Prevalence, correlates of major depression: A mental health survey among undergraduates at a mainland Chinese university

Physical punishment and lifelong outcomes in low‑ and middle‑income countries: a systematic review and multilevel meta-analysis

Research from high-income countries has found negative outcomes associated with physical punishment. Yet, the extent to which such research evidence generalizes to children in low- and middle-income countries (LMICs) is largely unknown. The objective of the current pre-registered study (PROSPERO: CRD42022347346 ) was to conduct a meta-analysis of the associations between childhood physical punishment and individual outcomes in LMICs. We identified eligible articles by searching for keywords related to physical punishment in six languages across 11 databases, with search periods from April to August 2021 and June to July 2024. This process yielded 5,072 unique records, of which 189 studies, comprising 1,490 unique effect sizes and representing 92 LMICs, met our inclusion criteria. Findings from random-effects multilevel meta-analyses indicated that physical punishment was associated with detrimental outcomes, including mental health problems, worse parent-child relationships, substance use, impaired social-emotional development, negative academic outcomes and heightened externalizing behaviour problems, among others. Despite some variation by contextual and study-level characteristics, all subgroup estimates were consistent in direction. Sensitivity checks indicated that these findings were not typical of other non-violent methods of discipline but were specific to physical punishment and psychological aggression. The analysis confirmed that physical punishment is associated with detrimental outcomes for individuals in LMICs. Additional research is needed to inform the design, implementation, and evaluation of policies and interventions to prevent the physical punishment of children and adolescents worldwide.

A review of traditional Chinese medicine intervention methods for depression among college students

Depression has become the most prevalent psychological issue among college students, necessitating urgent intervention measures. Traditional Chinese Medicine (TCM) boasts a long history in the prevention and treatment of psychological and emotional disorders, encompassing non-pharmacological therapies (such as TCM health exercises, Tai Chi, Wu Qin Xi, Ba Duan Jin, acupuncture, etc.) and pharmacological treatments. Key research findings indicate that these TCM interventions can significantly alleviate depressive symptoms and improve sleep quality in college students. However, the studies also acknowledge certain limitations, including varied effectiveness of interventions among individuals and the need for professional diagnosis and treatment in the case of acupuncture and herbal remedies. This provides early prevention and intervention measures for the treatment of depression among college students, and promotes the inheritance of traditional Chinese culture.

Factors Associated with the Prevalence of Psychiatric Disorders Among Saudi Adults in the Eastern Region and Their Health Implications

BACKGROUND/OBJECTIVES

The present study examined the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients in Saudi Arabia's Eastern Region (Al-Hassa), as well as health outcomes, including basic hematological and biochemical markers.

METHODS

The patients included 89 females and 79 males with psychiatric disorders, with ages ranging from 19 to 59. Sociodemographic characteristics, anthropometric proxies, and fundamental hematological and biochemical markers were assessed.

RESULTS

The sociodemographic characteristics of the patients were poor and varied within and between sexes. This study observed that male psychiatric patients had greater anthropometric proxies, particularly those who were overweight or obese, than females. Most of the patients' hematological and biochemical parameters were below the normal level, with some higher than normal. Moreover, anemia was identified in 40.51% of the male participants in the study, with a higher percentage among those diagnosed with depressive disorders (Dep-d, 57.14%) and schizophrenia spectrum and other psychotic disorders (SsP-d, 32.43%), and 49.44% of the female participants, with a higher percentage among those diagnosed with depressive disorders (52.50%) and other psychotic disorders (46.15%). Furthermore, to confirm the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients, the Spearman correlation coefficient and simple regression analysis of such variables was carried out. The results revealed that the majority of sociodemographic characteristics were either favorably or adversely correlated with patients' anthropometrics and type of depression in both sexes.

CONCLUSION

Low sociodemographic characteristics and high anthropometric variables may be risk factors for people with psychotic disorders, which have been linked to negative health consequences.

