title: The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study.
abstract: BACKGROUND
  Previous findings suggest that stressful life events have a causal relationship with depressive symptoms. However, to date little is known concerning the contribution of the number and severity of recent stressful life events on the prevalence of depressive symptoms among university students. The aim of this study was to investigate the prevalence of depressive symptoms and its association with the number and the severity of self-reported stressful life events among university students in Cyprus.
  
  
  METHODS
  A descriptive correlational design with cross sectional comparison was used. The CES-D scale was applied for the assessment of depressive symptoms and the LESS instrument for stressful life events. Both scales were completed anonymously and voluntarily by 1.500 students (response rate 85%).
  
  
  RESULTS
  The prevalence of mild to moderate depressive symptoms [CES-D score between 16 and 21] and of clinically significant depressive symptoms [CES-D score ≥ 22] were 18.8% and 25.3% respectively. There were statistically significant differences in clinically significant depressive symptoms by gender, with higher rates among women (x(2) = 8.53, df = 1, p = 0.003). Higher scores on the LESS scale were associated with more frequent reports of clinical depressive symptoms (x(2) = 70.63, df = 4, p < 0.001). Similarly, an association was found between the number of life events and clinical depressive symptoms (x(2) = 40.06, df = 4, p < 0.001). Logistic regression analysis after adjusting for socio-demographic characteristics confirmed that the responders who reported a high number (n = 12-21) of stressful life events during the previous year (OR = 2.64 95% CI: 1.02, 6.83) and a severe degree of stress due to these events (total LESS score > 351, OR = 3.03 95% CI: 1.66, 5.39) were more likely to manifest clinical depressive symptoms.
  
  
  CONCLUSIONS
  The high frequency of occurrence of depressive symptoms among Cypriot university students, as well as the strong association with stressful life events, highlights the need for psychological empowerment strategies towards students by institutional counseling services.
authors.affiliation: Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Vragadinou Street, Limassol, Cyprus. sokratis.sokratous@cut.ac.cy.
authors.forename: Sokratis
authors.initials: S
authors.lastname: Sokratous
authors.forename: Anastasios
authors.initials: A
authors.lastname: Merkouris
authors.forename: Nicos
authors.initials: N
authors.lastname: Middleton
authors.forename: Maria
authors.initials: M
authors.lastname: Karanikola
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003535:Cyprus / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D014495:Universities; D055815:Young Adult