Rural/urban background, depression and suicidal ideation in Chinese college students: a cross-sectional study

Depression Takes a Toll on Academic Performance: Evidence from Rural Students in China

Purpose

Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses.

Patients and Methods

We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609).

Results

We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348-0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets.

Conclusion

Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.

Exploring the Interplay between Stress Perception and Approach-Avoidance Achievement Goal Orientation among Rural Students in College: A Longitudinal Study in China

The objective of this study was to examine the relationship between stress perception and achievement goals among rural college students in China. Using a two-wave random intercept cross-lagged model, this study analyzed data from a longitudinal survey conducted at 15 public universities in Beijing. First, there was a significant decline in stress levels among Chinese rural students from their junior to senior years. Second, the achievement goal orientations of these students remained relatively stable during the period. Third, while no significant association was found between approach goals and stress perception, a clear positive reciprocal relationship emerged between avoidance goals and stress perception. These results suggest that educators should focus on alleviating the stress experienced by rural college students through academic, employment, and interpersonal support to break the vicious cycle of stress perception and avoidance goal orientation. Future research should further explore the influence of diverse group characteristics and emotional states on these outcomes.

Exploring the role of personal quantification in alleviating generalized anxiety disorder among Chinese PhD students: A cross-sectional study

Personal quantification plays a crucial role in preserving individual mental health. However, in previous research, its effectiveness in alleviating generalized anxiety disorder (GAD) has not been conclusively established. This study explores the impact of personal quantification on GAD among PhD students. The research data was obtained through questionnaires distributed to 308 PhD students across universities in China. Among these students, 118 anxiety-free participants were excluded, yielding valuable data from 190 students with GADs. We employed Python programming language and SPSS software for the empirical analysis. The results illustrated that personal quantification significantly and negatively impacted GAD (β = -0.148, P = .002), concurrently producing a significantly positive effect on self-efficacy (β = 0.359, P < .001). Further analysis showed that through 5000 sampling iterations and a 95% confidence level, self-efficacy significantly reduced certain symptoms of GAD (β = -0.1183; P = .026; 95% Cl: -0.2222 to -0.0144). Moreover, when the coefficient of self-efficacy was significantly negative, the impact of personal quantification on GAD remained statistically significant (β = -0.1056; P = .033; 95% Cl: -0.2025 to -0.0087). The findings indicated that personal quantification has a significant role in alleviating GAD among PhD students, which is partly mediated through self-efficacy. This study contributes valuable insights to the nonpharmacological alleviation of GAD in Chinese PhD students.

Introversion, Alexithymia, and Hostility: A Path Analysis From Personality to Suicidal Ideation Among University Students

PURPOSE

The aim of the current study was to investigate the relationship between state (i.e., hostility) and trait (i.e., social detachment, alexithymia) psychological constructs associated with suicidal ideation among university students.

METHODS

A group of 190 university students was consecutively recruited in the period between September 2022 and March 2023. After a clinical interview, a series of psychological tests were administered: the Cattell's 16-Personality Factors Questionnaire (16PF), the Toronto Alexithymia Scale (TAS-20), the Symptom Checklist-90-R (SCL-90-R), and the anamnestic form of the Cognitive Behavioral Assessment (CBA2.0), which contains a specific question regarding the suicidal ideation.

RESULTS

The analyses demonstrated that alexithymia fully mediated the relationship between a particular aspect of introversion (social detachment or low warmth) and hostility which, in turn, seemed to be a significant predictor of suicidal ideation.

CONCLUSIONS

The path analysis conducted seemed to highlight the importance of personality traits, such as social detachment and the ability to recognize and express one's internal states, on the mental health of university students in terms of hostility and suicidal ideation. Considering that the reduction of suicide mortality has been prioritized as a global target in the 15-19 age group, identifying the psychological factors associated with it is fundamental.

Investigation on the Attitude of Middle School Students with Depression in the City Toward Professional Psychological Help-Seeking

Background

Many middle school students are depressed due to pressure from family, study, life, and communication. With the increasing depression of middle school students, professional psychological counseling institutions have also become more numerous. Therefore, students need to be guided to correctly recognize difficulties and seek professional psychological assistance.

Aim

We aimed to investigate the depression status of middle school students in the city and analyze their attitude towards professional psychological help-seeking.

Methods

A total of 2485 students from two classes of each grade from six middle schools in the city were randomly selected as the research objects. They were subjected to answer the general questionnaire and professional psychological help-seeking attitude questionnaire to analyze their depression status, psychological help-seeking status, and attitude towards professional psychological help-seeking.

