Depressive symptoms and associated factors among left-behind children in China: a cross-sectional study

Effects of a 12-week dance intervention on left-behind children with co-occurring social anxiety and low self-concept

Objective

This study aimed to investigate the effects of a 12-week dance intervention on left-behind children (LBC) suffering from social anxiety and low self-concept, and to explore the relationship between social anxiety and self-concept.

Methods

Sixty LBC who met the criteria were selected from a school in Shaoyang City, Hunan Province, and were randomly divided into an Interventional group (n = 30) and a Control group (n = 30). The Interventional group received a 45-min dance intervention five times a week for 12 weeks, while the Control group maintained their original lifestyle. Social anxiety and self-concept were measured three times using the Social Anxiety Scale for Children and the Piers-Harris Child Self-concept Scale: at baseline (T0), post-intervention (12 weeks, T1), and follow-up (14 weeks after baseline, T2).

Results

(i) After the dance intervention, social anxiety and self-concept were significantly improved (p < 0.05). (ii) There was a significant negative correlation between the change scores (T1 minus T0) of social anxiety and self-concept (p < 0.05).

Conclusion

Dance intervention is an acceptable, practical and effective intervention that we can incorporate into a health programme to improve social anxiety and low self-concept in LBC.

Examining the Latent Dimensions of Social Anxiety Disorder

While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.

Relationships between gross motor skills, psychological resilience, executive function, and emotional regulation among Chinese rural preschoolers: A moderated mediation model

Background

Emotional regulation is a critical component of emotional intelligence, particularly during the preschool stage, a key period for children's development. Previous studies have demonstrated that executive function mediates the effect of gross motor skills on emotional understanding. However, studies specifically focusing on children from rural areas and investigating the role of psychological resilience are limited. The present study fills this knowledge gap by examining the effect of gross motor skills on emotional regulation and the roles of executive function and psychological resilience among Chinese rural preschool children.

Methods

This study included 430 children (aged 61.01 ± 6.98 months, 48.8 % boys) and their teachers from three rural preschools in China. Children's gross motor skills, including locomotor and object control skills, were assessed using the Test of Gross Motor Development-3. Executive function was measured using the Head-Toes-Knee-Shoulder task, and emotional regulation was assessed using the Emotional Regulation Checklist. Furthermore, psychological resilience was examined using the Devereux Early Childhood Assessment. Demographic information was collected, and the cross-sectional relationships between gross motor skills and emotional regulation were investigated through mediation and moderation analyses.

Results

Gross motor skills, executive function, and psychological resilience were associated with emotional regulation (p < 0.05), after controlling for sex, age, and only-child status. Executive function was found to mediate the relationship between gross motor skills and emotional regulation, with a mediation effect of 0.045. Psychological resilience moderated the relationship between executive function and emotional regulation (β = 0.078, p < 0.05). Simple slope analysis, based on categorizing psychological resilience into high, medium, and low groups, revealed that preschoolers with a higher level of psychological resilience exhibited a significantly stronger predictive effect of executive function on emotional regulation (β = 0.202, p < 0.01).

Conclusions

Gross motor skills significantly affect emotional regulation development in rural preschoolers, with executive function acting as a mediator in this relationship. Psychological resilience was found to moderate the effect of executive function on emotional regulation. The findings suggest that enhancing gross motor skills through physical activities can benefit children by promoting the development of executive function, which is crucial for emotional regulation. On the basis of our findings, we recommend focusing on cost-effective physical activity interventions for motor skills development among rural children while also addressing the development of executive function and psychological resilience. Future efforts should include workshops to improve physical literacy of parents and teachers regarding children's gross motor skills promotion.

Factors Associated with Depression among Working-Age Household Heads in Korea: A Cross-Sectional Household Study

BACKGROUND

Depression is a mental disorder common worldwide. This study determined the relationships between demographics, health status, household parameters, and depression rates among working-age household heads.

METHODS

We analyzed data from the Korea Welfare Panel Study Survey conducted in 2020. The 11-item version of the Center for Epidemiologic Studies Depression Scale was used to assess depression. Bivariate analyses and a multiple logistic regression model were used to evaluate the influence of these factors on depression among household heads.

RESULTS

The overall prevalence of depression among working-age household heads was 11.69% (19.83% of females and 9.58% of males). The relative risk of depression was 1.71 times higher among the unemployed than among wage earners and 2.18 times higher among those with low income than among those with general income. The relative risk of depression was 3.23 times higher in those with poor health status than in those with good health, and 2.45 times more in those with severe disabilities than in those without disabilities. The rate of depression decreased with education level, number of family members, and presence of children but increased with the presence of the disabled or elderly.

