Social Psychiatry and Psychiatric Epidemiology

, Volume 43, Issue 2, pp 105–112 | Cite as

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

  • Rafael T. Mikolajczyk
  • Annette E. MaxwellEmail author
  • Walid El Ansari
  • Vihra Naydenova
  • Christiane Stock
  • Snezhana Ilieva
  • Urszula Dudziak
  • Iveta Nagyova



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) 



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.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Rafael T. Mikolajczyk
    • 1
  • Annette E. Maxwell
    • 2
    Email author
  • Walid El Ansari
    • 3
  • Vihra Naydenova
    • 1
  • Christiane Stock
    • 4
  • Snezhana Ilieva
    • 5
  • Urszula Dudziak
    • 6
  • Iveta Nagyova
    • 7
  1. 1.Dept. of Public Health Medicine, School of Public HealthUniversity of BielefeldBielefeldGermany
  2. 2.School of Public Health and Jonsson Comprehensive Cancer CenterUniversity of California, Los AngelesLos AngelesUSA
  3. 3.Faculty of Sport, Health & Social CareUniversity of GloucestershireGloucesterUK
  4. 4.Unit for Health Promotion ResearchUniversity of Southern DenmarkEsbjergDenmark
  5. 5.Dept. of Social, Work and Educational Psychology, Faculty of PhilosophySofia University “St. Kl. Ohridski”SofiaBulgaria
  6. 6.Institute of Family ScienciesCatholic University of LublinLublinPoland
  7. 7.Institute for Society and Health – KISHPJ Safarik University KosiceKosiceSlovak Republic

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