Skip to main content
SpringerLink
Log in

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

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

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.

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.

Similar content being viewed by others

References

  • Adlaf, E.M., Gliksman, L., Demers, A., & Newton-Taylor, B. (2001). The prevalence of elevated psychological distress among Canadian undergraduates: findings from the 1998 Canadian Campus Survey.Journal of American College Health, 50, 67–72.

    Article  PubMed  Google Scholar 

  • Allik, J., & Realo, A. (2004). Individualism-collectivism and social capital.Journal of Cross-Cultural Psychology, 35, 29–49.

    Article  Google Scholar 

  • Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., Girolamo, G., Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J. M., Katz, S. J., Kessler, R. C., Kovess, V., Lepine, J. P., Ormel, J., Polidori, G., Russo, L. J., Vilagut, G., Almansa, J., Arbabzadeh-Bouchez, S., Autonell, J., Bernal, M., Buist-Bouwman, M. A., Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S. S., Martinez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacin, C., Romera, B., Taub, N., & Vollebergh,W. A. ({dy2004}). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.Acta Psychiatrica Scandinavica (Suppl.), 21-27.

  • Andrade, L., Caraveo-Anduaga, J. J., Berglund, P., Bijl, R. V., De Graaf, R., Vollebergh, W., Dragomirecka, E., Kohn, R., Keller, M., Kessler, R. C., Kawakami, N., Kilic, C., Offord, D., Ustun, T. B., & Wittchen, H. U. (2003). The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys.International Journal of Methods in Psychiatric Research, 12, 3–21.

    Article  PubMed  Google Scholar 

  • Angst, J., Gamma, A., Gastpar, M., Lepine, J. P., Mendlewicz, J., & Tylee, A. (2002). Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies.European Archives in Psychiatry and Clinial Neurosciences, 252, 201–209.

    Article  Google Scholar 

  • Ballenger, J. C., Davidson, J. R., Lecrubier, Y., Nutt, D. J., Kirmayer, L. J., Lepine, J. P., et al. (2001). Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety.Journal of Clinical Psychiatry, 62 (Suppl 13), 47–55.

    PubMed  Google Scholar 

  • Beck, A. T., & Beck, R. W. (1972). Screening depressed patients in family practice.Postgraduate Medicine, 52, 81–85.

    PubMed  Google Scholar 

  • Bobak, M., Pikhart, H., Rose, R., Hertzman, C., & Marmot, M. (2000). Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries.Social Science and Medicine, 51, 1343–1350.

    Article  PubMed  Google Scholar 

  • Bostanci, M., Ozdel, O., Oguzhanoglu, N. K., Ozdel, L., Ergin, A., Ergin, N., Atesci, F., & Karadag, F. (2005). Depressive symptomatology among university students in Denizli, Turkey: prevalence and sociodemographic correlates.Croatian Medical Journal, 46, 96–100.

    PubMed  Google Scholar 

  • Byrne, B. M., & Campbell, T. L. (1999). Cross-cultural compariosns and the presumption of equivalent measurement and theoretical stuctture: a look beneath the surface.Journal of Cross-Cultural Psychology, 30, 555–574.

    Article  Google Scholar 

  • Copeland, J. R., Beekman, A. T., Dewey, M. E., Hooijer, C., Jordan, A., Lawlor, B. A., Lobo, A., Magnusson, H., Mann, A. H., Meller, I., Prince, M. J., Reischies, F., Turrina, C., deVries, M. W., & Wilson, K. C. (1999). Depression in Europe. Geographical distribution among older people.British Journal of Psychiatry, 174, 312–321.

    Article  PubMed  Google Scholar 

  • Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys.Journal of the American Medical Association, 291, 2581–2590.

    Article  PubMed  Google Scholar 

  • Diener, E., & Biswas-Diener, R. (2002). Will money increase subjective well-being? A literature review and guide to needed research.Social Indicators Research, 57, 119–169.

    Article  Google Scholar 

  • Diener, E., Diener, M., & Diener, C. (1995). Factors predicting the subjective well-being of nations.Journal of Personality and Social Psychology, 69, 851–864.

    Article  PubMed  Google Scholar 

  • Diener, E., Oishi, S., & Lucas, R. E. (2003). Personality, culture, and subjective well-being: emotional and cognitive evaluations of life.Annual Review of Psychology, 54, 403–425.

    Article  PubMed  Google Scholar 

  • Furr, S. R., Westefeld, J. S., McConnell, G. N., & Jenkins, J. M. (2001). Suicide and depression among college students: a decade later.Professional Psychology: Research and Practice, 32, 97–100.

    Article  Google Scholar 

  • Hawton, K., Simkin, S., Fagg, J., & Hawkins, M. (1995). Suicide in Oxford University students, 1976–1990.British Journal of Psychiatry, 166, 44–50.