CONCLUSION

This study provides a comprehensive overview of depression among working-age household heads and identifies factors strongly associated with depression. These findings may have implications for policymakers to reduce the burden on and improve the quality of life of household heads.

Attentional bias for rejection and sad words in Chinese left-behind children with depression

BACKGROUND

This study aimed to examine attentional bias (AB) for sad and social rejection words in Chinese left-behind children (LBC) with depression.

METHOD

We investigated both stimulus specificity and components of AB in different groups using a cross-sectional design. Data were drawn from a school assessment of depression and anxiety, from which we selected LBC with depression (n = 40), LBC without depression (n = 33), a control group with depression (n = 31), and a control group without depression (n = 37). AB was measured with a dot-probe task covering two stimulus types (sad and rejection).

RESULTS

The analysis of AB scores revealed a significant three-way interaction (LBC × depression × word type), F(1, 137) = 4.00, p = 0.047, η2 = 0.028, with depressed non-LBC exhibiting a significant depression × word type interaction, F(1, 66) = 4.67, p = 0.034, η2 = 0.066, while the depression × word type interaction was not significant in LBC, F(1, 71) = 0.18, p = 0.675, η2 = 0.002. Depressed children living with their parents showed AB towards sad words but not rejection words, while depressed LBC showed greater AB towards both rejection and sad words.

CONCLUSIONS

The findings provide evidence that an AB towards sad information is critically involved in the depressed LBC. Compared with non-LBC depressed individuals, an AB for rejection may be involved as a risk factor in the LBC. It sheds light on the effective intervention programmes for LBC's depression and have important practical significance for reducing depression and improving the mental health of LBC.

Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model

BACKGROUND

Type 2 Diabetes mellitus (T2DM) has become a major lifestyle disease endangering human health worldwide. Patients with T2DM face varying degrees of loneliness, which adversely affects their family and the larger society. This study investigates the serial multiple mediating roles of depression and self-perceived burden between family function and loneliness in the T2DM population of China.

METHODS

In total, 260 T2DM patients were included. They rated themselves based on UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Family Care Index, and Self-Perceived Burden Scale. Pearson and Spearman correlation analyses were conducted to clarify the association among variables. The SPSS macro-PROCESS program was used for a series of multiple mediation analyses.

RESULTS

Family function, depression, self-perceived burden, and loneliness were significantly correlated (P < 0.01). Family function not only has a direct negative impact (effect = -2.809; SE = 0.213; 95%CI: LL = -3.228, UL = -2.390) on loneliness, but also has an indirect impact on loneliness through the independent mediating role of depression (effect = -0.862; SE = 0.165; 95%CI: LL = -1.202, UL = -0.567) and self-perceived burden (effect = -0.288; SE = 0.107; 95%CI: LL = -0.525, UL = -0.114) and the chain mediating role of depression and self-perceived burden (effect = -0.202; SE = 0.066; 95%CI: LL = -0.342, UL = -0.088).

CONCLUSIONS

Diversified interventions aimed at improving family function of T2DM patients would help in reducing the level of depression and self-perceived burden, and ultimately reducing loneliness.

Non-suicidal self-injury and professional psychological help-seeking among Chinese left-behind children: prevalence and influencing factors

BACKGROUND

Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China.

METHODS

We implemented a population-based cross-sectional study in participants aged 10-18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking.

RESULTS

The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it.

LIMITATIONS

This was an online survey.

CONCLUSIONS

The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior.

Left-Behind Children's Subtypes of Antisocial Behavior: A Qualitative Study in China

As a result of the recent decades of urbanization and industrialization, millions of people have migrated to cities in search of better work opportunities in China. Meanwhile, their children have often been left behind in the care of other family members. To classify the subtypes of antisocial behavior of the left-behind children, this qualitative study interviewed a total of 71 participants, including five groups: left-behind children, parents, teachers, principals and community workers. The findings showed that left-behind children's antisocial behavior is manifested as the type of limited adolescent antisocial behavior, and the three subtypes of left-behind children's antisocial behavior were rule-breaking behavior, delinquent behavior and criminal behavior. In addition, the development of children's antisocial behavior could range from general violations to delinquent behaviors and even to criminal behaviors.