Results

2485 questionnaires were distributed, and 2205 valid questionnaires were returned. A total of 791 (35.9%) of students had depressive symptoms. The detection rate and depression scores in girls were significantly higher than in boys, and the detection rate in junior high school students in the city was notably higher than in high school students and students from rural areas (P<0.05). Only 31 (3.9%) middle school students with depressive symptoms have sought professional psychological help. The scores of self-cognition, stigma tolerance, interpersonal openness, and trust scores of middle school students with depressive symptoms in help-seeking attitude were significantly lower than those of normal students, while self-stigma scores were significantly higher in those with depressive symptoms (P<0.001).

Conclusion

Middle school students in the city with depression have a poor attitude towards professional psychological help-seeking. Educators should positively and correctly guide depressed middle school students to seek professional psychological assistance when they need help.

Social Support, Psychological Strain, and Suicidality: Evidence from Chinese Universities

This study aimed to apply psychological strain theory to explore the relationship between psychological strain and suicidality among Chinese young adults with a moderating effect of perceived social support. A questionnaire was administered with the Multidimensional Scale of Perceived Social Support (MSPSS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strain Scale (PSS) among 13,250 college students across China. The main determinants of suicidal behavior were examined with multiple linear regression. Two steps of multiple regression were employed to define the moderating effect of social support. A positive relationship between psychological strain and suicidality was reported in the study, and social support was confirmed as a moderating factor between psychological strain and suicidal behavior.

The relationship between depressive and anxious symptoms and school attendance among adolescents seeking psychological services in a public general hospital in China: a cross-sectional study

BACKGROUND

School attendance problems (SAPs), whether absenteeism or dropout, are strongly associated with poor outcomes for adolescents. We examined multiple variables that influence SAPs to identify potential leverage points for improving school attendance.

METHODS

Self-reported SAPs and demographic information was collected from 392 adolescents in adolescents presenting to the general hospital for psychological services. PHQ-9 and GAD-7 were applied to assess the severity of depressive and anxious symptoms. We constructed logistic regression analysis and the Chi-Square Automatic Interaction Detection (CHAID) segmentation analysis via SPSS Decision Tree to identifying risk factors for the development of SAPs in adolescents.

RESULTS

SAPs were self-reported by 252 (64.3%) adolescents. The SAPs group and non-SAPs group showed a significant difference in age, PHQ9 total scores, GAD7 total scores, schools, siblings, residence, parental marital quality, general health, regular exercise, and regular diet. A post hoc comparison between the two groups showed that the frequency of SAPs was significantly higher in the moderately-severe and severe depressive groups compared with other three groups (none, mild, moderate). The frequency of SAPs in severe anxious groups was significantly different from the none-anxious group. According to the binary logistic regression analysis, the depressive severity, siblings, residence, marital quality of parents, general health, and regular diet were correlated with the SAPs among adolescents. The adjusted OR of SAPs according to moderately-severe depressive symptoms was 10.84 (95%CI: 1.967-59.742) and severe depressive symptoms was 6.659 (95%CI: 1.147-38.666). In the decision tree model, PHQ-9 severity was extracted as the first splitting variable, with regular exercise and residence as the second, and siblings as the third. The ROC curves for predicting SAPs showed a fair diagnostic accuracy of the model with AUCs of CHAID model (0.705,95%CI:0.652-0.759, P = 0.000) and logistic regression model (0.777,95%CI:0.729-0.824, P = 0.000).

CONCLUSION

Our study provides insights into the associations between depressive symptoms and poor school attendance and identifies a number of risk factors associated with SAPs. Effective intervention by mental health practitioners, more attention by policy makers, and further research in this area are urgently needed for adolescents.

Depression symptoms among adolescents in Morocco: a school-based cross-sectional study

Introduction

depression in adolescents is a major health condition that can interfere with daily life, lead to suicidal thoughts and behavior, and affect a person throughout life. However, studies about adolescents´ depression in Morocco are scarce. The aim of this study was to determine the prevalence of depression symptoms among in-school adolescents from the region of Settat-Morocco, as well as assessing its relation to daytime sleepiness and poor academic achievement.

Methods

the researchers conducted a cross-sectional school-based study. The sample included participants aged 12-20 years, in either urban or rural areas. We selected 722 students through a proportionate stratified sampling procedure. The participants responded to multiple questionnaires that included the Patient Health Questionnaire-9, the Epworth Sleepiness Scale, a questionnaire assessing several sociodemographic and socioeconomic variables, and finally an academic achievement questionnaire. We analyzed the collected data using descriptive statistical methods, χ2 test, and odds ratios.

Results

forty-four point seven percent (44.7%) of the respondents had "moderately severe" to "severe depression symptoms" and 32.5% of the sample suffered from excessive daytime sleepiness. Nineteen point nine percent (19.9%) of the total sample reported having a poor academic achievement. Significant predictors for depression symptoms included "female gender" (OR = 2.06; p-value < 0.001), "having divorced parents" (OR = 6.00; p-value < 0.001), "poor academic achievement" (OR = 5.03; p-value < 0.001), and "excessive daytime sleepiness" (OR = 2.30; p-value = 0.002).

