Alcohol Consumption and Depressive Symptoms in Romanian University Students: Post-Pandemic Insights from a Non-Clinical Cohort

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 ± 5.8, while the mean DASS-21 Depression score was 13.8 ± 9.5. A strong positive correlation was observed between AUDIT and depression scores (r = 0.72, 95% CI [0.62, 0.80], p < 1 × 10⁻¹⁷). Linear regression revealed that AUDIT scores significantly predicted depression severity (R² = 0.496, p < 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–depression 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.