Associations Between Consumption of Different Vegetable Types and Depressive Symptoms in Japanese Workers: A Cross-Sectional Study

Purpose

Vegetable intake is an important part of our everyday diet and is associated with many positive health outcomes. Although previous studies have investigated the association between vegetable consumption and depressive symptoms among various populations, no study has examined this association in the adult working population. The present study investigated whether the frequency of consumption of a specific type of vegetable is associated with the prevalence of depressive symptoms in Japanese adult workers.

Participants and Methods

The final participants consisted of 1724 Japanese adults, and a cross-sectional study was conducted to analyze the results. The frequency of vegetable consumption and depressive symptoms was evaluated using a brief-type self-administered diet history questionnaire and the Zung Self-Rating Depression Scale (SDS), respectively. The association between the variables was examined using Poisson regression analysis. Age-stratified analysis was performed, and SDS cut-off values of 45 and 50 were used to perform a sensitivity analysis.

Results

After adjustment for covariates, including age, body mass index, sociodemographic and lifestyle-related variables, health condition, C-reactive protein, and other dietary variables, an inverse association was found between tomato product consumption and the prevalence of depressive symptoms among men (P for trend <0.01); however, no significant association was found for other vegetable types. For women, there was no association between the frequency of consumption of any of the vegetable types and the prevalence of depressive symptoms. The results were confirmed by the age-stratified analysis for both genders.

Conclusion

Consumption of tomato products may help alleviate depressive symptoms, regardless of differences in dietary culture among men.

The impact of childhood parental loss on risk for depression and anxiety in adulthood: A community-based study in Southwest China

PURPOSE

Lack of parental raising is an important reason for parental loss in China due to urbanization. We aimed to explore the association between parental loss (including parental death, divorce, alcoholism, crime, drug addiction, bedridden, and lack of parental raising) before 17 years old and mental health disorders in adulthood in Southwest China.

METHODS

Childhood parental loss, age, gender, socioeconomic status, smoking, drinking, and medical history were self-reported. Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) were used for identifying depression and anxiety, respectively. We use logistic regression with inverse probability weighting according to the propensity score to assess the risk of childhood parental loss on mental health disorders in adulthood.

RESULTS

A total of 8014 adults were enrolled in this study. Childhood parental loss increased the risk of adulthood depression (OR, 1.60, 95%CI, 1.30-1.98) but not anxiety (p= 0.07) after adjustment of all covariates. Sensitivity analyses including logistic regression with original data, nearest neighbor matching, full matching, and propensity score as the only covariate all yielded similar results.

LIMITATIONS

Recall bias could not be fully eliminated due to the retrospective nature of study design. Our study had been conducted in a less-prosperous area in Southwest China and the results may not be representative at nation level.

CONCLUSIONS

Childhood parental loss was associated with depression in adulthood in Southwest China, highlighting the need for early intervention in children with parental loss, to prevent long-term negative effects on their mental health.

Life-Events Mediate the Prediction of Parental Alienation on Depression in Rural Left-Behind Children: A Longitudinal Study

OBJECTIVES

Long-time separation with parents during early life, such as left-behind children (LBC, one or both of whose parents are leaving for work for at least a period of 6 months), may contribute to high alienation toward parents and endanger their mental health (e.g., depression). However, the dynamic status of depression and potential prediction of alienation on depression in LBC remained largely unknown. This study aimed to examine the dynamic status of depression, prediction of alienation toward parents on later depression in rural LBC, and a potential mediation of life-events.

METHODS

A total of 877 LBC in rural areas of China were recruited and surveyed at five time-points (baseline, T0: 1-month, T1: 3-months, T2: 6-months, T3: 12-months, T4) with the Inventory of Alienation Toward Parents, Childhood Depression Inventory, and Adolescent Self-Rating Life-Events Checklist. The Hierarchical Linear Model (HLM) and Hayes's PROCESS macro model were conducted to estimate the developmental trend and hierarchical predictors of depression.

RESULTS

The left-behind children aged 9-years old experienced higher depression than the children with other ages. At baseline, the children in the family atmosphere of frequent quarrels and compulsive parenting style reported a higher level of alienation toward parents, life-events, and depression. Alienation toward parents, life-events, and depression were positively and moderately correlated with each other (r = 0.14 ~ 0.64). The HLM model depicted a linear decline in depression, alienation, and life-events with an average rate of 0.23, 0.24, and 0.86, respectively, during the five time-points. Also, T0 alienation toward parents and T0 life-events positively predicted the developmental trajectory of depression over time, and T0 life-events positively predicted the descendant rate of depression. Notably, life-events mediated the prediction of baseline alienation toward parents on T4 depression in LBC.

