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BMC Psychiatry
Published in: BMC Psychiatry 1/2023

Open Access 01-12-2023 | Anxiety | Research

Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students

Authors: Zhangming Chen, Silan Ren, Ruini He, Yudiao Liang, Youguo Tan, Yi Liu, Fanglan Wang, Xu Shao, Shanshan Chen, Yanhui Liao, Ying He, Jin-guang Li, Xiaogang Chen, Jinsong Tang

Published in: BMC Psychiatry | Issue 1/2023

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Abstract

Background

Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.

Methods

Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the “survey” package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.

Results

A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.

Conclusion

Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.
Literature
1.
2.
Oldehinkel AJ, Ormel J. A longitudinal perspective on childhood adversities and onset risk of various psychiatric disorders. Eur Child Adolesc Psychiatry. 2015;24(6):641–50.PubMed
3.
Tang X, Tang S, Ren Z, Wong DFK. Prevalence of depressive symptoms among adolescents in secondary school in mainland China: a systematic review and meta-analysis. J Affect Disord. 2019;245:498–507.PubMed
4.
Zhang Y, Bao X, Yan J, Miao H, Guo C. Anxiety and depression in chinese students during the COVID-19 pandemic: a Meta-analysis. Front Public Health. 2021;9:697642.PubMedPubMedCentral
5.
Wang C, Zhang P, Zhang N. Adolescent mental health in China requires more attention. Lancet Public Health. 2020;5(12):e637.PubMed
6.
Zhou SJ, Zhang LG, Wang LL, Guo ZC, Wang JQ, Chen JC, Liu M, Chen X, Chen JX. Prevalence and socio-demographic correlates of psychological health problems in chinese adolescents during the outbreak of COVID-19. Eur Child Adolesc Psychiatry. 2020;29(6):749–58.PubMedPubMedCentral
7.
Xu Q, Mao Z, Wei D, Liu P, Fan K, Wang J, Wang X, Lou X, Lin H, Wang C, et al. Prevalence and risk factors for anxiety symptoms during the outbreak of COVID-19: a large survey among 373216 junior and senior high school students in China. J Affect Disord. 2021;288:17–22.PubMedPubMedCentral
8.
Mohammadi MR, Ahmadi N, Yazdi FR, Khaleghi A, Mostafavi SA, Hooshyari Z, Molavi P, Sarraf N, Hojjat SK, Mohammadzadeh S, et al. Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents. Asian J Psychiatr. 2020;53:102059.PubMed
9.
Anjum A, Hossain S, Hasan MT, Alin SI, Uddin ME, Sikder MT. Depressive Symptom and Associated factors among School Adolescents of Urban, Semi-Urban and Rural Areas in Bangladesh: a scenario prior to COVID-19. Front Psychiatry. 2021;12:708909.PubMedPubMedCentral
10.
Girma S, Tsehay M, Mamaru A, Abera M. Depression and its determinants among adolescents in Jimma town, Southwest Ethiopia. PLoS ONE. 2021;16(5):e0250927.PubMedPubMedCentral
11.
Moeini B, Bashirian S, Soltanian AR, Ghaleiha A, Taheri M. Prevalence of depression and its associated sociodemographic factors among iranian female adolescents in secondary schools. BMC Psychol. 2019;7(1):25.PubMedPubMedCentral
12.
Chi X, Becker B, Yu Q, Hossain MM, Lin J, Yeung A, Seiler-Ramadas R, Grabovac I, Bu H, Xie F, et al. Persistence and remission of depressive symptoms and psycho-social correlates in chinese early adolescents. BMC Psychiatry. 2020;20(1):406.PubMedPubMedCentral
13.
Abdul Latiff L, Tajik E, Ibrahim N, Abubakar AS, Ali SS. Depression and its associated factors among secondary school students in Malaysia. Southeast Asian J Trop Med Public Health. 2016;47(1):131–41.PubMed
14.
Hafstad GS, Sætren SS, Wentzel-Larsen T, Augusti EM. Adolescents’ symptoms of anxiety and depression before and during the Covid-19 outbreak - A prospective population-based study of teenagers in Norway. Lancet Reg Health Eur. 2021;5:100093.PubMedPubMedCentral
15.
Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, et al. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet. 2018;392(10164):2567–82.PubMedPubMedCentral
16.
