<![CDATA[Mental health disorders, particularly depression, pose a serious challenge for university students during the transition phase of emerging adulthood. This study aimed to analyze the determinants of depressive symptoms among students at the Universitas Islam Negeri Sumatera Utara (UINSU), Tuntungan Campus IV. A quantitative cross-sectional design was used with a sample of 403 active students from the 2nd to the 8th semester, selected through proportionate stratified random sampling. Data were analyzed using Spearman rank correlation, the Mann-Whitney test, the Kruskal-Wallis test, and multiple linear regression. The results showed that the prevalence of “extremely severe” depressive symptoms reached 61.0%. Bivariately, depressive symptoms were significantly associated with socio-demographic characteristics (age, semester, gender, faculty, employment status), lifestyle factors (sleep duration, smoking habit), and psychosocial factors (psychological distress, academic stress, peer support, and family support). Simultaneously, the model explained 49.0% of the variance in depression scores (Adjusted R² = 0.49, p = 0.000). Multivariate analysis identified psychological distress (β = 0.603) as the dominant determinant, followed by family support as the main protective factor (β = -0.202), academic stress (β = 0.101), spirituality (β = 0.089), and daily sleep duration (β = -0.079). In conclusion, student depression is dominantly driven by the accumulation of psychological distress and academic pressure combined with insufficient sleep, while family support serves as the main protector and increased spirituality functions as a coping mechanism. Preventive measures should include accessible campus counseling services, strengthening family support, facilitating religious activities, and educating students on healthy sleep management.]]>
