Abstract
BackgroundMedical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice. Although there have been many empirical studies about depression or anxiety in medical students in China, no previous studies have conducted a related systematic review about this topic in English. This analysis can convey the general findings from China to other areas of the world.MethodsA systematic review and meta-analysis of depression or anxiety in medical students and related determinants were conducted. Three Chinese and three English databases were searched for the review, with no restrictions on language. Articles published between January 1, 2000 and April 1, 2018 were included.ResultsTwenty-one articles investigating a total of 35,160 individual Chinese medical students were included in this review. The prevalence of depression ranged from 13.10 to 76.21% with a mean of 32.74%, and the prevalence of anxiety ranged from 8.54 to 88.30% with a mean of 27.22%. Based on the meta-analysis, gender, grade level, residence, satisfaction with current major and monthly household income per capita were significantly associated with depression. Grade level and satisfaction with current major were significantly associated with anxiety. Other risk factors were identified and described using a narrative approach.ConclusionThe mean prevalence of depression was 32.74% amongst medical students in China, whereas the mean prevalence of anxiety was 27.22%. The determinants of depression and anxiety included individual factors, social and economic factors, and environmental factors. More measures should be taken towards at-risk medical students based on the identified risk factors.
Highlights
Medical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice
Based on the above findings, this study aimed to examine the prevalence of depression or anxiety amongst medical students in China by conducting a systematic review and a systematic research study about their determinants
15 articles were eliminated because they lacked original data, 60 articles were removed because they lacked standard sampling, 80 articles were removed because they did not analyse the determinants of depression or anxiety, nine articles were not cross-sectional, Fig. 2 Forest plots of depression-related factors and two articles used the same database
Summary
Medical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice. There have been many empirical studies about depression or anxiety in medical students in China, no previous studies have conducted a related systematic review about this topic in English. This analysis can convey the general findings from China to other areas of the world. The determinants of depression and anxiety are similar, according to previous studies [13, 14]
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