Guo J, Li M, Wang X, Ma S, Ma J. Being bullied and depressive symptoms in chinese high school students: the role of social support. Psychiatry Res. 2020;284:112676.PubMed
17.
18.
Tolêdo J, Batista J, Lyra MCA, Júnior M, Santos M, Heimer MV. Sleep disturbance and depression in adolescence: an integrative review of literature. Int J Adolesc Med Health. 2020;33(6):299–303.PubMed
19.
Brown WJ, Wilkerson AK, Boyd SJ, Dewey D, Mesa F, Bunnell BE. A review of sleep disturbance in children and adolescents with anxiety. J Sleep Res. 2018;27(3):e12635.PubMed
20.
Kuss DJ, Griffiths MD. Online gaming addiction in children and adolescents: a review of empirical research. J Behav Addict. 2012;1(1):3–22.PubMed
21.
Torres-Rodríguez A, Griffiths MD, Carbonell X, Oberst U. Internet gaming disorder in adolescence: psychological characteristics of a clinical sample. J Behav Addict. 2018;7(3):707–18.PubMedPubMedCentral
22.
Rao WW, Xu DD, Cao XL, Wen SY, Che WI, Ng CH, Ungvari GS, He F, Xiang YT. Prevalence of depressive symptoms in children and adolescents in China: a meta-analysis of observational studies. Psychiatry Res. 2019;272:790–6.PubMed
23.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.PubMed
24.
Sun J, Liang K, Chi X, Chen S. Psychometric Properties of the generalized anxiety disorder Scale-7 item (GAD-7) in a large sample of chinese adolescents. Healthc (Basel) 2021, 9(12).
25.
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of Mental Disorders. Patient Health Questionnaire Jama. 1999;282(18):1737–44.PubMed
26.
Wang W, Bian Q, Zhao Y, Li X, Wang W, Du J, Zhang G, Zhou Q, Zhao M. Reliability and validity of the chinese version of the Patient Health Questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2014;36(5):539–44.PubMed
27.
Peng P, Chen S, Hao Y, He L, Wang Q, Zhou Y, Tang YY, Yang WF, Wu Q, Liu T. Network of burnout, depression, anxiety, and dropout intention in medical undergraduates. Int J Soc Psychiatry 2023:207640231166629.
28.
Peng P, Liang M, Wang Q, Lu L, Wu Q, Chen Q. Night shifts, insomnia, anxiety, and depression among chinese nurses during the COVID-19 pandemic remission period: a network approach. Front Public Health. 2022;10:1040298.PubMedPubMedCentral
29.
Peng P, Yang WF, Liu Y, Chen S, Wang Y, Yang Q, Wang X, Li M, Wang Y, Hao Y, et al. High prevalence and risk factors of dropout intention among chinese medical postgraduates. Med Educ Online. 2022;27(1):2058866.PubMedPubMedCentral
30.
Mynard H, Joseph S. Development of the multidimensional peer-victimization scale. Aggressive Behav. 2000;26(2):169–78.
31.
Zhao K, Tong S, Hong L, Yang S, Yang W, Xu Y, Fan Z, Zheng J, Yao K, Zheng T. Childhood trauma, peer victimization, and non-suicidal self-injury among chinese adolescents: a latent variable mediation analysis. BMC Psychiatry. 2023;23(1):436.PubMedPubMedCentral
32.
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.
33.
Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, Fang SC. Psychometric evaluation of the chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14(8):1943–52.PubMed
34.
Pontes, Halley M, Griffiths, Mark D. Measuring DSM-5 internet gaming disorder: development and validation of a short psychometric scale. Comput Hum Behav. 2015;45(Apr):137–43.
35.
Qin L, Cheng L, Hu M, Liu Q, Tong J, Hao W, Luo T, Liao Y. Clarification of the cut-off score for nine-item internet gaming disorder scale-short form (IGDS9-SF) in a chinese context. Front Psychiatry. 2020;11:470.PubMedPubMedCentral
36.
Wang D, Chen H, Chen Z, Liu W, Wu L, Chen Y, Sun M, Fan F. Current psychotic-like experiences among adolescents in China: identifying risk and protective factors. Schizophr Res. 2022;244:111–7.PubMed
37.
Deng J, Zhou F, Hou W, Heybati K, Lohit S, Abbas U, Silver Z, Wong CY, Chang O, Huang E, et al. Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: a meta-analysis. Ann N Y Acad Sci. 2023;1520(1):53–73.PubMed
38.
Wang L, Feng Z, Yang G, Yang Y, Wang K, Dai Q, Zhao M, Hu C, Zhang R, Liu K, et al. Depressive symptoms among children and adolescents in western china: an epidemiological survey of prevalence and correlates. Psychiatry Res. 2016;246:267–74.PubMed
