soc Sci Med 53:1621–1630

    Article  PubMed  CAS  Google Scholar 

  38. Stewart AL, Dean ML, Gregorich SE, Brawarsky P, Haas JS (2007) Race/ethnicity, socioeconomic status and the health of pregnant women. J Health Psychol 12:285–300

    Article  PubMed  Google Scholar 

  39. Torsheim T, Currie C, Boyce W, Samdal O (2006) Country material distribution and adolescents’ perceived health: multilevel study of adolescents in 27 countries. J Epidemiol Community Health 60:156–161

    Article  PubMed  Google Scholar 

  40. Torsheim T, Ravens-Sieberer U, Hetland J, Valimaa R, Danielson M, Overpeck M (2006) Cross-national variation of gender differences in adolescent subjective health in Europe and North America. Soc Sci Med 62:815–827

    Article  PubMed  Google Scholar 

  41. Wade TJ, Cairney J, Pevalin DJ (2002) Emergence of gender differences in depression during adolescence: national panel results from three countries. J Am Acad Child Adolesc Psychiatr 41:190–198

    Article  Google Scholar 

  42. Wardle J, Steptoe A, Gulis G, Sartory G, Sek H, Todorova I, Vogele C, Ziarko M (2004) Depression, perceived control, and life satisfaction in university students from Central-Eastern and Western Europe. Int J Behav Med 11:27–36

    Article  PubMed  Google Scholar 

  43. Zumbo BD (1999) A handbook on the theory and methods of Differential Item Functioning (DIF): logistic regression modeling as a unitary framework for binary and likert-type (ordinal) item scores (available at: http://educ.ubc.ca/faculty/zumbo/DIF/ accessed Oct 10, 2007). Directorate of Human Resources Research and Evaluation, Department of national Defense, Ottawa

Download references

Acknowledgement

In addition to the authors, the Cross National Students Health Study group includes: Alexander Kraemer, Sabine Meier (Bielefeld, Germany); Nazmi Bilir, Hilal Ozcebe, Dilek Aslan (Ankara, Turkey); Janina Petkeviciene, Jurate Klumbiene, Irena Miseviciene (Kaunas, Lithuania); Francisco Guillen Grima (Pamplona, Spain) and others.

Author information

Authors and Affiliations

  1. Dept. of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany

    Rafael T. Mikolajczyk & Vihra Naydenova

  2. School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Dr. South, A2-125 CHS, Los Angeles, CA, 90095-6900, USA

    Annette E. Maxwell

  3. Faculty of Sport, Health & Social Care, University of Gloucestershire, Gloucester, UK

    Walid El Ansari

  4. Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark

    Christiane Stock

  5. Dept. of Social, Work and Educational Psychology, Faculty of Philosophy, Sofia University “St. Kl. Ohridski”, Sofia, Bulgaria

    Snezhana Ilieva

  6. Institute of Family Sciencies, Catholic University of Lublin, Lublin, Poland

    Urszula Dudziak

  7. Institute for Society and Health – KISH, PJ Safarik University Kosice, Kosice, Slovak Republic

    Iveta Nagyova

Authors
  1. Rafael T. Mikolajczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annette E. Maxwell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Walid El Ansari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vihra Naydenova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christiane Stock
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Snezhana Ilieva
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Urszula Dudziak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Iveta Nagyova
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Annette E. Maxwell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mikolajczyk, R.T., Maxwell, A.E., El Ansari, W. et al. Prevalence of depressive symptoms in university students from Germany, Denmark, Poland and Bulgaria. Soc Psychiat Epidemiol 43, 105–112 (2008). https://doi.org/10.1007/s00127-007-0282-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-007-0282-0

Key words

Search

Navigation