Epidemiology of depressive disorders among youth during Gaokao to college in China: results from Hunan Normal University mental health survey

BACKGROUND

Given the serious consequences of depression and the lack of information about it during the crucially developmental period from the National College Entrance Exam (CEE, i.e., Chinese gaokao) to college, this study aimed to estimate the cumulative incidence, prevalence, age of onset, correlates, and service use of depressive disorders (DDs) among youth who passed the CEE and were enrolled at Hunan Normal University in China.

METHODS

A two-stage cross-sectional epidemiological survey of DDs was conducted from October to December, 2017 among 6,922 incoming college students (98.5% effective response, N = 6,818, 71.4% female, age range: 16-25 years, mean age = 18.6). Using a stratified sampling method based on the risk of depression, 926 participants (mean age = 18.5, 75.2% female) were selected and subsequently interviewed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and lifetime version (K-SADS-PL).

RESULTS

The sex-adjusted 9-month (i.e., 3 months pre-CEE, 3 months after CEE, and 3 months post-matriculation) incidence of new-onset DDs was 2.3% (standard error [S.E.] 0.3%), and the sex-adjusted 1-month, 6-month and lifetime prevalence were 0.7 (S.E. 0.3%), 1.7 (S.E. 0.2%) and 7.5% (S.E. 1.3%), respectively. The median age of onset was 17 (interquartile range: 16-18) years. Critically, over one-third (36.5%, S.E. 0.6) of depressed youth had their new onset during the 9-month period. The risk factors for depression included having mothers with higher education, experiencing major life events, being female, and experiencing parental divorce or death. The adjusted lifetime treatment rate was 8.7%.

CONCLUSION

The 9-month incidence of new-onset depression from gaokao to college among the youth sample in China is similar to the global annual incidence (3.0%), but the 1-month and lifetime prevalence are significantly lower than the global point (7.2%) and lifetime prevalence (19%). These findings suggest a high proportion of new-onset depression during the CEE to college among the sample youth in China. The risk of depression is associated with familial and stress correlates. Low treatment is a serious concern. Emphasis on early prevention and available treatment for adolescent and young adult depression is a critical need in China.

Perceived parenting styles and incidence of major depressive disorder: results from a 6985 freshmen cohort study

BACKGROUND

Even though a fair amount of studies focus on depression among college students, the effect of perceived parenting styles on the incidence of major depressive disorder (MDD) among representative freshmen in Chinese context is scarcely studied. The aim of this study is to investigate the effect of parenting styles on MDD in Chinese freshmen.

METHODS

A total of 9,928 Chinese freshmen were recruited in 2018. 6985 valid questionnaires were collected at one-year follow-up. Composite International Diagnostic Interview 3.0 (CIDI-3.0) was used for the diagnosis of MDD. Egna Minnen Beträffande Uppfostran (EMBU) questionnaire and Beck Depression Inventory-II (BDI-II) were used to assess parenting styles and baseline depressive symptoms, respectively. The associations between parenting styles and MDD incidence was analyzed with logistic regression.

RESULTS

The incidence of MDD in freshmen was 2.23% (95%CI: 1.91-2.60%). Maternal overprotection (OR = 1.03, 95%CI: 1.01-1.05) and disharmony relationship between parents (OR = 2.35, 95% CI: 1.42-3.89) increased the risk of new-onset MDD in freshmen, respectively. Mild depressive symptoms (OR = 2.06, 95%CI: 1.06-4.02), moderate (OR = 4.64, 95%CI: 2.55-8.44) and severe depressive symptoms (OR = 7.46, 95%CI: 2.71-20.52) at baseline increased the risk of new-onset MDD.

CONCLUSIONS

Maternal overprotection, disharmony relationship between parents and baseline depressive symptoms are risk factors for new-onset MDD in Chinese freshmen.

Influencing factors, prediction and prevention of depression in college students: A literature review

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health, academic development, and interpersonal communication. This paper reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for college students' depression. The influencing factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression, given that the coronavirus has spread quickly with high infection rates, and the pandemic has changed the daily routines of college life. To predict and measure mental health, more advanced methods, such as machine algorithms and artificial intelligence, have emerged in recent years apart from the traditional commonly used psychological scales. Regarding nonpharmaceutical prevention measures, both general measures and professional measures for the prevention and treatment of college students' depression were examined in this study. Students who experience depressive disorders need family support and personalized interventions at college, which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy. Through this literature review, we insist that the technology of identification, prediction, and prevention of depression among college students based on big data platforms will be extensively used in the future. Higher education institutions should understand the potential risk factors related to college students' depression and make more accurate screening and prevention available with the help of advanced technologies.