39.
Wang L, Feng Z, Yang G, Yang Y, Dai Q, Hu C, Liu K, Guang Y, Zhang R, Xia F, et al. The epidemiological characteristics of depressive symptoms in the left-behind children and adolescents of Chongqing in China. J Affect Disord. 2015;177:36–41.PubMed
40.
Ming HU, Zheng L, Xia Q, Deng YX. An investigation into the prevalence and related factors of anxiety in middle school students of Hunan Province. Chin J Clin Psychol 2007.
41.
Wan PF, Sun YJ, Yuan J. Characteristics of anxiety and the related risk factors among adolescent students in Dalian City. Chin J Behav Med Sci 2005.
42.
Xu WQ, Tan WY, Li XL, Huang ZH, Zheng HR, Hou CL, Jia FJ, Wang SB. Prevalence and correlates of depressive and anxiety symptoms among adults in Guangdong Province of China: a population-based study. J Affect Disord. 2022;308:535–44.PubMed
43.
Hu W, Fang X, Chen H, Deng L, Lin X. The relationship between three-domain Competences and Internalizing and externalizing problems in Chinese High School Students. Child Indic Res. 2015;8(4):943–59.
44.
Ma L, Gao L, Chiu DT, Ding Y, Wang W, Wang Y. Depressive symptoms prevalence, associated family factors, and gender differences: a national cohort study of middle school students in China. J Affect Disord. 2020;274:545–52.PubMed
45.
Chen W, Huang Y, Riad A. Gender differences in depressive traits among rural and urban chinese adolescent students: secondary data analysis of Nationwide Survey CFPS. Int J Environ Res Public Health 2021, 18(17).
46.
Tso WWY, Wong RS, Tung KTS, Rao N, Fu KW, Yam JCS, Chua GT, Chen EYH, Lee TMC, Chan SKW, et al. Vulnerability and resilience in children during the COVID-19 pandemic. Eur Child Adolesc Psychiatry. 2022;31(1):161–76.PubMed
47.
Modecki KL, Minchin J, Harbaugh AG, Guerra NG, Runions KC. Bullying prevalence across contexts: a meta-analysis measuring cyber and traditional bullying. J Adolesc Health. 2014;55(5):602–11.PubMed
48.
Gong Z, Han Z, Zhang H, Zhang G. Weight status and school bullying Experiences in Urban China: the difference between boys and girls. J Interpers Violence. 2020;35(15–16):2663–86.PubMed
49.
Han Z, Zhang G, Zhang H. School bullying in Urban China: prevalence and correlation with School Climate. Int J Environ Res Public Health 2017, 14(10).
50.
Xu S, Ren J, Li F, Wang L, Wang S. School bullying among Vocational School students in China: Prevalence and Associations with Personal, Relational, and School factors. J Interpers Violence. 2022;37(1–2):NP104–24.PubMed
51.
Morin CM, Carrier J, Bastien C, Godbout R, Canadian S, Circadian N. Sleep and circadian rhythm in response to the COVID-19 pandemic. Can J Public Health. 2020;111(5):654–7.PubMedPubMedCentral
52.
Becker SP, Gregory AM. Editorial perspective: perils and promise for child and adolescent sleep and associated psychopathology during the COVID-19 pandemic. J Child Psychol Psychiatry. 2020;61(7):757–9.PubMedPubMedCentral
53.
Yan W, Li Y, Sui N. The relationship between recent stressful life events, personality traits, perceived family functioning and internet addiction among college students. Stress Health. 2014;30(1):3–11.PubMed
54.
Bonnaire C, Phan O. Relationships between parental attitudes, family functioning and internet gaming disorder in adolescents attending school. Psychiatry Res. 2017;255:104–10.PubMed
55.
Zadra S, Bischof G, Besser B, Bischof A, Meyer C, John U, Rumpf HJ. The association between internet addiction and personality disorders in a general population-based sample. J Behav Addict. 2016;5(4):691–9.PubMedPubMedCentral
Metadata
Title
Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students
Authors
Zhangming Chen
Silan Ren
Ruini He
Yudiao Liang
Youguo Tan
Yi Liu
Fanglan Wang
Xu Shao
Shanshan Chen
Yanhui Liao
Ying He
Jin-guang Li
Xiaogang Chen
Jinsong Tang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2023
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-023-05068-1

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