Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

Abstract

Aims Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic. Methods Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Results In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3–28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB. Conclusions Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

Understanding the psychiatric symptoms of COVID-19: a meta-analysis of studies assessing psychiatric symptoms in Chinese patients with and survivors of COVID-19 and SARS by using the Symptom Checklist-90-Revised

“…The JBI checklist has nine methodological items, with each having four answer choices (yes, no, unclear, or not applicable): sample frame, sampling, sample size, description of subjects and setting, sample coverage of the data analysis, validity of the method for assessing the outcome, standardization and reliability of the method for assessing outcome, statistical analysis, and response rate. The quality score is the total number of “yes” answers, which can range from 0 to 9, with higher scores suggesting higher quality 26 . A JBI score of “9” suggests “good quality”.…”

Anxiety and Depression in Chinese Students During the COVID-19 Pandemic: A Meta-Analysis

“…The meta-analysis of Panda et al (14) revealed that the overall prevalence of anxiety and depression among children worldwide was 34.5 and 41.7%, respectively. Luo et al (15) indicated that the pooled prevalence of depressive symptoms in Chinese university students was 26.0% during the COVID-19 pandemic. However, to the best of our knowledge, no meta-analysis has evaluated the prevalence of anxiety and depression among Chinese students overall.…”

Demographics, Socioeconomic Status, Social Distancing, Psychosocial Factors and Psychological Well-Being among Undergraduate Students during the COVID-19 Pandemic

“…The new coronavirus disease (COVID- 19), initially detected in China in the end of 2020, was quickly disseminated into different countries. Once the SARS-Cov-2 virus related to COVID-19 proved to be highly contagious, the World Health Organization Emergency Committee declared that the outbreak constituted a Public Health Emergency of International Concern [1,2].…”

“…University students from different countries remained a vulnerable population group to psychological and health-related problems during the COVID-19 pandemic, including insomnia, anger and fear, alcohol intake and tobacco consumption, anxiety, stress, depression and poor perception of health [ 17 , 18 , 19 , 20 , 21 ].…”