Depressive symptoms, socio-economic background, sense of control, and cultural factors in University students from 23 Countries

Abstract

We measured depressive symptoms with the Beck Depression Inventory in 17,348 university students from 23 high-, middle-, and low-income countries, and assessed associations with individual level and ecological level factors using multi-level random effects regression modelling. Wide variations in depressive symptoms were observed between countries, with lower levels in Western and Southern Europe and South and North America, intermediate levels in Central and Eastern Europe, and higher levels in Pacific-Asian samples. Poorer socio-economic background and low sense of control were associated with depressive symptoms within each country. Independently of individual level effects, higher depressive symptoms were recorded in countries with greater income inequality and with less individualistic cultures. Personal circumstances, beliefs, and cultural factors may all contribute to depressive symptoms in this population.

Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis

“…Eight articles reported results from multi-country studies 12,27,29,[31][32][33][34][35] ; ten studies were conducted in the USA 28,30,[36][37][38][39][40][41][42][43] ; three studies were carried out in the UK [44][45][46] ; two articles reported results from a study carried out in Brazil 47,48 ; one study was conducted in Australia 49 , one in Mexico 50 , one in Spain 51 , and one in South Africa 26 (Table 1).…”

“…One article included university students 35 , one included 11, 13 and 15-year-old students 31 and one sampled women with infant children 40 . Twenty-two articles assessed psychiatric diagnoses 12,[26][27][28][29][30]32,[34][35][36][37][39][40][41][42][43][44][45][46][47] , whereas three assessed psychological distress/symptoms or mental well-being/functioning 31,33,49 . One article assessed both psychiatric diagnosis and psychological symptoms 38 , and one article reported use of mental health services 48 .…”

“…In the quality assessment (Appendix 2), ten studies 12,[26][27][28]32,35,39,40,42,45 scored two or less; the remaining 17 scored 3 or 4. The main problems identified were use of cross-sectional and ecological study design and absence of missing data assessment.…”

“…Nine articles [26][27][28]31,32,35,40,45,49 reported that the prevalence/incidence of mental health problems was higher in areas with greater income inequality. These studies assessed depression 28,37,41,51 , psychological distress/symptoms 31 and psychosis 26,27,32,45 .…”

Assessment of Depression among Applied Medical Science College Students at Taif University: A Questionnaire Survey

“…Previous study of Steptoe et al also showed that Asian countries had the highest incidence of depression as compared to other countries [18]. However, this percentage is quite high as compared to the findings of Sreeramareddy et al (20%) and Chan DW (21%) [19,20].…”