Conclusion

this study provides important information about Morocco adolescents´ depression symptoms. These findings can help in implementing school-based mental and sleep health programs that target the promotion of mental wellness, prevention of mental health problems, and reduction of adolescent suicide risk.

Prevalence of mental health problems among rural adolescents in India: A systematic review and meta-analysis

Adolescent mental health problems have been recognised as a major issue in low-income countries including India. Through a meta-analytic approach, the present review delineate the overall prevalence of each of the most discussed mental health problems among rural adolescents in India, comprising depression, anxiety disorders, generalised anxiety disorder, panic disorder, separation anxiety, social anxiety disorder, suicidality, hyperactivity, emotional problems, conduct problems and peer problems. The review also presents the potential determinants of such mental health problems. Using PRISMA guidelines, a total of thirty-five studies were finalized from databases such as PubMed, Science Direct, JSTOR, Web of Science, Google Scholar and ProQuest. From the findings, it is observed that male and female adolescents does not differ significantly in the prevalence of most mental health problems. However, social anxiety was found to be more prevalent among females when compared to males. In meta-regression, factors like tools used (screening tools vs diagnostic interviews), sample size, setting (school-based vs community-based), sampling technique and year of publication were found to influence the prevalence rates of certain mental health problems, reported in the studies. Major determinants influencing the prevalence of mental health problems in rural adolescents were age, socio-economic status, academic and family environment. Individual factors such as social media usage, physical activity, and substance use also contribute to mental health problems. As India accounts for one-fifth of the world's adolescent population, the findings of this review can have global implications.

Investigation on Depression of College Students Majoring in Physical Education and Nonphysical Education: A StudyBased on the Age Region and Gender of 374 Students

In the research on the relationship between depression and college students' major, there are some differences in the degree of depression between sports major and nonsports major students. Based on these results, we assume that there is the possibility of emotional differences between professional and nonprofessional sports. A total of 374 samples of students majoring in physical education and nonphysical education at the same university were analyzed by using the methods of literature review and data analysis. A total of 188 subjects, including 121 males and 253 females (186 majoring in sports and nonsports), were asked to fill in the SDS (Self-Rating Depression Scale). SDS is widely used in rough screening, emotional state evaluation, investigation, and scientific research of outpatients in clinical psychology departments. The research obtained the difference in depression degree in the whole sample and further compared the depression degree of students of different ages and native places. Statistical analysis was performed on all data using SPSS 23.0 software. Basic data description, paired chi-square analysis, and covariance analysis were used. The results show that in this sample, the maximum value (minimum/maximum value) of one item of the total depression score of nonphysical education students exceeds the average value by 3 standard deviations, and this shows that the general level of depression scores of non-PE majors is high; most non-PE majors are in mild depression, which is equal to the number of PE majors who are in a normal mood; and nonsports majors in cities are more likely to have mild depression.

Prevalence and risk factors of depressive symptoms among 140,259 college students during the COVID-19 epidemic normalization in China: A cross-sectional survey

Objective

College students are one of the most vulnerable populations to the COVID-19 pandemic's mental health effects. During the coronavirus disease 2019 (COVID-19) outbreak, we wanted to see how common depressive symptoms were among college students and what factors contributed to that.

Methods

Between 21 and 27 May 2021, 140,259 college students from three cities in Henan Province, China, were involved. The Patient Health Questionnaire-9 was used to determine depressive symptoms (PHQ-9). Multiple logistic regression analysis was used to calculate odds ratios (ORs) and 95% CIs for potential depressive symptom factors.

Results

Mild depressive symptoms and above are present in 21.12% of college students. Women had a higher prevalence of mild depressive symptoms than men (61.38 vs. 59.75%), and depressive symptoms were most prevalent among rural students and least prevalent among city students (21.44 vs. 20.29%). Participants with depressive symptoms are also more likely to have a poor-behavioral status. From none-to-severe depressive symptoms, 78.88, 15.78, 2.80, 1.67, and 0.88% had them. Gender, residential location, and behavioral status were found to be associated with depressive symptoms after adjusting for potential confounders.

Conclusion

This cross-sectional study identified the factors that influence the prevalence of depression in college students. It found that the government should pay more attention to mental health issues affecting college students in combating the COVID-19 epidemic normalization.

