Prevalence of depressive symptoms in university students from Germany, Denmark, Poland and Bulgaria.
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 > or =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 > or =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.
Mikolajczyk
Rafael T
RT
Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany.
Maxwell
Annette E
AE
El Ansari
Walid
W
Naydenova
Vihra
V
Stock
Christiane
C
Ilieva
Snezhana
S
Dudziak
Urszula
U
Nagyova
Iveta
I
D000328:Adult; D000704:Analysis of Variance; D003431:Cross-Cultural Comparison; D003863:Depression / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology*