Mental health of medical students in culturally diverse learning environments: a cross-sectional study in Georgia
DOI:
https://doi.org/10.66636/gmj.v1.i3.a186Keywords:
mental health, students mental health, depression, anxiety, medical students, international students, Georgia, PHQ-9, GAD-7, cross-sectional studyAbstract
Background: Mental health is an increasing topic of concern among medical students worldwide. International medical students may face additional stressors related to academic pressure, cultural adjustment, language barriers, and social isolation. Despite Georgia's rapidly growing international student population, limited research has examined the mental well-being of international medical students within Georgian medical universities.
Objective: To assess the prevalence and severity of depression and anxiety among international medical students in Georgia, and to explore key psychological and institutional factors contributing to psychological distress, including academic stress, language barriers, homesickness, and access to mental health support.
Methods: An analytical cross-sectional study was conducted among international medical students enrolled at East-West University (EWU) and East European University (EEU) in Tbilisi, Georgia. An anonymous online questionnaire was distributed via university communication channels, yielding 396 valid responses (response rate: 31%). Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7) scales, respectively. Descriptive and inferential statistics were applied to quantitative data. A semi-structured interview with a university dean provided qualitative institutional context, analysed thematically and integrated with quantitative findings.
Findings: Among 296 international medical students, 79.05% exhibited depressive symptoms (PHQ-9). Prevalence was higher at EEU (81.77%) than at EWU (74.78%), and significantly greater among preclinical (82.76%) than clinical students (70.97%). Anxiety was identified in 58.45% of participants (GAD-7), with 67.33% of affected students in the moderate-to-severe range. Female students demonstrated higher anxiety prevalence (62.01%) compared to males (52.99%). The majority of students had not accessed professional mental health services (77.0%), despite widespread functional impairment.
Conclusions: International medical students in Georgia face exceptionally high rates of depression and anxiety, driven by academic overload, cultural displacement, language barriers, and limited institutional support. Urgent and coordinated action from universities, mental health professionals, and policymakers is required to strengthen mental health services, reduce stigma, and create a more supportive educational environment.
Keywords: medical students; mental health; depression; anxiety; international students; Georgia; PHQ-9; GAD-7; cross-sectional study
References
1. Business Insider Georgia. Number of foreign students in Georgia. Tbilisi: GeoStat; 2023. https://www.businessinsider.ge/ka/tsnobilia-ramdeni-utskhoeli-stsavlobs-sakartvelosi
2. Galt & Taggart. Educational sector in Georgia. Tbilisi: Galt & Taggart; 2024. https://galtandtaggart.com/en/reports/research-reports/education-sector-georgia
3. Forbes-Mewett H, Sawyer AM. International students and mental health. J Int Stud. 2016;6(3):661–677. https://doi.org/10.32674/jis.v6i3.348
4. Nazir T, Taha MM. Language barrier, language-related issues, and stress among international students in Turkish universities. Int J Adv Multidiscip Res Stud. 2022;2(2):213–218.
5. Tomyn AJ. Mental Wellbeing Survey of Prospective International and Overseas Students. Sydney: Bupa ANZ; 2019.
6. Yan L, Bissell K. Home away from home: how international students handle difficult and negative experiences in American higher education. J Int Stud. 2018;8(1):453–472.
7. Gagnidze A, Hassan N. Mental health of medical students in culturally diverse learning environments: literature review. Am J Biomed Sci Res. 2025;26(5):729–732.
8. Hunt J, Eisenberg D. Mental health problems and help-seeking behavior among college students. J Adolesc Health. 2010;46(1):3–10. https://doi.org/10.1016/j.jadohealth.2009.08.008
9. Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735. https://doi.org/10.3390/ijerph16152735
10. Vincent ST. The prevalence of depressive symptoms among medical students of Tbilisi State Medical University in Georgia. Georgian Biomed News. 2024;2(1):1–10. https://doi.org/10.52340/GBMN.2024.01.01.64
11. Abashishvili LK. Stress level among medical students in Georgia and its causative factors. Exp Clin Med Georgia. 2022;2:1–6. https://doi.org/10.52340/jecm.2022.02.01
12. Dowrick C, Frances A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ. 2013;347:f7140. https://doi.org/10.1136/bmj.f7140
13. Mehrete T, Worku A. Loneliness and depression among international students: a systematic review. J Int Educ Res. 2019;15(4).
14. Roberts LW, Warner TD, Lyketsos C, Frank E, Ganzini L, Carter D; Collaborative Research Group on Medical Student Health. Perceptions of academic vulnerability associated with personal illness: a study of 1,027 students at nine medical schools. Compr Psychiatry. 2001;42(1):1–15.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Avtandil Gagnidze , Namaa Hassan

This work is licensed under a Creative Commons Attribution 4.0 International License.
This article is published open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.
You are free to: share and adapt the work for any purpose, even commercially.
Conditions: provide appropriate credit to the authors and the Georgian Medical Journal (GMJ), link to the licence, and indicate if changes were made. Do not apply legal terms or technological measures that legally restrict others from doing anything the licence permits.
Licence: creativecommons.org/licenses/by/4.0 · Legal code: creativecommons.org/licenses/by/4.0/legalcode
Third-party material. Images or other content credited to a third party are not covered by CC BY 4.0; permission must be obtained from the rights holder for reuse beyond statutory exceptions.
Authors' rights. Authors retain copyright. First publication rights are granted to GMJ.
Data and code. Where provided, datasets or code may carry their own licences; please follow the licence stated in the article or repository record.




















