Prevalence of mental health problems among college students in mainland China from 2010 to 2020: A meta-analysis

Abstract

<p id="p00005">College students are a huge part and an important member of the young people. Their physical and mental health not only directly affects their own long-term development, but also has a significant influence on the future of the nation. Therefore, the mental health of college students has become the focus of families, schools and even the whole society. In recent years, some studies have conducted meta-analyses on the prevalence of a certain mental health problem (such as depression and sleep problem) among college students in China, but such studies cannot reflect the mental health status of college students comprehensively. And some of the previous studies cannot reflect the current status of contemporary college students’ mental health. Furthermore, the selection of moderator variables was not comprehensive enough to reveal the key factors affecting the prevalence. Therefore, we employed a meta-analysis in this study to estimate the prevalence of typical mental health problems among college students in mainland China from 2010 to 2020, and the moderating effects of publication year, measurement tools and detection standards, detection time, region, birthplace, only child or not were further analyzed. For the selection of indicators, mental health problems were divided into two categories: internalizing problems and externalizing problems. The indicators of internalizing problems include anxiety, depression, sleep problem, somatization, and suicidal ideation, while the indicators of externalizing problems include nonsuicidal self-injury and suicide attempt. <br/>Through the process of literature search and selection, 128 studies (136 effect sizes) of anxiety, 237 studies (244 effect sizes) of depression, 56 studies (58 effect sizes) of sleep problem, 49 studies (49 effect sizes) of somatization, 31 studies (31 effect sizes) of nonsuicidal self-injury, 51 studies (51 effect sizes) of suicide ideation, and 8 studies (8 effect sizes) of suicide attempt were included in this study. Homogeneity test indicated that random effects model was appropriate for the meta-analysis. The p-curve analysis illustrated no publication bias. Ultimately, the results of the main effect test showed that the prevalence rates of sleep problem, depression, nonsuicidal self-injury, anxiety, suicidal ideation, somatization, and suicide attempt were 23.5%, 20.8%, 16.2%, 13.7%, 10.8%, 4.5%, and 2.7%, respectively. The results indicate that internalizing problems, especially sleep problem and emotional problem, are more serious among Chinese college students compared to externalizing problems. <br/>The results of the moderating effect indicated that (1) The prevalence of anxiety, depression, sleep problem and suicide attempt among college students has increased significantly in the last decade, while the prevalence of self-harm has declined significantly; (2) The prevalence of anxiety, depression, sleep problem, and somatization varied significantly between measurement tools and detection standards, and the prevalence of suicidal ideation differed to a significant extent depending on the detection time. Therefore, the fluctuation of prevalence was accounted by measurement tools, detection standards and detection time. (3) There existed obvious regional differences in the prevalence of sleep problem and suicidal ideation, with the feature of the worst mental health among college students in western China and better mental health among college students in northeastern and central China. (4) The prevalence of mental health problems among demographical variables including gender, only child or not, and birthplace showed no significant difference, which indicated that gender, only child or not, urban or rural areas were not the critical factors influencing college students’ mental health. <br/>In summary, by employing the method of meta-analysis, this study is the first study to systematically investigate the prevalence of the typical mental health problems of college students in mainland China from 2010 to 2020. The results clarified the controversy over the inconsistent prevalence in previous studies and explored the main reasons for the inconsistent findings. Thus, this meta-analysis is conducive to promoting subsequent studies and educational practice.