    Article  PubMed  Google Scholar 

  • Heiligenstein, E., Guenther, G., Hsu, K., & Herman, K. (1996). Depression and academic impairment in college students.Journal of American College Health, 45, 59–64.

    PubMed  Google Scholar 

  • Heine, S. J. (2005). Where is the evidence for pancultural selfenhancement? A reply to Sedikides, Gaertner, and Toguchi (2003).Journal of Personality and Social Psychology, 89, 531–538.

    Article  PubMed  Google Scholar 

  • Heine, S. J., Lehman, D. R., Markus, H. R., & Kitayama, S. (1999). Is there a universal need for positive self-regard?Psychological Review, 106, 766–794.

    Article  PubMed  Google Scholar 

  • Hindin, M. J., & Gultiano, S. (2006). Associations between witnessing parental domestic violence and experiencing depressive symptoms in Filipino adolescents.American Journal of Public Health, 96, 660–663.

    Article  PubMed  Google Scholar 

  • Hofstede, G. ({dy2001}).Cultures consequences, (2nd ed). Thousand Oaks, CA: Sage.

  • Hofstede, G., & McCrae, R. R. (2004). Personality and culture revisited: linking traits and dimensions of culture.Cross-Cultural Research, 38, 52–88.

    Article  Google Scholar 

  • Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of depression on the academic productivity of university students.Journal of Mental Health Policy and Economics, 8, 145–151.

    PubMed  Google Scholar 

  • Inglehart, R., & Klingemann, H.-D. (2000). Genes, culture, democracy, and happiness. In E. Diener & E. M. Suh (Eds.),Culture and subjective well-being (pp. 165–183). Cambridge, MA: MIT Press.

    Google Scholar 

  • Iwata, N., & Buka, S. (2002). Race/ethnicity and depressive symptoms: a cross-cultural/ethnic comparison among university students in East Asia, North and South America.Social Science and Medicine, 55, 2243–2252.

    Article  PubMed  Google Scholar 

  • Iwata, N., Turner, R. J., & Lloyd, D. A. (2002). Race/ethnicity and depressive symptoms in community-dwelling young adults: a differential item functioning analysis.Psychiatry Research, 110, 281–289.

    Article  PubMed  Google Scholar 

  • Kanagawa, C., Cross, S. E., & Markus, H. R. (2001). “Who am I” The cultural psychology of the conceptual self.Personality & Social Psychology Bulletin, 27, 90–103.

    Article  Google Scholar 

  • Kitayama, S. (2002). Culture and basic psychological processes- toward a system view of culture: comment on Oyserman et al. (2002).Psychological Bulletin, 128, 89–96.

    Article  PubMed  Google Scholar 

  • Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: self-enhancement in the United States and self-criticism in Japan.Journal of Personality and Social Psychology, 72, 1245–1267.

    Article  PubMed  Google Scholar 

  • Lachman, M. E., & Weaver, S. L. (1998). The sense of control as a moderator of social class differences in health and well-being.Journal of Personality and Social Psychology, 74, 763–773.

    Article  PubMed  Google Scholar 

  • Lalwani, A. K., Shavitt, S., & Johnson, T. (2006).What is the relation between cultural orientation and socially desirable responding?Journal of Personality and Social Psychology, 90, 165–178.

    Article  PubMed  Google Scholar 

  • Lee, M. (2003). Korean adolescents’ “examination hell” and their use of free time.New Directions in Child and Adolescent Development, 99, 9–21.

    Article  Google Scholar 

  • Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: a meta-analysis.American Journal of Epidemiology, 157, 98–112.

    Article  PubMed  Google Scholar 

  • Meilman, P. W., Manley, C., Gaylor, M. S., & Turco, J. H. (1992). Medical withdrawals from college for mental health reasons and their relation to academic performance.Journal of American College Health, 40, 217–223.

    PubMed  Google Scholar 

  • Mirowsky, J., & Ross, C. E. (2003).Education, social status and health. New York: Aldine De Gruyter.

    Google Scholar 

  • Mkize, L. P., Nonkelela, N. F., & Mkize, D. L. (1998). Prevalence of depression in a university population.Curationis, 21, 32–37.

    PubMed  Google Scholar 

  • Muntaner, C., Eaton, W. W., Miech, R., & O’Campo, P. (2004). Socioeconomic position and major mental disorders.Epidemiological Revviews, 26, 53–62.

    Article  Google Scholar 

  • Murray, C. J. L., & Lopez, A. (1996).Quantifying Global Health Risks: the burden of disease attributable to selected risk factors. Cambridge, MA: World Health Organization/Harvard University Press.