Depression and suicidal ideation among medical students in a private medical college of Bangladesh. A cross sectional web based survey

This study was done to investigate the prevalence of depression and suicidal ideation among private medical students in Bangladesh. A total of 237 medical students participated in this cross-sectional web-based survey by e-questionnaire using the Google Form. The study was conducted from November 2020 to December 2020 at Enam Medical College and Hospital which is situated in Savar, Dhaka, Bangladesh. Out of 237 medical students, prevalence of depression was found 58.6%, and prevalence of suicidal ideation was found 27.4% which is higher than the global prevalence. Bivariate and multivariate analysis and logistic regression-based odds ratios (ORs) was done to see the association between grade of depression and suicidal thoughts with different variables. Association between grade of depression with family problems (x² = 16.716, P = 0.001), drug addiction (x² = 16.601, P = 0.001), committed relationship status (x² = 40.292, P = <0.001) were statistically significant. Whereas, the association between suicidal thoughts with family problems (x² = 29.881, P = <0.001), failed any subject during study (x² = 12.024, P = 0.007), alcohol uses (x² = 15.977, P = 0.001), drug addiction (x² = 22.633, P = <0.001), committed relationship status (x² = 35.219, P = <0.001) were statistically significant. However, medical students whom had to earn other than their family income were 2.3 times (OR: 2.285, 95% CL: 0.897, 5.820) greater prone to be depressed than those who do not had to earn by themselves. On the contrary, medical students who are single were 2.35 times (OR: 2.352, 95% CL: 0.926, 5.973) greater prone to have suicidal thoughts than the married students. This study showed that a large percentage of Bangladeshi medical students have been suffering from depression and suicidal ideation. Our recommendation for the authority of the medical colleges are, to build a system with counselling facilities inside every medical colleges in Bangladesh.

Mental Health Outcomes among Chinese College Students over a Decade

Background: Economic growth in China has brought about significant social and psychological changes in society. Objective: This study aims to explore how the mental and psychological health of college students has changed over the past decade. Methods: We observed several cohort samples in a Chinese university over a decade and looked at five mental health outcomes, including suicidal ideation, depression, optimism, self-esteem, and perceived social support, throughout each year of testing. Results: Our study highlights the declining rates of suicidal ideation and depression, combined with relative stability and even small increases in optimism, self-esteem, and perceived social support across a range of demographic variables. Conclusions: The findings of this study imply that in the context of economic growth, stabilizing and improving positive mental health states can help prevent and reduce the risk of depression and suicidal ideation among college students. The study also highlighted the need for more public health campaigns and interventions in universities to help students cope with mental health problems.

Effects of Church Attendance Vs. Private Religious Activities on Suicidal Ideation: A Study of Rural US College Students

To examine how religiosity and depression directly/indirectly affect suicidal ideation in White and African American rural college students. The data from 272 rural college students were used to test the moderated mediation model using PROCESS macro. Students with higher church attendance and/or private religious activities had lower depressive symptoms, which in turn significantly alleviated their suicidal ideation. There was no significant racial group difference in the direct/indirect effects. The college students who did not engage in religious meetings and private religious activities were inclined to have depressive symptoms and a higher risk of suicidal ideation.

Suicidal ideation among Bangladeshi university students early during the COVID-19 pandemic: Prevalence estimates and correlates

Lockdown, social isolation, and interruption of daily life during the COVID-19 period have impacted many lives. University students are particularly vulnerable to such disruptions and may be particularly disposed to suicidal ideation, potentially creating a new public health crisis. This study aimed to assess suicidal ideation and associated factors among university students in Bangladesh during the early stages of the COVID-19 pandemic. A cross-sectional online survey was conducted using the Google form (Google survey tool) from April to May 2020. Initially, 3366 respondents voluntarily completed the survey form. Finally, 3331 surveys were included in the final analyses after removing incomplete surveys. The data ware reviewed, rechecked, and analyzed with SPSS (25.0 version) software. A total of 1979 (59.4%) males and 1352 (40.6%) females participated. Respondents were between the ages of 18 to 28 years (mean age 21.4 years [SD = 1.9]). The prevalence estimate of suicidal ideation was 12.8%. Potential risk factors included less sleep, excess sleep, cigarette smoking, past suicidal thoughts, suicide attempt history, family history of suicidality, depression, anxiety, and stress. Potential protective factors included being male, having lower SES, living in rural areas, regular physical exercise, and satisfactory study. Suicidal ideation was prevalent among Bangladeshi university students during the onset of the COVID-19 pandemic. Understanding the correlates of suicidal ideation may aid to develop targeted strategies to support students during and after the COVID-19 pandemic.

Suicidality among Chinese college students: A cross-sectional study across seven provinces

BACKGROUND

Although the suicide rate in China has decreased over the past 20 years, there have been reports that the younger age group has been experiencing an increased incidence of completed suicide. Given that undergraduate groups are at higher risks of suicidality, it is important to monitor and screen for risk factors for suicidal ideation and behaviors to ensure their well-being.

OBJECTIVE

To examine the risk and protective factors contributing to suicidality among undergraduate college students in seven provinces in China.

METHODS

We conducted a cross-sectional study involving 13,387 college students from seven universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, Shaanxi, and Xinjiang. Data were collected using self-report questionnaires.

