Depressiveness in German higher education students – a systematic review and meta-analysis

Abstract

Abstract Introduction Evidence shows that German higher education students are vulnerable to depressive symptoms. However, there is no recent review compiling these findings. Thus, our study aims at describing the extent to which higher education students in Germany are affected by depressive symptoms. Methods We searched three databases for suitable publications using three core concepts (‘depressive symptoms’, ‘students’, and ‘Germany’). The inclusion criteria were: (a) the population studied consisted of students from higher education institutions, (b) data was assessed at higher education institutions in Germany, (c) information on depressive symptoms were pro-vided as outcome of instruments assessing depressive symptoms, (d) articles were published in peer-reviewed journals, in (e) English or German and (f) between 2002 and 2023. Random effects models were used to calculate both general and subgroup-specific pooled prevalence rates. Subgroups were formed based on the included literature (e.g. gender, before or during the COVID-19 pandemic, study phase and programme). Results The literature search resulted in 992 articles. After the removal of duplicates and the two-stage screening process, prevalence data was extracted from 60 articles. The overall pooled prevalence rate was 21.1% (95% CI: 17.6% - 24.6%). Medical students (13.2%; 95% CI: 9.9% - 16.4%) and first-year students (11.0%; 95% CI: 7.7% - 14.3%) were less likely to be affected than students in general. Women (29.0%; 95% CI: 21.4% - 36.5%) were more prone to depressive symptoms than men (23.1%; 95% CI: 16.5% - 29.6%). In samples collected during the COVID-19 pandemic, the pooled prevalence rates were higher than in pre-pandemic times (30.6%; 95% CI: 22.1% - 39.1% vs. 18.0%; 95% CI: 14.7% - 21.2%). Conclusions This analysis emphasizes the pressing need to address the mental health of higher education students both at the policy level and within universities. Key messages • German higher education students show alarming levels of depressive symptoms, demanding immediate action. • During the pandemic mental health was even poorer than before, highlighting the need for tailored interventions and support in challenging times.