Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep 2;19(1):327.
doi: 10.1186/s12909-019-1744-2.

A systematic review of depression and anxiety in medical students in China

Ying Mao  1 , Ning Zhang  2 , Jinlin Liu  2 , Bin Zhu  2   3 , Rongxin He  2 , Xue Wang  2
Affiliations

A systematic review of depression and anxiety in medical students in China

Ying Mao et al. BMC Med Educ. .

Abstract

Background: Medical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice. Although there have been many empirical studies about depression or anxiety in medical students in China, no previous studies have conducted a related systematic review about this topic in English. This analysis can convey the general findings from China to other areas of the world.

Methods: A systematic review and meta-analysis of depression or anxiety in medical students and related determinants were conducted. Three Chinese and three English databases were searched for the review, with no restrictions on language. Articles published between January 1, 2000 and April 1, 2018 were included.

Results: Twenty-one articles investigating a total of 35,160 individual Chinese medical students were included in this review. The prevalence of depression ranged from 13.10 to 76.21% with a mean of 32.74%, and the prevalence of anxiety ranged from 8.54 to 88.30% with a mean of 27.22%. Based on the meta-analysis, gender, grade level, residence, satisfaction with current major and monthly household income per capita were significantly associated with depression. Grade level and satisfaction with current major were significantly associated with anxiety. Other risk factors were identified and described using a narrative approach.

Conclusion: The mean prevalence of depression was 32.74% amongst medical students in China, whereas the mean prevalence of anxiety was 27.22%. The determinants of depression and anxiety included individual factors, social and economic factors, and environmental factors. More measures should be taken towards at-risk medical students based on the identified risk factors.

Keywords: Anxiety; Depression; Medical students; Meta-analysis; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Forest plots of depression-related factors
Fig. 3
Fig. 3
Forest plots of anxiety-related factors
See this image and copyright information in PMC

References

    1. Zhu B, Fu Y, Liu J, Mao Y. Modeling the dynamics and spillovers of the health labor market: evidence from China’s provincial panel data. Sustainability. 2018;10:333. doi: 10.3390/su10020333. - DOI
    1. Sun T, Gao L, Li F, et al. Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: a large cross-sectional study. BMJ Open. 2017;7:e017182. doi: 10.1136/bmjopen-2017-017182. - DOI - PMC - PubMed
    1. Shan HP, Yang XH, Zhan XL, Feng CC, Li YQ, Guo LL, et al. Overwork is a silent killer of Chinese doctors: a review of Karoshi in China 2013–2015. Public Health. 2017;147:98–100. doi: 10.1016/j.puhe.2017.02.014. - DOI - PubMed
    1. Elkins C, Plante KP, Germain LJ, Morley CP. Burnout and depression in MS1 and MS3 years: a comparison of cohorts at one medical school. Fam Med. 2017;49:456–459. - PubMed
    1. Ranasinghe P, Wathurapatha WS, Mathangasinghe Y, Ponnamperuma G. Emotional intelligence, perceived stress and academic performance of Sri Lankan medical undergraduates. BMC Med Educ. 2017;17:41. doi: 10.1186/s12909-017-0884-5. - DOI - PMC - PubMed

Publication types