RESULTS

Higher scores in the psychological strain, depression, anxiety, stress, and psychache (psychological risk factors for suicidality) and lower scores in self-esteem and purpose in life (psychological protective factors against suicidality) were associated with increased suicidality among undergraduate students in China. Demographic factors which were associated with higher risks of suicidality were female gender, younger age, bad academic results, were an only child, non-participation in school associations, and had an urban household registration. Perceived good health was protective against suicidality.

CONCLUSIONS

Knowing the common risk and protective factors for suicidality among Chinese undergraduate students is useful in developing interventions targeted at this population and to guide public health policies on suicide in China.

Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample

The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.

Suicide in Chinese Graduate Students: A Review From 2000 to 2019

Suicide is an important public problem in China. The characteristics of Chinese graduate students' suicides and the reasons they occur have never been reported systematically. We conducted a systematic search of public reports on local media and medical websites in this review to gain a basic understanding of these questions. A total of 150 cases of graduate students' suicides were reported from 2000 to 2019. Among the 150 students, 65.8% were male, nearly half between 26 and 30 years old, most (83.3%) never married, and 43.4% of graduation students committed suicide in graduation year and postponed years. The top three suicide methods were jumping, hanging, and drowning. Graduation pressure, depression, and academic pressure were the three leading suicidal causes. There is an urgent need for the Chinese government and universities to pay more attention to prevent suicides among graduate students.

Self-Esteem and Depression as Mediators of the Effects of Gratitude on Suicidal Ideation Among Taiwanese College Students

This study aimed at examining the roles of self-esteem and depression in the relationship between gratitude and suicidal ideation. A total of 814 Taiwanese college students ranging in age from 18 to 22 years completed measures of gratitude, self-esteem, depression, and suicidal ideation. Structural equation modeling showed partial mediation effects of self-esteem and depression between gratitude and suicidal ideation. Moreover, a multigroup analysis found that males with higher levels of self-esteem could protect themselves from depression more easily than their female counterparts. Implications for future research and limitations of the present findings are discussed.

The association between psychological strain and suicidal behaviors among college students: A mental health survey in Jilin Province, Northeast China

BACKGROUND

Suicide is a major global mental health problem among college students. The aim of the current study was to explore the association between the psychological strains of the strain theory of suicide and suicidal behaviors among college students.

METHODS

Participants comprised 1912 college students (16-28 years old, 47.2% female) from three universities in Jilin Province, China, who completed the self-report assessments of psychological strains (40 items Psychological Strains Scale) and suicidal behaviors (Suicidal Behaviors Questionnaire-Revised). The demographic characteristics included four variables: health status, psychological status, academic status and economic status.

RESULTS

Approximately 15.0% (286/1912) of participants were classified as having suicide risk, based on the cut-off scores of the SBQ-R. The prevalence of suicidal behaviors among males and females was 11.9% (120/1009) and 18.4% (166/903), respectively. Value strain (OR = 1.075, 95%CI: 1.057-1.094), aspiration strain (OR = 1.082, 95%CI: 1.064-1.101), deprivation strain (OR = 1.073, 95%CI: 1.052-1.093), and coping strain (OR = 1.095, 95%CI: 1.075-1.116) were risk factors for suicidality in college students. Coping strain (OR = 1.050, 95%CI: 1.023-1.077) was still positively associated with suicide risk in multivariate logistic regression. Logistic regression analysis indicated that coping strain had the highest correlation with suicidal behaviors.

LIMITATIONS

The directionality of the relationships cannot be deduced because this study is cross-sectional.

CONCLUSION

This study confirms a strong association between psychological strains and suicidal behaviors in college students. Some measures can be taken to reduce psychological strains to mitigate suicide risk among college students. More studies investigating coping strain among college students are warranted.

Mental health symptoms among rural adolescents with different parental migration experiences: A cross-sectional study in China

In rural regions of China, the rural-to-urban migrant worker population and their left-behind children-60 million children who remain in home villages-have diversified the rural adolescence experience in terms of family life, compounding known mental health disparities. This study examined the impact of a comprehensive panel of home- and school-related variables on the prevalence of three common mental health complaints among rural adolescents. Data were collected using a self-formulated questionnaire administered to 1347 seventh grade students in a rural county of Hunan Province in Fall 2017. The prevalence of mental health symptoms was 10-18%. Bullying, loneliness, and stress from home and school environments were risk factors; good life satisfaction and willingness to reach out to adult and peer social networks were protective. Being a left-behind child was only significantly associated with depression symptoms, and notably, none of the other variables specific to left-behind children were found to be influential on mental health outcomes. These results suggest that the school-related factors included in our analysis accounted for a share of the risk typically explained by home-related factors alone. Schools may therefore be reliable settings for mental health programs in rural areas with ever more unpredictable home environments.