The effects of childhood trauma on personality in unaffected first-degree relatives of patients with major depressive disorder

ABSTRAC

OBJECTIVES: This study aimed to preliminarily and exploratorily examine the associations between childhood trauma (CT), its subtypes, and personality traits among unaffected first-degree relatives (FDR, children, or siblings) of patients with major depressive disorder (MDD).

METHODS

The study sample included three subgroups: MDD patients (N = 85), Patients' FDRs (N = 35), and healthy control individuals (HC, N = 89). The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma and the Eysenck Personality Questionnaire was used to assess personality traits.

RESULTS

Significant differences were found in a few personality traits (p < 0.05 for extraversion, neuroticism, and psychoticism) among MDD patients, FDR, and HC, and there were no significant differences between HC and FDR. In the FDR group, compared with those without CT, participants with CT scored significantly higher for neuroticism (N) (F = 3.246, p = 0.046). CT was significantly associated with N, psychoticism (P) and Lie (L), and the strongest association was between CT total score and N. Significantly positive correlations were found between N and sexual abuse (SA) (r = 0.344, p = 0.043), emotional neglect (EN) (r = 0.394, p = 0.019), physical neglect (PN) (r = 0.393, p = 0.019), and CTQ total score (r = 0.452, p = 0.006); between P and CTQ total score (r = 0.336, p = 0.049); and significant negative correlations were found between L and EN (r = -0.446, p = 0.007), CTQ total score (r = -0.375, p = 0.027).

CONCLUSION

In unaffected FDRs, there were significant associations between childhood trauma and a few personality traits, including neuroticism, psychoticism, and lie, and emotional neglect was significantly associated with neuroticism.

Somatic Symptoms, Anxiety, and Depression Among College Students in the Czech Republic and Slovakia: A Cross-Sectional Study

Studying in college can be a challenging time for many students, which can affect their mental health. In addition to academic pressure and stressful tasks, another aggravating factor in student life is the ongoing coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to examine the prevalence of anxiety, depression, and somatic symptoms in Czech and Slovak college students during the COVID-19 pandemic and to evaluate possible socio-demographic determinants of mental health problems. A total of 3,099 respondents participated in this cross-sectional study (Czech Republic: 1,422, Slovakia: 1,677). The analyzes included the Patient Health Questionnaire for somatic symptoms (PHQ-15), the Generalized Anxiety Disorder instrument (GAD-7), and the Patient Health Questionnaire for depression (PHQ-9). Socio-demographic factors were gender, age, family structure, marital status, form of study, degree of study, year of study, field of study, distance between home and college, residence, and housing during the semester. Among Czech students, prevalence of somatic complaints, anxiety and depression was 72.2, 40.3, and 52%, respectively. Among Slovak students, prevalence of somatic complaints, anxiety and depression was 69.5, 34.6, and 47%, respectively. During the COVID-19 pandemic, the most severe mental health problems were identified in a non-negligible part of the sample (Czech Republic: PHQ-15 = 10.1%, GAD-7 = 4.9%, PHQ-9 = 3.4%; Slovakia: PHQ-15 = 7.4%, GAD-7 = 3.5%, PHQ-9 = 2.7%). Regarding the differences between the analyzed countries, a significantly higher score in somatic symptoms, anxiety, and depression was identified in the Czech Republic. Significant differences in mental disorders were found in most socio-demographic characteristics. The main results of the logistic regression analysis revealed that risk factors for mental health disorders in Czech and Slovak students were female gender, younger age, third degree of study, and study of Informatics, Mathematics, Information and Communication Technologies (ICT). Especially in the case of these high-risk groups of students, public policies should consider a response to impending problems. The findings are an appeal for a proactive approach to improving the mental health of students and for the implementation of effective prevention programs, which are more than necessary in the Czech and Slovak college environment.

Symptoms of Depression, Anxiety, and Stress and Prevalence of Major Depression and Its Predictors in Female University Students

Depression, anxiety and stress are increasingly concerning phenomena in our society, with serious consequences on physical and mental health. The repercussions may be particularly devastating in particular population subgroups, such as female university students. The purpose of this study was to determine the levels of depression, anxiety, and stress and the prevalence of depression and associated factors, in Spanish university women. A cross-sectional study was conducted with a random sample of 871 students from the Santiago de Compostela University (mean age 20.7 years, SD = 2.8). Information was collected on sociodemographic and academic characteristics; symptoms of depression, anxiety, and stress; diagnosis of major depression; optimism, resilience, social support, life engagement, and five personality domains, using validated instruments. Of the participants, 18.1%, 22.8% and 13.5% presented with severe/very severe levels of depression, anxiety and stress, respectively. A total of 12.9% had major depression. Higher life engagement was associated with lower risk of depression (OR = 0.92, 95% CI 0.87–0.98), while higher levels of neuroticism (OR = 1.20, 95% CI, 1.12–1.28) and openness to experience (OR = 1.08, 95% CI, 1.02–1.14) were associated with greater risk. These findings reveal an alarming percentage of female university students who experience major depression and severe/very severe stress.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis

INTRODUCTION

Though university years are peak time for the onset of many mental health problems including depression, knowledge on the prevalence of depressive symptoms among university students in low and middle-income countries (LMICs) is limited. This study examined the prevalence of depressive symptoms among university students in LMICs.

METHODS

We systematically searched PubMed, Web of Science, and WHO Global Health Library for studies published between January 1, 2009 and December 31, 2018. Cross-sectional and longitudinal studies conducted in LMICs (as defined by World Bank), having a sample size≥500 and published in English were identified. Data on study characteristics and prevalence of depressive symptoms was extracted by two investigators. Estimate of prevalence was pooled in meta-analysis using random-effects meta-analysis. Sub-group differences were estimated using mixed-effects meta-analysis and meta-regression.

RESULTS

Depressive symptoms prevalence data were extracted from 37 studies involving 76,608 individuals in 20 countries. Studies on depression among university students in LMICs were limited, and most were based on non-representative and small study samples. The overall prevalence of depressive symptoms was 24.4% (95% CI, 19.2% -30.5%). Subgroup analysis revealed that the prevalence did not vary by study design, sampling technique, sample size, study major, educational level, economic regions, and screening instrument.

LIMITATIONS

Only English language studies were included. Included studies were diverse in design, screening tool, and sample size that introduced substantial heterogeneity.

CONCLUSION

Overall prevalence of depressive symptoms among university students in LMICs was 24.4%, however, finding should be interpreted with caution. Further research is needed to address the issue.

Prevalence of major depressive disorder in the general population of Iran: A systematic review and meta-analysis

Background: Major depressive disorder (MDD) is the most common psychological disorder and affects many people worldwide. Surveying the prevalence of mental disorders, especially general disorders, such as major depressive disorder, is highly important for health professionals and policymakers. Due to a wide variation of studies concerning the prevalence of major depressive disorder in Iran, the present study was conducted to integrate such results. Methods: To conduct this study, English (PubMed/Medline, Scopus and Web of Science) and Persian (MHRN, Noormgs, Magiran, Iran-Medex, Irandoc, and SID) databases, from 1990 to 2018, were explored. All articles related to the point prevalence of depressive disorders in the general population of Iran were reviewed. The inclusion criteria of the present study were as follow: cross sectional studies based on general populations; the expression of the point prevalence rate and incidence of major depressive disorder for people over 15 years; and the use of a structured or semi-structured clinical interview for diagnosis of the disorder. Studies that were not original (such as review studies) and those that did not represent general populations were excluded from the study. To analyze the data obtained from this study, the second version of Comprehensive Meta-Analysis (CMA) software was used. The total point prevalence was calculated using the meta-analysis method, and the I2 index was used to measure the heterogeneity of the studies. Results: Of 6734 studies, 30 studies with a total sample size of 37 867 were finally included based on proposed inclusion and exclusion criteria. The sample included 20641 women (55%), and 17 226 (45%) men. In the present meta-analysis study, due to significant heterogeneity (I=97.1%, p=0.001) among studies, the randomized method was used, and the total point prevalence was 4.1% (CI: 3.1% 5.5%). The overall point prevalence of major depressive disorder was 4.8% (CI: 3.6% -5.6%) in women and 2.3% (CI: 1.6% -3.6%)in men, which indicated that the incidence of this disorder was 1.95 times more in women than in men. Conclusion: This meta-analysis study found a considerable prevalence of major depressive disorder among Iranian participants and revealed that the point prevalence of the disease was more than two-fold in women compared to men. Considering these findings and the high burden of this disorder for communities, the need to formulate and implement prevention and treatment programs is highly required.

Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study

Nursing students from vocational college programs contribute to over 60% of the nursing student population in China. However, there remains a lack of systematic, quantitative studies examining the prevalence of mental health problems in this population. The purpose of this study was to explore the prevalence of depression, anxiety and stress symptoms and associated factors in vocational college nursing students in Sichuan, China. A total of 554 nursing students from vocational colleges participated in this cross-sectional study. Outcomes were measured with the Depression, Anxiety and Stress Scale 21 (DASS 21). Logistic regressions analysis was performed to examine correlates of mental health problems. The prevalence rates of depression, anxiety and stress symptoms among vocational college nursing students in China were 28.7% (95% CI 24.9%-32.5%), 41.7% (95% CI 37.6%-45.9%) and 20.2% (95% CI 16.8%-23.6%). Mental health problems were elevated as compared to a reference population of Chinese college students of all majors. However, only two percent indicated to seek treatment. The most consistent correlates of mental health problems were reduced engagement in physical and other leisure activities, poor sleep quality, experience of negative life events and poor self-perceived mental health.

Depressive symptoms and negative life events: What psycho-social factors protect or harm left-behind children in China?

BACKGROUND

In China, children under 18 years old who are left at rural residences for at least 6 months by either one or both of their parents migrating to work in cities are called "left-behind children (LBC)". Due to restricted family support, they are at a greater risk of developing depressive symptoms than non-left-behind children (NLBC). The objective of this study is to explore how depressive symptoms and stress induced by negative life events such as interpersonal conflicts, punishment and loss, as well as their relationships vary for LBC with different left-behind-related characteristics.

METHODS

Using data from a large school-based survey conducted in Chongqing between December 2012 and June 2013, we first identified the differences in depressive symptoms and negative-event-induced stress between LBC and NLBC, and then analyzed the variances among LBC with different left-behind-related characteristics. The data was analyzed with Chi-square test, MANCOVA, ANCOVA, ANOVA, T-test and hierarchical multiple regression analyses.

RESULTS

We found that LBC were more stressed when experiencing negative events and had more depressive symptoms than NLBC. Children left behind by both parents were most depressed. Negative-event-induced stress and communication on life difficulties with migrant parents were risk factors for depressive symptoms, whereas adequate communication on academic performance or children's feelings was a protective factor against depressive symptoms. Communication duration and frequency, communication by visiting, communication on academic performance, life difficulties and children's feelings moderated the relationship between stress and depressive symptoms, respectively. Duration of separation, communication duration and frequency, communication on academic performance, learning difficulties and children's feelings moderated the relation between the type of parental migration and depressive symptoms, respectively.

CONCLUSIONS

Our findings suggest that children left behind by both parents should be the focus of public attention for their higher susceptibility to stress-related depression. To help LBC stay mentally healthy, governments need to formulate regulations contributing to LBC's family reunion, communities need to involve more residents to attend LBC as "surrogate parents" and teach migrant parents to communicate with LBC properly, and schools need to teach LBC how to deal with stress and communicate with migrant parents.

The Current Situation on Major Depressive Disorder in China: Research on Mechanisms and Clinical Practice

Depression is the most disabling disorder worldwide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only ~50% of patients respond to frontline antidepressants, and <33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Furthermore, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.