CONCLUSION

This study is among the first to reveal that alienation toward parents predicts the developmental trajectory of later depression in LBC. The findings that life-events mediate the prediction of alienation on later depression further suggest the importance of family and social factors in the occurrence of depression in LBC. The findings warrant the necessity to consider the family and social factors when evaluating and reducing risks for mental health problems in LBC, i.e., relationship with parents (especially alienation toward parents) and life-events need further attention.

The Influence of Discrepancies between Parents' Educational Aspirations and Children's Educational Expectations on Depressive Symptoms of Left-Behind Children in Rural China: The Mediating Role of Self-Efficacy

Although long-term separation has made discrepancies between parents’ educational aspirations and children’s own educational expectations among families with left-behind children (LBC), limited researches on the influence of these discrepancies on children’s mental health are carried out at present. Based on China Family Panel Studies (CFPS) conducted in 2018, we selected 875 LBC aged 9~15 as the sample, explored the influence of the direction and degree of these discrepancies on LBC’s depressive symptoms by hierarchical regression, and examined the mediating role of children’s academic self-efficacy and mediation effect pathway with Baron and Kenny method and Bootstrap mediation analysis methods. Results showed that LBC’s mental health was worse when parents’ educational aspirations were higher than their children’s educational expectations, compared to that without discrepancies. The degree of such discrepancies was negatively associated with LBC’s mental health. In the relationship between the direction of discrepancies and LBC’s depressive symptoms, academic self-efficacy played a mediating role partially. In addition, the study indicated that mothers played a significant role in the development of LBC’s mental health. These findings also provided critical evidence for the intervention practice of LBC’s mental health.

Environmental Risk Factors and Their Different Effects in Depressive Symptoms of Left-Behind Children in Rural China Compared with Non-Left-Behind Children

In China, 61 million children were left behind in rural areas as a result of massive urbanization and migration of parents from the countryside to the cities in search of economic opportunities. This study explores the effects of environmental risk factors (i.e., peer victimization, perceived discrimination, and stressful life events) on depressive symptoms of left-behind children (LBC) and examines whether these risk factors have a higher impact on LBC compared with that of non-left-behind children (NLBC). Data collected involve 1548 first and second-year middle school students. Logistic regressions were conducted to examine the associations between environmental risk factors and LBC's depressive symptoms, the moderating effect of the parental separation duration on these associations, and to compare if the risk factors had a higher impact on LBC's depressive symptoms than on those of NLBC. Peer victimization is associated with an increased likelihood of depressive symptoms for LBC who were left behind for more than five years. Finally, stressful life events have a higher impact on LBC's depressive symptoms, while peer victimization has a higher impact on NLBC's depressive symptoms. The results suggest that stressful life events are an important risk factor that puts LBC at a disadvantage in terms of their mental health.

Bullying Victimization and Life Satisfaction Among Rural Left-Behind Children in China: A Cross-Sectional Study

Objectives: This study aimed to evaluate the associations between bullying victimization and life satisfaction in primary school children and also investigate the interactive effects of left-behind status and bullying victimization on life satisfaction. Materials and Methods: Bullying victimization was measured using the Chinese version of the revised Olweus Bully/Victim Questionnaire. Life satisfaction was assessed using the Multidimensional Students' Life Satisfaction Scale (MSLSS). Life satisfaction is composed of five domains, namely, family, school, friends, environment, and self-satisfaction. Left-behind status of rural children was defined as one or both their parents migrating to working in cities. The data were analyzed using Mann-Whitney U tests, Chi-square tests, and multivariate linear and logistic regression analyses. Results: A total of 810 primary school children were involved, of which 8.5% reported bullying victimization, and 44.3% were left-behind children (LBC). We found that bullying victimization was negatively associated with all domains of life satisfaction (all p < 0.05). With further left-behind status-stratified analysis, we found that negative association between bullying victimization and friend satisfaction was more profound in the LBC group than in the non-LBC group [b(SE)= -0.133 (0.03) vs. -0.061 (0.026) for LBC and non-LBC, respectively, p < 0.05]. When further interaction analysis was conducted, we identified interaction effects between left-behind status and bullying victimization on friend satisfaction (p interaction = 0.048). Similar interaction effect between bullying victimization and left-behind status on school satisfaction was also found (p interaction = 0.004). Conclusions: Bullying victimization was associated with low life satisfaction (including lower family, friends, school, self, and environment satisfaction). There were significant interactions between left-behind status and bullying victimization on friend satisfaction, as well as school satisfaction. Left-behind status of children may exaggerate the impact of bullying victimization on friends/school satisfaction rating.