Prevalence and associated factors of depression and anxiety among doctoral students: the mediating effect of mentoring relationships on the association between research self-efficacy and depression/anxiety

Purpose

Although the mental health status of doctoral students deserves attention, few scholars have paid attention to factors related to their mental health problems. We aimed to investigate the prevalence of depression and anxiety in doctoral students and examine possible associated factors. We further aimed to assess whether mentoring relationships mediate the association between research self-efficacy and depression/anxiety.

Methods

A cross-sectional study was conducted among 325 doctoral students in a medical university. The Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 scale were used to assess depression and anxiety. The Research Self-Efficacy Scale was used to measure perceived ability to fulfill various research-related activities. The Advisory Working Alliance Inventory-student version was used to assess mentoring relationships. Linear hierarchical regression analyses were performed to determine if any factors were significantly associated with depression and anxiety. Asymptotic and resampling methods were used to examine whether mentoring played a mediating role.

Results

Approximately 23.7% of participants showed signs of depression, and 20.0% showed signs of anxiety. Grade in school was associated with the degree of depression. The frequency of meeting with a mentor, difficulty in doctoral article publication, and difficulty in balancing work–family–doctoral program was associated with both the level of depression and anxiety. Moreover, research self-efficacy and mentoring relationships had negative relationships with levels of depression and anxiety. We also found that mentoring relationships mediated the correlation between research self-efficacy and depression/anxiety.

Conclusion

The findings suggest that educational experts should pay close attention to the mental health of doctoral students. Active strategies and interventions that promote research self-efficacy and mentoring relationships might be beneficial in preventing or reducing depression and anxiety.

Factors Associated with Depression among School-going Adolescent Girls in a District of Northern India: A Cross-sectional Study

CONTEXT

Depression among adolescents, especially among girls, is a rising public health problem worldwide. It has been associated with a profound negative impact on their physical, social, and mental well-being.

AIM OF THE STUDY

To ascertain the factors associated with depression among school-going adolescent girls in district Barabanki of Uttar Pradesh.

SETTINGS AND DESIGN

School-based cross-sectional study.

SUBJECT AND METHODS

The study was conducted among 2187 school-going adolescent girls (10-19 years) in Barabanki district from September 2016 to September 2017 using multistage sampling. Sociodemographic characteristics such as age, residence, family background, and socioeconomic status were assessed through direct interview of the adolescent girl, with its reconfirmation from school records. Eleven-item Kutcher Adolescent Depression Scale was used for assessment of depression.

STATISTICAL ANALYSIS USED

Probability (P) was calculated to test for statistical significance at 5% level of statistical significance. Association between risk factors and depression was determined using bivariate analysis followed by multivariate logistic regression.

RESULTS

The prevalence of depression was found to be 39.7%. Multiple logistic regression revealed that depression was significantly higher among those residing in rural areas [odds ratio (OR) 3.32; P < 0.001], those in early and mid-adolescent age group (OR 2.51; P < 0.001), those studying in private schools (OR 3.22; P < 0.001), and those with Hindi as the medium of instruction (OR12.50; P < 0.001). Depression was also found to be significantly higher among those whose mothers were educated up to primary (OR 3.19; P < 0.01) or up to intercollege (OR 1.59; P < 0.001) when compared with illiterate mothers. Similarly, depression was found to be more common among those girls whose fathers were educated up to intercollege (OR 1.29; P < 0.05) or were graduate and above (OR 1.58; P < 0.001).

CONCLUSION

A significant proportion of school-going adolescent girls were suffering from depression, which reflects the need for reinforcement and strengthening of school-based mental health screening programs. Parents, teachers, and community health workers should work as a team to deal with the problem in a more effective way.

Depressive symptoms among first-year Chinese undergraduates: The roles of socio-demographics, coping style, and social support

The prevalence of depressive symptoms among Chinese university students seems to be increasing. However, little research has been conducted in order to examine whether and how socioeconomic factors, coping style and social support affect depressive symptoms among university freshmen. The present study aimed to explore these effects on a sample of freshmen from single- and multi-child households in urban and rural environments. A total of 2,563 university freshmen (883 women, 1,680 men; mean age, 18.27 yr) from three universities in China completed a demographic questionnaire, Patient Health Questionnaire-9, Social Support Rating Scale, and Coping Style Questionnaire. Pearson correlation coefficients suggested that gender and place of origin affected students' coping styles, social support, and depression. Depression was negatively associated with problem-solving and help-seeking, but positively associated with self-blaming, fantasizing, avoidance, and rationalization. Logistic regression showed that depression was predicted by engaging in self-blame and fantasizing, being female, coming from a rural area, being an only child, lacking subjective and social support, having low skills at problem-solving and help-seeking. These findings may help psychological service providers identify first-year students at risk of depressive symptoms and provide them with systematic, gender-specific interventions that pay specific attention to self-blaming and fantasizing coping style.