    Google Scholar 

  • Oyserman, D., Coon, H. M., & Kemmelmeier, M. (2002). Rethinking individualism and collectivism: evaluation of theoretical assumptions and meta-analyses.Psychological Bulletin, 128, 3–72.

    Article  PubMed  Google Scholar 

  • Pearlin, L. I., Lieberman, M. A., Menaghan, E. G., & Mullan, J. T. (1981). The stress process.Journal of Health and Social Behaviour, 22, 337–356.

    Article  Google Scholar 

  • Perlman, F., Bobak, M., Steptoe, A., Rose, R., & Marmot, M. (2003). Do health control beliefs predict behaviour in Russians?Preventive Medicine, 37, 73–81.

    Article  PubMed  Google Scholar 

  • Reifman, A., & Dunkel-Schetter, C. (1990). Stress, structural social support, and well-being in university students.Journal of American College Health, 38, 271–277.

    PubMed  Google Scholar 

  • Sastry, J., & Ross, C. E. (1998). Asian ethnicity and the sense of personal control.Social Psychology Quarterly, 61, 101–120.

    Article  Google Scholar 

  • Schyns, P. (1998). Crossnational differences in happiness: Economic and cultural factors explored.Social Indicators Research, 43, 3–26.

    Article  Google Scholar 

  • Sherina, M. S., Rampal, L., & Kaneson, N. (2004). Psychological stress among undergraduate medical students.Medical Journal of Malaysia, 59, 207–211.

    PubMed  Google Scholar 

  • Simon, G. E., Goldberg, D. P., Von Korff, M., & Ustun, T. B. (2002). Understanding cross-national differences in depression prevalence.Psychological Medicine, 32, 585–594.

    Article  PubMed  Google Scholar 

  • Smith, P. B. (2004). Acquiescent response bias as an aspect of cultural communication style.Journal of Cross-Cultural Psychology, 35, 50–61.

    Article  Google Scholar 

  • Steptoe, A., & Wardle, J. (1996). The European Health and Behaviour Survey: the development of an international study in health psychology.Psychology and Health, 11, 49–73.

    Article  Google Scholar 

  • Steptoe, A., Wardle, J., Cui, W., Baban, A., Glass, K., Pelzer, K., Tsuda, A., & Vinck, J. (2002a). An international comparison of tobacco smoking, beliefs and risk awareness in university students from 23 countries.Addiction, 97, 1561–1571.

    Article  PubMed  Google Scholar 

  • Steptoe, A., Wardle, J., Fuller, R., Davidsdottir, S., Davou, B., & Justo, J. (2002b). Seatbelt use, attitudes, and changes in legislation: an international study.American Journal of Preventive Medicine, 23, 254–259.

    Article  PubMed  Google Scholar 

  • Takakura, M., & Sakihara, S. (2001). Psychosocial correlates of depressive symptoms among Japanese high school students.Journal of Adolescent Health, 28, 82–89.

    Article  PubMed  Google Scholar 

  • Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health.Psychological Bulletin, 103, 193–210.

    Article  PubMed  Google Scholar 

  • Van Hemert, D. A., Van de Vijver, F. J. R., & Poortinga, Y. H. (2002). The Beck Depression Inventory as a measure of subjective well-being: a cross-national study.Journal of Happiness Studies, 3, 257–286.

    Article  Google Scholar 

  • Veenhoven, R. (1998). Quality of life in individualistic society.Social Indicators Research, 48, 159–188.

    Article  Google Scholar 

  • Wilkinson, R. G. (1999). Health, hierarchy, and social anxiety.Annals of the New York Academy of Sciences, 896, 48–63.

    Article  PubMed  Google Scholar 

  • Wilkinson, R. G. (2005).The impact of inequality: How to make sick societies healthier. London: Routledge.

    Google Scholar 

  • World Bank. (2000).Higher education in developing countries: peril and promise. Washington, DC: The International Bank for Reconstruction and Development/The World Bank.

    Google Scholar 

  • World Resources Institute. (1996).World resources 1996–1997: The urban environment. New York: Oxford University Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 6BT, London, UK

    Andrew Steptoe & Jane ardle

  2. Graduate School of Psychology, Department of Psychology, Kurume University, Kurume-shi, Japan

    Akira Tsuda & Yoshiyuki Tanaka

Authors
  1. Andrew Steptoe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jane ardle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akira Tsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshiyuki Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew Steptoe.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steptoe, A., ardle, J., Tsuda, A. et al. Depressive symptoms, socio-economic background, sense of control, and cultural factors in University students from 23 Countries. Int. J. Behav. Med. 14, 97–107 (2007). https://doi.org/10.1007/BF03004175

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03004175

Key words

Search

Navigation