*4.2. Association of Depression and Anxiety Risk with Other Variables*

Exposure to COVID-19, perceived impact of COVID-19 on students' well-being, including graduation, economic status, and relationships' quality, as well as general and comparative health, turned out to be associated with anxiety and depression in the majority of the surveyed countries. Therefore, these variables can be designated as key mental health risk factors from the cross-cultural perspective.

Even though previous research has shown the importance of physical activity for anxiety and depression in the student population [39], this study clearly manifests that the cultural context should be taken into account when analyzing this issue. Physical activity was associated with anxiety only in two (Poland and Ukraine) out of nine countries. The association with depression was revealed only in four countries (Poland, Ukraine, Russia and Israel). Therefore, in most countries, physical activity was not associated with mental health in students. One of the factors related to physical activity from the cross-cultural perspective is motivation to participate, as in individualistic cultures, like USA, the key motivation was competition, whereas in collectivistic cultures, like China, it was rather a social affiliation and wellness [77].

Living in a city or town/village turned out to be irrelevant for depression in the nine countries. This is in congruence with previous meta-analyses [20,78,79]. Students are quite a homogeneous group. Therefore, both groups living in rural and urban areas have common characteristics (i.e., young age) linked to depressive symptoms during the pandemic [13–15]. However, living in a small city or a village was associated with anxiety risk exclusively in Polish students. In all the remaining countries, it was an irrelevant factor. Previous research also showed inconsistent results. Living in an urban area was linked to lower anxiety in China [42] but higher anxiety in Bangladesh [43].

Our research showed that the association between gender and mental health risk is not clear when analyzed in different countries. Female students from Ukraine, Russia, and Turkey had a higher prevalence of anxiety and depression risk compared to male students in those countries. The highest rate of both depression and anxiety risk was revealed among Turkish female students. Furthermore, Polish and Israeli female students showed a higher prevalence of anxiety risk, whereas Colombian female students manifested the risk of depression. Previous research showed a gender effect on the prevalence of depression [20,70,79,80]. Additionally, a recent meta-analysis regarding students' mental health during the COVID-19 pandemic has revealed that female students were found to have a higher prevalence of anxiety and depression [81]. However, we have found no gender association with mental health issues among Slovenian, Czech, and German students. Therefore, the cultural context should be incorporated when exploring gender association with mental health issues.