Prevalence & factors associated with depression among schoolgoing adolescents in Chandigarh, north India

Background & objectives:

Depression among adolescents is a rising problem globally. There is a need to understand the factors associated with depression among adolescents. This study was conducted to ascertain the prevalence of depressive disorders and associated factors among schoolgoing adolescents in government and private schools in Chandigarh, India.

Methods:

A cross-sectional study was conducted among 542 randomly selected schoolgoing adolescents (13-18 yr), from eight schools by multistage sampling technique. Depression was assessed using Patient Health Questionnaire-9 (PHQ-9) and associated factors by pretested semistructured interview schedule. Multivariate analysis was done to identify significant associated factors.

Results:

Two-fifth (40%) of adolescents had depressive disorders, 7.6 per cent major depressive disorders and 32.5 per cent other depressive disorders. In terms of severity, 29.7 per cent had mild depression, 15.5 per cent had moderate depression, 3.7 per cent had moderately severe depression and 1.1 per cent had severe depression. Significant associated factors included being in a government school, studying in class X^th and XII^th, rural locality, physical abuse by family members, alcohol use and smoking by father, lack of supportive environment in school, spending less time in studies, lower level of participation in cultural activities and having a boy/girlfriend. Significant predictors on binary logistic regression analysis were being in class X^th [odds ratio (OR)=5.3] and lack of self-satisfaction with own academic performance (OR=5.1).

Interpretation & conclusions:

Our study showed that a significant proportion of schoolgoing adolescents suffered from depression. The presence of depression was associated with a large number of modifiable risk factors. There is a need to modify the home as well as school environment to reduce the risk of depression.

Psychological distress and risk for suicidal behavior among university students in contemporary China

BACKGROUND

Psychological distress and suicidal behavior are important mental health problems among university students and warrant research to inform strategies for effective prevention in this young population. The present study aimed to assess psychological distress and suicidal behavior and to unravel their associations among university students.

METHODS

A total of 5972 undergraduate students, randomly selected from six universities in central China, comprised the sample. The Chinese version of the Symptom Checklist-90-revised (SCL-90-R) was used to assess various psychological symptoms. Logistic regression analysis was used to examine the relationship between psychological distress and risk for suicidal behavior.

RESULTS

40.7% of the university students reported positive in a least one of the 9 psychological symptom dimensions assessed by the SCL-90-R. 7.6% of the students reported suicidal behavior in the previous twelve months. The risk of suicidal behavior was significantly associated with psychological symptoms of all types, but there were notable differences by sex. For male students, depression and phobic anxiety increased the risk of suicidal behavior. Meanwhile, depression and obsessive-compulsiveness were positively associated with suicidal behavior in female students. Furthermore, increasing risk of suicidal behavior was associated with increasing positive symptom total (PST) score and a statistically significant trend was observed.

LIMITATIONS

Data collected from a cross-sectional survey does not allow any examination of causal inference.

CONCLUSIONS

Psychological distress and suicidal behavior were both common among university students; and psychological distress was highly associated with suicidal behavior. The findings underscore the importance of mental health care for university students.

Traumatization, Loneliness, and Suicidal Ideation among Former Prisoners of War: A Longitudinally Assessed Sequential Mediation Model

Although highly researched among veterans, the underlying mechanisms of suicidal ideation (SI) among former prisoners of war (ex-POWs), especially in the long-term, have rarely been investigated. Furthermore, while posttraumatic stress symptoms (PTSS) and loneliness have been individually associated with veteran SI, and both may be differentially implicated by captivity versus war traumas, the interplay between them has yet to be examined. Filling this gap, the current longitudinal study examined a hypothetical sequential model wherein war captivity, compared with combat-induced trauma, is implicated in worse PTSS, which is then implicated in worse loneliness and PTSS, which together may explain subsequent SI. Two groups of Israeli veterans of the 1973 Yom Kippur War, 163 ex-POWs and 185 matched non-captive veterans were assessed 18 (T1) and 30 (T2) years after the war. Analyses indicated that compared with war, captivity was implicated in worse PTSS, which was implicated in worse loneliness, and these worked in tandem to implicate SI. Loneliness, however, was not directly affected by the type of trauma, nor was its relation to SI linked to its implication in subsequent PTSS. These results may inform future research and clinical practice as the study underscores the importance of both PTSS and loneliness in ex-POWs' long-term SI.

Psychological strain and suicidal ideation: A comparison between Chinese and US college students

OBJECTIVE

This study was to explore the relation between psychological strains and suicidal ideation among Chinese and American college students. Another secondary purpose of the study was to examine the reliability of the psychological strains scales (PPS: Ref) one more time in China and the United States in college populations.