The relationship between psychological resilience and emotion regulation among preschool left-behind children in rural China

To evaluate the relationship between resilience and emotion regulation among preschool left-behind children (LBC) in rural China. A total of 620 preschool LBC were enrolled from rural areas in Anhui province, China. Multivariate logistic regression was used to evaluate the associations between resilience and variables. The results showed that 20.2% of LBC had higher resilience. Emotion regulation was correlated with resilience among preschool LBC. Children with higher cognitive reconstruction (adjusted OR (AOR) = 0.349,95%CI:0.249-0.489), passive dealing (AOR = 0.577, 95%CI:0.411-0.810), alternative action (AOR = 0.369, 95%CI:0.267-0.510) and self-comforting (AOR = 0.441, 95%CI:0.315-0.619) would have lower risk of low resilience. Our findings suggest that strengthening emotion regulation could promote psychological resilience and prevent adverse developments in LBC.

Emotional and Behavioral Problems of Left-Behind Children in Impoverished Rural China: A Comparative Cross-Sectional Study of Fourth-Grade Children

PURPOSE

Children who are left behind when their parents migrate for work have a high prevalence of emotional and behavioral problems, which affect social function and increase family burden. To date, no national survey has been conducted on the emotional and behavioral problems of left-behind children (LBC) in China. This study aimed to investigate the emotional and behavioral outcomes of primary school LBC in the fourth grade in impoverished rural China and the possible influences of family environment and parenting practices.

METHODS

A cross-sectional study was carried out in 27 rural counties in the central and western parts of China from November 2016 to January 2017. The method of quota sampling was adopted to achieve a representative sample using postweighting adjustment. The survey sample was distributed proportionately across each county. LBC were defined as children aged <16 years who had two parents leave home to work or one parent leave home while the other lost the capacity to rear their children. The term "non-left-behind children" (NLBC) refers to children who have at least one parent who has not migrated for work. The Strengths and Difficulty Questionnaire (SDQ) was applied to measure children's emotional and behavioral problems.

RESULTS

After the weighted calculations were performed, there were 1,147 LBC and 3,953 NLBC. The proportion of abnormal SDQ total scores (>17) was significantly higher in the LBC group than in the NLBC group (15.6% vs. 11.6%; p < .01). Binary regression analysis showed that high levels of insomnia (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.04-2.27), loneliness (OR 1.65, 95% CI 1.13-2.43), and self-harm (OR 1.92, 95% CI 1.17-3.16) may increase the risk of abnormal SDQ total scores in LBC.

CONCLUSIONS

LBC showed a higher prevalence of abnormal SDQ total scores than NLBC. Insomnia, loneliness, and self-harm behavior were associated with abnormal SDQ total scores in LBC.

The relationship between depression and loneliness levels of the students at the faculty of health sciences and the factors affecting them

PURPOSE

The aim of this study is to determine the relationship between the loneliness and depression levels of students studying at Inonu University, Faculty of Health Sciences, Departments of Nursing, Midwifery, Physiotherapy, Audiology and Child Development and the factors that affect these levels.

DESIGN AND METHODS

This descriptive cross-sectional study which used a socio-demographic information form, the UCLA Loneliness Scale and the Beck Depression Inventory included 1004 students.

FINDINGS

According to the results of the research, there was a positive relationship between loneliness and depression levels among university students. Class year, family type, place of residence, mother's education level, and economic situation were important indicators of loneliness and depression.

PRACTICE IMPLICATIONS

Psychiatric nurses can help students express their psychological difficulties and help them change their behaviors and lifestyles.

Self-harm behaviors, suicidal ideation, and associated factors among rural left-behind children in west China

PURPOSE

This population-based cross-sectional study describes self-harm (SH) behaviors and associated factors in 2898 Chinese left-behind children (LBC).

METHODS

Descriptive statistics were used to present and compare the distributional characteristics of SH behaviors. Binary and ordinal logistic-regression models for survey data were applied to explore associated factors of SH.

RESULTS

Among the LBC, 48% (95% CI: 42%-54%) reported SH behaviors. SH was prominently associated with suicidal ideation. Boys, junior high-school students, and LBC whose fathers were poorly educated were observed to have higher prevalence of SH. Boys, local ethnic minorities, junior high-school students, and LBC whose fathers were comparatively well educated were observed to be at increased risk of more medically serious SH behaviors.

