Prevalence of depressive symptoms in children and adolescents in China: a meta-analysis of observational studies
Abstract
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.
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Chinese children and adolescents have a high prevalence of depressive symptoms or major depressive disorders.
“has a high prevalence of depressive symptoms or major depressive disorders30–32”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [31]
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“00 00 4v 1 育压力,因此,无论是独生还是非独生学生,在当下均能够享受家庭中的资源, 心理健康水平并无显著差异(廖友国, 连榕, 2020)。其次,在生源地因素上,近年 来由于国民素质的普遍提升,使得城乡家庭教养理念进一步缩小。此外,由于我 国农村家庭可支配收入的增加,使得农村和城镇家庭对子女的教育投入差距进一 步缩小。这些都使得城乡初中正面对的成长环境更加相似,心理健康水平更加趋 同。 经济区域:本研究将被试按经济区域归属分为东北、东部、中部和西部四个 亚组,结果发现仅有焦虑和自我伤害存在显著的区域差异,中西部地区检出率偏…”
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“9% among Chinese children and adolescents [3].”
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“A meta-analysis involving 29,626 cases revealed a pooled prevalence of depressive symptoms among Chinese adolescents at 19.85% [4], highlighting a concerning statistic for the healthcare system.”
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“In China, this issue has evolved into a significant public health concern, with the prevalence of depression among children and adolescents reaching an estimated 19.8% in 2015 [7].”
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Li, Q., Song, K., Feng, T., Zhang, J., & Fang, X. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.06.006 · Cited by 9 · see citing works
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“In consonance with international trends, Chinese children and adolescents face an elevated risk of experiencing depressive symptoms (Rao et al., 2019).”
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Negative efficacy of antidepressants in pharmacotherapy of child and adolescent depression
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“A recent meta-analysis shows that approximately 19.9% of Chinese adolescents experience depressive symptoms [4].”
InfluentialPlateau Environment, Gut Microbiota, and Depression: A Possible Concealed Connection?
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“[15,16].”
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“Studies have shown that, compared to the pre-pandemic period, the prevalence of depressive and anxiety symptoms among Chinese youth has signi fi cantly increased during and post-pandemic (32 – 34).”
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“Globally, 25.2% of adolescents were depressed during the COVID-19 pandemic, according to a recent meta-analysis, while in China, the prevalence is 19.85% [2].”
InfluentialChen, P., Jiang, P., Cui, Y., Yuan, X., Ren, J., Gong, J., Liao, Y., Li, Y., Pan, Q., Zhang, H., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119941 · Cited by 6 · see citing works
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“Moreover, children residing in relatively economically underdeveloped regions exhibit significantly elevated levels of depression and anxiety (H. Liu et al., 2018; Rao et al., 2019).”
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“Recent evidence has shown that approximately 20% of children and adolescents in China experience symptoms of depression (Rao et al., 2019).”
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“A study published in 2019 showed that the aggregate prevalence of depressive symptoms among Chinese children and adolescents stood at 19.85% [4].”
InfluentialLi, J., Zhang, Y., Yang, N., Du, J., Liu, P., Dai, W., & Dong, Q. (2025) · Psychiatry Investigation · doi:10.30773/pi.2024.0295 · Cited by 8 · see citing works
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“The overall prevalence of depression symptoms and anxiety symptoms before the COVID-19 pandemic among Chinese students was reported to be 15.4–32.7% and 13.7–27.2%, respectively [27–30].”
InfluentialA Systematic Review and Meta-Analysis of Anxiety among Children and Youth in Ethiopia
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“In China, the prevalence of depressive symptoms in children and adolescents ranges from 4% to 41%, with a pooled prevalence of 19.85% (Rao et al., 2019).”
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“A recent meta-analysis of observational studies involving 29,626 Chinese children and adolescents reported that approximately 19.9% of students had DSs, with estimates of 17.8%, 23.7%, 22.7%, and 14.5% in the eastern, central, western, and northeastern regions of China, respectively (6).”
InfluentialPeng, B., Zhu, X., Han, T., Zhao, S., Zheng, J. X., & Jia, F. (2025) · BMC Psychology · doi:10.1186/s40359-025-03710-z · Cited by 5 · see citing works
“Another 2019 meta-analysis of Chinese adolescents, which included 18 studies with 29,626 participants, revealed a 19.85% prevalence of depressive symptoms [24].”
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- Authors
- Rao, W.-W., Xu, D.-D., Cao, X.-L., Wen, S.-Y., Che, W.-I., Ng, C. H., Ungvari, G. S., He, F., & Xiang, Y.-T.
- Affiliations
- University of Macau (MO)
- Harbin University (CN)
- Shenzhen KangNing Hospital (CN)
- Karolinska Institutet (SE)
- The University of Melbourne (AU)
- The University of Western Australia (AU)
- Capital Medical University (CN)
- Corresponding author
- He, Fan
- Xiang, Yu-Tao
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 272
- Pages
- 790-796
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2906196871
- Cited by
- 165
- References
- 34
- Citations by year
- 2026: 24 · 2025: 41 · 2024: 35 · 2023: 20 · 2022: 12 · 2021: 16 · 2020: 13 · 2019: 4
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- niversity of Macau (MYRG2015-00230-FHS, MYRG2016-00005-FHS)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- depressive symptoms, childhood depression, adolescent depression, prevalence, China, regional variation, depression screening, mental health
- MeSH terms
- Adolescent, Child, China, Depression, Female, Humans, Male, Mass Screening, Prevalence, Databases, Factual, Observational Studies as Topic, Neurodevelopmental Disorders
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