Cited by 286Healthcare professionals’ stress and burnoutMental Health Treatment and AccessCOVID-19 and Mental Health

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Prevalence of mental health problems among medical students in China: A meta-analysis

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Zeng, Wen, Chen, Ruiqi, Wang, Xingyue, Zhang, Qin, Deng, Wei·2019·Medicine

DOI 10.1097/md.0000000000015337PMC PMC6504335

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Abstract

Background: The prevalence of mental health problems in medical students has continuously increased and is higher than the prevalence of mental health problems in students with other majors, which could lead to undesirable consequences for the students and their future patients. In China, the current states of medical education and healthcare workplaces differ in certain areas from those in Western or other Asian countries. However, the mental health status of Chinese medical students has not been systematically analyzed. Objectives: The purpose of this meta-analysis was to summarize the prevalence of mental health problems in Chinese medical students. Methods: All cross-sectional studies that investigated the prevalence of any mental health problem among Chinese medical students were retrieved from the following databases: EMBASE, PubMed, PsycINFO, OVID, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. We accepted each individual trial's inclusion and exclusion criteria for participants. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was adopted to appraise the methodological quality of each study. RevMan (version 5.3) was used to analyze the data. Results: Ten cross-sectional studies involving a total of 30,817 Chinese medical students were included. The prevalence of depression, anxiety, suicidal ideation, and eating disorders were 29%, 21%, 11%, and 2%, respectively. Subgroup analysis revealed no significant differences in the prevalence of depression and suicidal ideation between genders and no significant difference in the prevalence of depression between individuals of different ages (20 years and older or younger than 20 years). Conclusions and implications of key findings: Chinese medical students have relatively high prevalence of depression, anxiety, and suicidal ideation but a low prevalence of eating disorders. Mental health problems in Chinese medical students should be taken seriously, and timely screening of and proper intervention in these mental health problems are highly recommended.

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Figure 1 Study flow diagram using the PRISMA flow chart.CC BY-NC-ND · PubMed Central

Figure 2 Forest plot assessing the prevalence of depression among medical students in China. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 3 Forest plot assessing the prevalence of depression among medical students in China, stratified by the gender of the participants. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 4 Forest plot assessing the prevalence of depression among medical students in China, stratified by the mean age of the participants. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 5 Forest plot assessing the prevalence of anxiety among medical students in China. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 6 Forest plot assessing the prevalence of suicidal ideation among medical students in China, stratified by the gender of the participants. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 7 Forest plot assessing the prevalence of suicidal ideation among medical students in China. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 8 Forest plot assessing the prevalence of eating disorders among medical students in China. CI = confidence interval, SE = standard error.CC BY-NC-ND · PubMed Central

Figure 9 Funnel plot assessing the prevalence of depression among medical students in China. SE = standard error.CC BY-NC-ND · PubMed Central

Figure 10 Plot of the sensitivity analysis, which was conducted by excluding 1 study each time and pooling the estimate for the rest of the studies.CC BY-NC-ND · PubMed Central