CONCLUSIONS

SH is a substantial public health problem among rural Chinese LBC. Targeted intervention measures should be developed to reduce future suicide risk.

Physical activity and prevention of chronic disease in Chinese youth: A public health approach

•The proportion of school-aged children and adolescents in China who engage in recommended levels of physical activity (PA), in or outside of school time, has been declining for decades.•Current PA promotion policies for Chinese schools are primarily "stand-alone" approaches and their efficacy appears limited.•Re-evaluating the problem from a comprehensive social-ecological perspective within a public health model offers greater potential for developing effective and culturally appropriate interventions to increase PA among Chinese youth.•If the goals of Healthy China 2030, including the prevention of the early onset of chronic diseases among Chinese children and adolescents, are to be met by reversing the trend of declining PA, careful consideration of this new paradigm is imperative.

Latent profile analysis of anxiety disorder among left-behind children in rural Southern China: a cross-sectional study

OBJECTIVES

Previous studies have used latent profile analysis (LPA) to examine rural left-behind children's anxiety. Further study is needed to identify the heterogeneous characteristics of rural left-behind children's anxiety and explore the related factors.

SETTING

A cross-sectional survey using a school-based sample was conducted in January 2018 in Qingxin district, Qingyuan city, Guangdong province.

PARTICIPANTS

1026 left-behind children (effective response rate of the questionnaire: 95.39%).

MAIN OUTCOME MEASURES

Profile latent classes (LC) and anxiety disorder.

RESULTS

The LPA identified three anxiety LC: 'low anxiety' (56.6%), 'medium anxiety' (34.8%) and 'severe anxiety' (8.6%). The multinomial logistic regression model was used to predict the relationship between personal, family, school factors and anxiety. We found that the variables directly related to lower anxiety classes included age (12-14 years), harmonious or fair relationship with classmates, no neglect, harmonious parental relationship and the duration of mother migration <6 months.

CONCLUSIONS

These findings suggested the need for careful consideration of differences in anxieties among rural left-behind children. Identifying latent subgroups may provide an empirical basis for teachers and public health practitioners to implement anxiety intervention efforts.

Depressive symptoms and quality of life among Chinese medical postgraduates: a national cross-sectional study

High workloads and heavy academic pressure can have significant implications for the risk for depression and poor quality of life (QoL). This study aimed to investigate QoL and depressive symptoms in medical students undergoing postgraduate neurology specialty training in China. The survey covered demographic characteristics, the 8-itemMedical Outcomes Study Short-Formquestionnaire (SF-8), and the 2-itemPrimary Care Evaluation of Mental Disorders depression screening tool. Logistic regression analysis was used to investigate the determinants of QoL and depressive symptoms. Participants were 1,814 postgraduates from 249 hospitals in 27 Chinese provinces. The mean SF-8 physical and mental component summary scores were 78.17 (standard deviation [SD] 15.20) and 68.33 (SD 17.15), respectively. One-third of respondents had depressive symptoms, and those without depressive symptoms had significantly higher QoL scores. The multivariate regression analysis showed that factors independently associated with depressive symptoms were being in the second year of study, a lower household income, and less sleep  time. Although QoL among our sample of Chinese medical students undergoing postgraduate neurology specialty training was favorable relative to other comparable populations, one-third of respondents had depressive symptoms. Accurate measures should be taken to change this situation.

Prevalence of depressive symptoms in children and adolescents in China: A meta-analysis of observational studies

Depressive symptoms are common in children and adolescents. The prevalence of depressive symptoms in children and adolescents in China vary significantly across studies. A meta-analysis of the prevalence of depressive symptoms in children and adolescents in China was conducted. Literature search was performed in both English (PubMed, PsycINFO and EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and SinoMed) databases. Random-effects model was used to synthesize the prevalence of depressive symptoms. Eighteen studies covering 29,626 participants were identified and analyzed. All these studies used the same measurement to identify depressive symptoms. The reported point prevalence of depressive symptoms ranged between 4% and 41% in the studies; the pooled prevalence of depressive symptoms was 19.85% (95% confidence interval: 14.75%-24.96%). In the subgroup analyses the prevalence of depressive symptoms was significantly associated with the region where the study was conducted: 17.8% in eastern, 23.7% in central, 22.7% in western, and 14.5% in northeast regions of China (P < 0.001). Considering the adverse impact of depressive symptoms on health outcomes, regular screening and effective interventions should be implemented in this population.