{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T22:37:04Z","timestamp":1781044624165,"version":"3.54.1"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: University students are increasingly vulnerable to both depressive symptoms and hazardous alcohol use, particularly in the aftermath of the COVID-19 pandemic. Disruptions in circadian rhythms, hormonal dysregulation, and changing social dynamics may heighten susceptibility to maladaptive coping behaviors such as alcohol consumption. While this relationship has been widely studied in Western populations, limited data exist for Eastern European contexts. This study investigated the association between alcohol consumption and depressive symptoms among Romanian university students and explored potential gender differences in this post-pandemic cohort. Methods: A cross-sectional study was conducted among 103 Romanian university students at the University of Medicine and Pharmacy of Craiova, Romania. Participants anonymously completed a combined survey integrating the Alcohol Use Disorders Identification Test (AUDIT) and the Depression subscale of the Depression, Anxiety and Stress Scale (DASS-21). Statistical analyses included Pearson correlation, linear regression, and subgroup comparisons to evaluate associations between alcohol use and depression severity. Results: The mean AUDIT score was 5.4 \u00b1 5.8, while the mean DASS-21 Depression score was 13.8 \u00b1 9.5. A strong positive correlation was observed between AUDIT and depression scores (r = 0.72, 95% CI [0.62, 0.80], p &lt; 1 \u00d7 10\u221217). Linear regression revealed that AUDIT scores significantly predicted depression severity (R2 = 0.496, p &lt; 0.001), with each one-point increase in AUDIT score associated with a 1.31-point rise in depression score. Male students reported significantly higher alcohol use than females (p = 0.005), while depression scores did not differ significantly by gender (p = 0.110). The alcohol\u2013depression association was similarly strong across genders. Conclusions: Hazardous alcohol use was highly prevalent and strongly associated with increased depressive symptoms among university students. These findings highlight the need for integrated mental health and substance use screening programs in university settings to support early identification and intervention.<\/jats:p>","DOI":"10.3390\/jcm15031314","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T08:15:54Z","timestamp":1770624954000},"page":"1314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Alcohol Consumption and Depressive Symptoms in Romanian University Students: Post-Pandemic Insights from a Non-Clinical Cohort"],"prefix":"10.3390","volume":"15","author":[{"given":"Daniela Gabriela","family":"Glavan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Aldea","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"B\u0103lu\u021boiu","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona-Constantina","family":"Vasile","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-2858","authenticated-orcid":false,"given":"Alexandra Daniela","family":"Rotaru-Zavaleanu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia-Danai","family":"Dampa","sequence":"additional","affiliation":[{"name":"Independent Researcher, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Andrei","family":"Ruscu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Gre\u0219i\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Citto Iulian","family":"Taisescu","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4366-0410","authenticated-orcid":false,"given":"Eleftheria","family":"Dampa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kilkis General Hospital, Al. Gialamidi 2, 611 00 Kilkis, Greece"},{"name":"Medical Research, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venera Cristina","family":"Dinescu","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Occupational Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e41671","DOI":"10.1097\/MD.0000000000041671","article-title":"Depression and substance abuse among university students","volume":"104","author":"Mengistie","year":"2025","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sousa, R.D., Henriques, A.R., de Almeida, J.C., Canh\u00e3o, H., and Rodrigues, A.M. (2023). Unraveling Depressive Symptomatology and Risk Factors in a Changing World. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20166575"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1080\/07448481.2017.1351445","article-title":"An examination of the impact of maladaptive coping on the association between stressor type and alcohol use in college","volume":"65","author":"Metzger","year":"2017","journal-title":"J. Am. Coll. Health"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Georgescu, O.S., Martin, L., T\u00e2rtea, G.C., Rotaru-Zavaleanu, A.-D., Dinescu, S.N., Vasile, R.C., Gresita, A., Gheorman, V., Aldea, M., and Dinescu, V.C. (2024). Alcohol Consumption and Cardiovascular Disease: A Narrative Review of Evolving Perspectives and Long-Term Implications. Life, 14.","DOI":"10.3390\/life14091134"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kassew, T., Tarekegn, G.E., Alamneh, T.S., Kassa, S.F., Liyew, B., and Terefe, B. (2023). The prevalence and determinant factors of substance use among the youth in Ethiopia: A multilevel analysis of Ethiopian Demographic and Health Survey. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1096863"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Debela, S.A., Tefera, Y.M., Debela, E.A., Gebrehiwot, M., Bezie, A.E., Dadi, E.B., and Daba, C. (2025). Alcohol consumption among university students in Ethiopia: A systematic review and meta-analysis of epidemiological studies. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1513242"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Wolter, C., Lesener, T., Thomas, T.A., Hentschel, A.-C., and Gusy, B. (2021). Finding the Right Balance: A Social Norms Intervention to Reduce Heavy Drinking in University Students. Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.653435"},{"key":"ref_8","first-page":"270","article-title":"Drinking patterns and drinking problems among Asian-Americans and Pacific Islanders","volume":"22","author":"Makimoto","year":"1998","journal-title":"Alcohol Health Res. World"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"620","DOI":"10.15288\/jsad.2016.77.620","article-title":"Gender Differences in the Relationships Among Major Depressive Disorder, Heavy Alcohol Use, and Mental Health Treatment Engagement Among College Students","volume":"77","author":"Pedrelli","year":"2016","journal-title":"J. Stud. Alcohol Drugs"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"\u0218imon, S., F\u0103rca\u0219iu, M.A., and Dragomir, G.M. (2022). Cultural Perspectives, Feelings and Coping Behaviors during the COVID-19 Pandemic: A Case Study of Romanian Students. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912445"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dumitrache, L., St\u0103nculescu, E., Nae, M., Dumbr\u0103veanu, D., Simion, G., Talo\u0219, A.M., and Mareci, A. (2021). Post-Lockdown Effects on Students\u2019 Mental Health in Romania: Perceived Stress, Missing Daily Social Interactions, and Boredom Proneness. Int. J. Environ. Res. Public Health, 18.","DOI":"10.20944\/preprints202107.0473.v1"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Rada, C., Faludi, C., and Lungu, M. (2024). Emotional, coping factors and personality traits that influenced alcohol consumption in Romanian students during the COVID-19 pandemic. A cross-sectional study. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-18247-w"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9069","DOI":"10.1097\/MS9.0000000000004009","article-title":"Circadian rhythm disruption and melatonin dysregulation as overlooked drivers of immune imbalance and multiorgan failure in post-COVID syndrome: A call for chronotherapy-based interventions","volume":"87","author":"Rizvi","year":"2025","journal-title":"Ann. Med. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102116","DOI":"10.1016\/j.smrv.2025.102116","article-title":"Chronotype and substance use disorder: A systematic review with meta-analysis on the impact of circadian misalignment on psychopathology and clinical course","volume":"82","author":"Steardo","year":"2025","journal-title":"Sleep Med. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"482802","DOI":"10.5402\/2012\/482802","article-title":"The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence","volume":"2012","author":"Kuria","year":"2012","journal-title":"ISRN Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s10571-025-01569-7","article-title":"Ethanol-Induced Depression: Exploring the Underlying Molecular Mechanisms","volume":"45","author":"Razazpour","year":"2025","journal-title":"Cell. Mol. Neurobiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/da.22771","article-title":"Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature","volume":"35","author":"Turner","year":"2018","journal-title":"Depress. Anxiety"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yu, X., Gain, E.P., Ajoku, M.J., and Kedia, S.K. (2024). Bidirectional Associations Between Alcohol Drinking and Depressive Symptoms Among US Adults Aged 50 to 75: The US Health and Retirement Study. Healthcare, 13.","DOI":"10.3390\/healthcare13010053"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Lloyd, K., Schubotz, D., Roche, R., Manzi, J., and McKnight, M. (2023). A Mental Health Pandemic? Assessing the Impact of COVID-19 on Young People\u2019s Mental Health. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20166550"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e24009","DOI":"10.1002\/ajhb.24009","article-title":"Effect of COVID-19 pandemic on lifestyle and bone mineral density in young adults","volume":"36","author":"Sulis","year":"2024","journal-title":"Am. J. Hum. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"219","DOI":"10.21101\/cejph.a8118","article-title":"Long-term consequences of COVID-19 on mental and physical health in young adults","volume":"32","year":"2024","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Serrano-Fern\u00e1ndez, V., Barroso-Corroto, E., Rivera-Pic\u00f3n, C., Molina-Gallego, B., Quesado, A., Carmona-Torres, J.M., L\u00f3pez-Soto, P.J., S\u00e1nchez-Gil, A., S\u00e1nchez-Gonz\u00e1lez, J.L., and Rodr\u00edguez-Mu\u00f1oz, P.M. (2025). Motivational Interventions for Reducing Excessive Alcohol Consumption Among University Students: A Systematic Review and Meta-Analysis. Healthcare, 13.","DOI":"10.3390\/healthcare13192405"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1080\/00952990.2018.1456545","article-title":"A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions","volume":"44","author":"Babor","year":"2018","journal-title":"Am. J. Drug Alcohol Abus."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e200895","DOI":"10.1001\/jamanetworkopen.2020.0895","article-title":"Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults","volume":"3","author":"Khan","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00737-025-01569-y","article-title":"Gender difference in rumination subtypes connecting to depression","volume":"28","author":"Zou","year":"2025","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1017\/S2045796023000070","article-title":"Alcohol use as a predictor of the course of major depressive disorder: A prospective population-based study","volume":"32","author":"Schouten","year":"2023","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mitincu-Caramfil, S.D., Moroianu, L.