Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries.

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.