METHOD

Samples of college students were randomly recruited from China and United States. All of 529 college students (aged 17-27, 68.9% female) completed self-report assessments of psychological strains (Psychological Strain Scale), suicidal ideation (Beck Scale for Suicide Ideation), and indicators of psychological well-being (e.g., depression, anxiety, and stress).

RESULTS

Empirical results show that Psychological Strain Scales (PSS) has a good reliability. Chinese college students reported higher suicide ideation scores than American students whereas there was no statistical difference in psychological strains. Psychological strains and, depression, anxiety, and stress, were positively related to suicidal ideation in both countries. Stepwise multiple regression analysis indicated that psychological strain can significantly predict suicidal ideation.

CONCLUSIONS

These findings provide support for the Strain Theory of Suicide for both Chinese and American college students and some measures can be taken to reduce psychological strains in students. However, future work could extend these findings by utilizing a longitudinal design to determine whether psychological strains are in fact antecedents, and not simply correlates, of suicide ideation.

Association of depressive symptoms and suicidal ideation among university students in China: A systematic review and meta-analysis

The aim of this study was to investigate whether depressive symptoms are associated with suicidal ideation among university students in China.Five Chinese and English electronic databases (EBSCO, PubMed, Chinese Web of Knowledge, Wanfang, and Weipu) were searched to identify relevant studies. Cross-sectional studies published from 2000 to 2016 reporting about the association between depressive symptoms and suicidal ideation among university students in China were used for meta-analysis to approximate the overall association between depression and suicidal ideation among university students in mainland China. StatsDirect 3 was used for meta-analysis of included literatures.Of 513 initially identified references, 44 studies were selected, including 88,431 participants with depressive symptoms. The combined odd ratio of the relationship was 2.174 (95% confidence interval: 2.027-2.333; P < 0.0001).There exists a moderate association between depressive symptoms and suicidal ideation among university students in China, and depressive symptoms contribute to the development of suicidal ideation. In particular, university students from western regions of China, from nonmedical background, should be provided more psychological and clinical assistance.

Prevalence of Depression among Chinese University Students: A Meta-Analysis

Background

Depression is a major mental health issue worldwide, and university students with heavy burdens of study are at a high risk for depression. While a number of studies have been conducted regarding depression among university students in China, there is a lack of information regarding the national prevalence of depression among Chinese university students. Therefore, we performed a meta-analysis to statistically pool the prevalence of depression among Chinese university students.

Methods

A systematic search of scientific databases was conducted, including Chinese Web of Knowledge, Embase, PubMed, Wanfang (a Chinese database) and Weipu (a Chinese database) to find relevant publications published between 1995 and December 2015. This was supplemented by a secondary review of the reference lists of all retrieved papers to find additional relevant citations. Studies published in either English or Chinese that provided prevalence estimates of depression in Chinese university students were considered. Prevalence estimates of each eligible study were extracted and pooled in our meta-analysis using a random-effects model.

Results

A total of 39 studies conducted between 1997 and 2015 including 32,694 university students were analyzed. Our results indicate that the overall prevalence of depression among Chinese university students is 23.8% (95% CI: 19.9%–28.5%). Substantial heterogeneity in prevalence estimates was noted. Subgroup analysis revealed that the prevalence of depression among medical students is higher than among other students.

Conclusions

Overall, the prevalence of depression among Chinese university students is exceedingly high. This suggests that it is imperative that more attention be given to the development of appropriate mental healthcare strategies for university students in China.

Psychological distress and dyslipidemia in chinese police officers: a 4-year follow-up study in Tianjin, China

OBJECTIVE

This study aimed at investigating whether psychological distress in police officers was associated with dyslipidemia.

METHODS

A survey was conducted to examine the psychological distress among 5867 police officers in Tianjin, China, from 2007 to 2011. Psychological distress was measured using the Symptom Check List-90-Revised. Cox proportional hazard regression was used to calculate the hazard ratios (HR) of the incidence of dyslipidemia predicted by psychological distress.

RESULTS

Among the 3300 participants without dyslipidemia at baseline (2567 with dyslipidemia), 60.5% (n = 1829) developed incident dyslipidemia 2.61 years (median) later. The adjusted HR was 1.15 (95% confidence interval, 1.05 to 1.26) after the adjustment of police classifications and other variables. The adjusted HR for police officers in charge of traffic control was 1.30 (95% confidence interval, 1.09 to 1.56).

CONCLUSIONS

Further investigations for associations of psychological factors with dyslipidemia and cardiovascular diseases are needed.

Social support moderates stress effects on depression

This study examined the moderator effect of social support on the relationship between stress and depression of university students. A total of 632 undergraduate students completed the measures of perceived stress, perceived social support, and depression. Hierarchical regression analysis showed that social support moderated the association between stress and depression. Undergraduate students with high stress reported higher scores in depression than those with low stress with low social support level. However, the impact of stress on depression was much smaller in the high social support group compared with that in the low social support group.