Germany is a popular destination for international students. However, little is known about their mental health issues. Further, there is limited research in European countries investigating risk and protective factors for acculturative stress and mental health issues among international student samples. This study aimed to investigate the prevalence of depression, anxiety and acculturative stress among international students in Germany. Further, we examined the association of possible protective and risk factors with these outcome variables. A total of 327 international students in Germany completed an online survey. Standardised measures for depression (PHQ-9), anxiety (GAD-7), and acculturative stress were used. Hierarchical regression analyses were employed to assess the impact of demographic factors, psychological variables, and coping strategies on mental health outcomes. The prevalence of depression and anxiety was high among international students (46.5% and 46.8%, respectively). A substantial proportion of the sample (31.2%) reported suicidal ideation or thoughts of self-harm. Further, international students in our study reported moderate acculturative stress. Mindfulness, different sources of social support, self-efficacy, optimism and acceptance were protective factors against depression, anxiety or acculturative stress. However, less than half of our sample was well supported by university facilities. A few demographic variables (gender, graduation, education, home country) were related to higher acculturative stress and anxiety. Acculturative stress was a significant predictor of depression and anxiety. Our findings highlight the importance of addressing mental health issues among international students. The results suggest that universities may consider providing adequate psychological services and strengthening institutional support for international students.
Karing et al. (2026) studied this question.