Understanding the risk and protective factors associated with depressive symptoms in international students

A systematic review and meta-analysis

Authors

  • Shawn Raphael Tan The University of Western Australia https://orcid.org/0000-0001-5154-0873
  • Ashleigh Lin The University of Western Australia https://orcid.org/0000-0002-4054-0242
  • Colleen Fisher The University of Western Australia
  • Hamza Bouras Mental Health Commission Western Australia
  • Craig D'Mello The University of Western Australia
  • James Hill The University of Western Australia
  • Aims Hansen The University of Western Australia
  • Ross Marriott The University of Western Australia

DOI:

https://doi.org/10.32674/47n8z156

Keywords:

Acculturative Stress, Depression, International Students, Tertiary Students, Systematic Review, Meta analyses

Abstract

International students face unique challenges, placing them at high risk of experiencing mental disorders. A systematic review and meta-analysis were conducted to investigate 20 predetermined, modifiable exposures associated with depressive symptoms. The literature search included cross-sectional, case‒control, and cohort studies in English. Eighty-four studies with 148,510 international tertiary students were included, 43 of which (12,721 participants) were meta-analyzed. Four exposures were significantly associated with depressive symptoms in international tertiary students: acculturative stress was most strongly associated (summary Pearson’s correlation, r = 0.44, 95% CI = 0.39 to 0.49), followed by social support (r = -0.29, 95% CI = -0.35 to -0.22), social connectedness (r = -0.26, 95% CI -0.36 to -0.15), and language (r = -0.18, 95% CI = -0.23 to -0.11). To our knowledge, this systematic review and meta-analysis are the first to quantify associations between modifiable exposures and depressive symptoms, specifically in international tertiary students.

Author Biographies

  • Shawn Raphael Tan, The University of Western Australia

    Shawn Raphael Tan (he/him), FRSA, AFHEA, MAICD, Assoc MAPS, GMBPsS, is a PhD Candidate at The University of Western Australia. His major research interests lie in the areas of mental health, intercultural psychology, depression, and suicide prevention. E-mail: shawnraphael.tan@research.uwa.edu.au

  • Ashleigh Lin, The University of Western Australia

    Ashleigh Lin (she/her), PhD, is a NHMRC Emerging Leadership Fellow, youth mental health researcher, and Professor at The University of Western Australia. Ashleigh's research is focused on the detection and prevention of mental ill health in young people, with a particular interest in the mental health of marginalised youth, including LGBTQIA+ and Aboriginal young people. E-mail: ashleigh.lin@uwa.edu.au

  • Colleen Fisher, The University of Western Australia

    Colleen Fisher, PhD, is a Professor and Former Head of the School of Population and Global Health at The University of Western Australia. She has methodological expertise in qualitative and mixed methods research, which are approaches she teaches to students at all levels. E-mail: colleen.fisher@uwa.edu.au

  • Hamza Bouras, Mental Health Commission Western Australia

    Hamza Bouras is a former research assistant with The Kids, Australia, formerly Telethon Kids Institute, currently working at the Mental Health Commission as a senior data analyst. E-mail: hamza.bouras@mhc.wa.gov.au

  • Craig D'Mello, The University of Western Australia

    Craig D’Mello is a PhD Candidate in Psychology at The University of Western Australia. E-mail: craig.dmello@research.uwa.edu.au

  • James Hill, The University of Western Australia

    James Hill (he/him) is a PhD Candidate in Psychology and Masters of Clinical Psychology student at The University of Western Australia. James’ PhD is exploring how trans and gender diverse young people experience stigma, which describes the variety of negative attitudes and actions directed at trans and gender diverse people. Through his research he aims to identify the risk stigma poses to mental health and day-to-day life in trans and gender diverse young people. E-mail: james.hill@research.uwa.edu.au

  • Aims Hansen, The University of Western Australia

    Aims Hansen is a research assistant at The University of Western Australia School of Population and Global Health. E-mail: aims.hansen@uwa.edu.au

  • Ross Marriott, The University of Western Australia

    Ross Marriott, PhD, is a Research Fellow who is presently employed as the statistician and data manager on an international collaborative research project called the Androgens In Men Study (AIMS), led by Prof. Bu Yeap. He is a scientist with expertise in statistics and simulation modelling, who also has a research background as a marine biologist. Recent employments have included statistical analyses mostly to do with epidemiological research, although he has also been employed to analyse educational and engineering datasets. In addition to a qualification in statistics, Ross also has a PhD in marine biology and extensive coding experience, primarily using the R software program. E-mail: ross.marriott@uwa.edu.au

     

     

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Tan, S. R., Lin, A., Fisher, C., Bouras, H., D’Mello, C., Hill, J., Hansen, A., & Marriott, R. (2025). Understanding the risk and protective factors associated with depressive symptoms in international students: A systematic review and meta-analysis. Journal of International Students, 15(10), 199-249. https://doi.org/10.32674/47n8z156