-A., Bradeanu, A.V., Isail\u0103, O.-M., Curis, C., and Drima, E. (2025). The Correlation Between Emotionality Changes and Alcohol Consumption in Young Persons: A Pilot Study. Healthcare, 13.","DOI":"10.3390\/healthcare13090987"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Manzar, M.D., Salahuddin, M., Nureye, D., Kashoo, F.Z., Noohu, M.M., Alotaibi, J.S., Alamri, M.S., and Griffiths, M.D. (2025). Depression, Anxiety, and Stress Scale-21 (DASS-21): Further psychometric exploration using robust item response theory and classical theory measures among university students. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0325238"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jad.2012.11.059","article-title":"The bidirectional relationships between alcohol, cannabis, co-occurring alcohol and cannabis use disorders with major depressive disorder: Results from a national sample","volume":"148","author":"Pacek","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Wittgens, C., Muehlhan, M., Kr\u00e4plin, A., Wolff, M., and Trautmann, S. (2022). Underlying mechanisms in the relationship between stress and alcohol consumption in regular and risky drinkers (MESA): Methods and design of a randomized laboratory study. BMC Psychol., 10.","DOI":"10.1186\/s40359-022-00942-1"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/s41386-019-0446-0","article-title":"Alcohol use disorder and sleep disturbances: A feed-forward allostatic framework","volume":"45","author":"Koob","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.37358\/RC.19.4.7138","article-title":"Clinical and Biochemical Changes Induced by Alcohol at the Patients with Mental Illness","volume":"70","author":"Gheorman","year":"2019","journal-title":"Rev. Chim."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Hernandez-Fuentes, G.A., Romero-Michel, J.C., Guzm\u00e1n-Sandoval, V.M., Diaz-Martinez, J., Delgado-Enciso, O.G., Garcia-Perez, R.R., God\u00ednez-Medina, M., Zamora-Barajas, V., Hilerio-Lopez, A.G., and Ceja-Espiritu, G. (2024). Substance Use and Mental Health in Emerging Adult University Students Before, During, and After the COVID-19 Pandemic in Mexico: A Comparative Study. Diseases, 12.","DOI":"10.3390\/diseases12120303"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Hyseni Duraku, Z., Davis, H., Blakaj, A., Seferi, A.A., Mullaj, K., and Grei\u00e7evci, V. (2024). Mental health awareness, stigma, and help-seeking attitudes among Albanian university students in the Western Balkans: A qualitative study. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1434389"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.1016\/j.addbeh.2007.04.014","article-title":"Evaluating personal alcohol feedback as a selective prevention for college students with depressed mood","volume":"32","author":"Geisner","year":"2007","journal-title":"Addict. Behav."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tembo, C., Burns, S., and Kalembo, F. (2017). The association between levels of alcohol consumption and mental health problems and academic performance among young university students. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178142"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1111\/add.14935","article-title":"Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: A systematic review and meta-analysis of cohort studies","volume":"115","author":"Li","year":"2020","journal-title":"Addiction"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Gavurova, B., Ivankova, V., and Rigelsky, M. (2020). Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension. Int. J. Environ. Res. Public Health, 17.","DOI":"10.20944\/preprints202011.0381.v1"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Apicella, M., Andracchio, E., Della Santa, G., Lanza, C., Guidetti, C., Trasolini, M., Iannoni, M.E., Maglio, G., Vicari, S., and Serra, G. (2025). Sex differences in pediatric major depressive episodes: A cross-sectional study on psychiatric symptoms in early-onset mood disorders. Front. Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1503794"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mu\u0219at, M.I., Militaru, F., Udri\u0219toiu, I., Mitran, S.I., and C\u0103t\u0103lin, B. (2024). Alcohol Consumption Is a Coping Mechanism for Male Patients with Severe Anxiety Disorders Treated with Antidepressants Monotherapy. J. Clin. Med., 13.","DOI":"10.3390\/jcm13092723"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mu\u0219at, M.I., Militaru, F., Gheorman, V., Udri\u0219toiu, I., Mitran, S.I., and C\u0103t\u0103lin, B. (2024). Moderate Alcohol Consumption Increases the Risk of Clinical Relapse in Male Depressed Patients Treated with Serotonin-Norepinephrine Reuptake Inhibitors. Diagnostics, 14.","DOI":"10.3390\/diagnostics14111140"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1037\/0021-843X.110.3.449","article-title":"Specifying the relations between affect and heavy alcohol use among young adults","volume":"110","author":"Hussong","year":"2001","journal-title":"J. Abnorm. Psychol."},{"key":"ref_43","first-page":"arcr-v40","article-title":"Alcohol Use Disorder and Depressive Disorders","volume":"40","author":"McHugh","year":"2019","journal-title":"Alcohol Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1314\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T09:53:16Z","timestamp":1770803596000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15031314"],"URL":"https:\/\/doi.org\/10.3390\/jcm15031314","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}