Abstract
Chinese men who have sex with men (MSM) are at high risk for depression, anxiety and suicide. The estimated prevalence of these problems is essential to guide public health policy, but published results vary. This meta-analysis aimed to estimate the prevalence of depressive symptoms, anxiety symptoms and suicide among Chinese MSM. Systematic searches of EMBASE, MEDLINE, PsycINFO, PubMed, CNKI and Wanfang databases with languages restricted to Chinese and English for studies published before 10 September 2019 on the prevalence of depressive symptoms, anxiety symptoms, suicidal ideation, suicide plans and suicide attempts among Chinese MSM. Studies that were published in the peer-reviewed journals and used validated instruments to assess depression and anxiety were included. The characteristics of studies and the prevalence of depression and anxiety symptoms, suicidal ideation, suicide plans and suicide attempts were independently extracted by authors. Random-effects modelling was used to estimate the pooled rates. Subgroup analysis and univariate meta-regression were conducted to explore potential sources of heterogeneity. This study followed the PRISMA and MOOSE. Sixty-seven studies were included. Fifty-two studies reported the prevalence of depressive symptoms, with a combined sample of 37 376 people, of whom 12 887 [43.2%; 95% confidence interval (CI), 38.9-47.5] reported depressive symptoms. Twenty-seven studies reported the prevalence of anxiety symptoms, with a combined sample of 10 531 people, of whom 3187 (32.2%; 95% CI, 28.3-36.6) reported anxiety symptoms. Twenty-three studies reported the prevalence of suicidal ideation, with a combined sample of 15 034 people, of whom 3416 (21.2%; 95% CI, 18.3-24.5) had suicidal ideation. Nine studies reported the prevalence of suicide plans, with a combined sample of 5271 people, of whom 401 (6.2%; 95% CI, 3.9-8.6) had suicide plans. Finally, 19 studies reported the prevalence of suicide attempts, with a combined sample of 27 936 people, of whom 1829 (7.3%; 95% CI, 5.6-9.0) had attempted suicide. The mental health of Chinese MSM is poor compared with the general population. Efforts are warranted to develop interventions to prevent and alleviate mental health problems among this vulnerable population.
Highlights
Gay, bisexual and other men who have sex with men (MSM) appear to be disproportionately affected by a variety of psychological problems, including depression, distress, generalised anxiety disorder, substance use and suicide (Batchelder et al, 2017; King et al, 2008)
Two authors (DW and XY) performed a systematic search of the EMBASE, MEDLINE, PsycINFO, PubMed, CNKI and Wanfang databases, with languages restricted to Chinese and English for studies published before 10 September 2019, on the prevalence of depressive symptoms, anxiety symptoms, suicidal ideation, suicide plans and suicide attempts among Chinese MSM
The database search combined terms related to MSM and study design with those related to depression or anxiety or suicidal ideation or suicide plans or suicide attempts, with the regional restriction of China
Summary
Bisexual and other men who have sex with men (MSM) appear to be disproportionately affected by a variety of psychological problems, including depression, distress, generalised anxiety disorder, substance use and suicide (Batchelder et al, 2017; King et al, 2008). A recent review indicated that Chinese MSM have a high prevalence of several mental health issues, including depression, anxiety, suicidal behaviour and alcohol abuse, which can be explained by minority stress (Sun et al, 2020) These psychological problems are conducive to the ‘syndemic’ conditions surrounding human immunodeficiency virus (HIV) transmission risk. We conducted a systematic review and meta-analysis of published studies on depressive symptoms, anxiety symptoms and suicide (including suicidal ideation, suicide plans and suicide attempts) among Chinese MSM The purposes of this metaanalysis were to (1) estimate the prevalence of these psychological problems and (2) identify the underlying methodological and sample characteristic moderators that can contribute to betweenstudy heterogeneity. Before the final analysis, all included data were checked again
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