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Method
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“, they can impair their quality of life and increase the risk of suicidal ideation and decrease academic performance, professionalism, and empathy toward their patients).([12,19,20]) The current state of the medical education system and healthcare working environment in China differs in some areas compared to those in…”
Result
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Background
Prevalence and risk factors of disordered eating risk among Yemeni medical students: A national multicenter cross-sectional study
Al-bawah, N., Baklola, M. I., Khalifeh, A. H., Al-Eryani, A., Nourelden, A. Z., Alaribi, S., sharyan, E., Al-wesabi, F., Wesabi, A. A. A., Al-Jaberi, A., et al. (2026) · PLoS ONE · doi:10.1371/journal.pone.0345771 · Cited by 2
Prevalence of Eating Disorders in University Going Students of Islamabad/ Rawalpindi
Abid, J., Latif, H. S. A. A. E., Sohail, A., Syed, S. F. T., Ahmad, S., Asif, T., & Farooq, M. (2022) · Journal of Innovative Sciences · doi:10.17582/journal.jis/2022/8.1.131.145 · Cited by 2
Troubles des conduites alimentaires : prévalence et facteurs de risque chez des étudiants en médecine tunisiens
Safi, E., Htira, Y., & Faïka, B. M. (2022) · Nutrition Clinique et Métabolisme · doi:10.1016/j.nupar.2022.08.002 · Cited by 2
The Impact of COVID-19 on the Mental Health of Foreign Students Stranded from Chinese Universities
Abbas, S., Tan, Q., Safdar, A., & Teng, L. (2022) · Quality in Sport · doi:10.12775/qs.2021.08.02.002 · Cited by 2
Mental Health Issues Among Medical Students
Grover, S. (2022) · Journal of Mental Health and Human Behaviour · doi:10.4103/jmhhb.jmhhb_297_22 · Cited by 2
The psychological impact of COVID-19 lockdown on the wellbeing, learning efficacy and sleeping behaviors of Romanian medical students
Burlacu, C.-C., Chelaru, V.-F., Drugan, T., & Bădulescu, A.-V. (2023) · Medicine and Pharmacy Reports · doi:10.15386/mpr-2411 · Cited by 2
A Friend in Need Is a Friend Indeed: Investigating the Quality of Training Data from Peers for Auto-generating Empathetic Textual Responses to Non-Sensitive Posts in a Cohort of College Students
Sharma, R. S., Mirzakhalov, J., Bharti, P., Goyal, R., Schmidt, T., & Chellappan, S. (2023) · ACM Journal on Computing and Sustainable Societies · doi:10.1145/3616382 · Cited by 3
Chain mediating role of moral values identification and positive psychological capital in the relationship between meaning in life and crisis vulnerability
Liu, Q., Chang, R.-J., Fang, S.-J., & Peng, J. (2024) · Medicine · doi:10.1097/md.0000000000039781 · Cited by 2
“[19] Therefore, they are at a higher risk of psychological crises; moreover, negative emotions such as burnout, depression, and anxiety [20] are inconducive to the cultivation of crisis tolerance and meaning in life.”
Background
The mediating role of behavioral systems in linking physical activity and anxiety symptoms in college students
Wang, W., & Liu, H. (2025) · Scientific Reports · doi:10.1038/s41598-025-91294-4 · Cited by 6
Association between Sleep Quality and Mental Health among Medical Students: A College Based Study in Himachal Pradesh, India
Verma, P., Jani, H., Bhanderi, P., Patel, B., & Parlewar, R. (2025) · Journal of Pharmacy And Bioallied Sciences · doi:10.4103/jpbs.jpbs_310_25 · Cited by 2
“[5] Varying prevalence of different sleep problems among medical students have been observed from Asian countries, Europe, North and South America.”
Factors affecting perception of Indian adolescent students toward interactive online mental health information during COVID-19
Kaushal, A., & Dogra, P. (2021) · Information Discovery and Delivery · doi:10.1108/idd-09-2020-0113 · Cited by 2
Alarming state of suicide among medical students, residents and early career physicians in China
Yang, J. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103336 · Cited by 2
Sleep quality, fatigue and sleepiness in medical students
Baljak, A., Nikolić, A., & Grujičić, S. Š. (2023) · Zdravstvena zastita · doi:10.5937/zdravzast52-43569 · Cited by 2
Depresión, ansiedad y burnout y su asociación con ideación de deserción académica en médicos residentes
Camarillo-Nava, V. M., López-Rojas, E., de León, S. H.-C., Gutiérrez-Muñoz, C. I., Andrade-Pineda, J. E., Quiroz-Cortés, G. D., & Pérez-López, D. (2024) · Atención Familiar · doi:10.22201/fm.14058871p.2024.287953 · Cited by 2
Cross-cultural validation and psychometric testing of the counseling center assessment of psychological symptoms: experience of Serbia
Cvjetković, S., Bjegovic-Mikanovic, V. M., & Langher, V. (2020) · Health Promotion International · doi:10.1093/heapro/daaa119 · Cited by 1
Risk of Eating Disorders (EDs) among Iranian Medical Students: Perceived Social Support (PSS) and COVID-19-Related Anxiety
Namjoo, M., Farid, M., & Kamrani, M. A. (2023) · Journal of Kermanshah University of Medical Sciences · doi:10.5812/jkums-138068 · Cited by 1
Evaluation of a Brief Mindfulness-based Intervention to Prevent Problematic Substance Use among First-year Medical Students
Castro, A. O., Pérez, R. P. B., Vargas-Huicochea, I., Márquez, A. F., & Castro, J. C. F. (2025) · Salud Mental · doi:10.17711/sm.0185-3325.2025.004 · Cited by 1
“Thus, for example, the percentage of depression in medical students ranges from 14.3 to 57.6%, while the percentage for anxiety in this same group ranges from 7.7 to 65.5% (Kumar et al., 2019; Tian-Ci et al., 2019; Zeng et al., 2019; Kunwar et al., 2016; Hope & Henderson, 2014).”
Influential
Differential directional effects between insomnia symptoms and suicidal ideation across trait depression levels: a cross-lagged network analysis among Chinese medical undergraduates
Zhang, J., Zhang, X., Hu, F., Li, K., Luo, M., Yu, Y., & Feng, Z. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1581827 · Cited by 1
“…on Chinese medical undergraduates as the sample, as this population is particularly susceptible to mental health problems such as insomnia and SI due to multiple stress (e.g., academic overload, unclear identity, occupational stress, and irregular sleep patterns) compared to other groups (53, 54).”
Results of Mental Health Well-Being and Burnout Screening Among Medical Students: A Descriptive Study Comparing 2020 and 2024 Data
Chumakov, E. M., Pchelin, I. Y., Makarova, P., Ventriglio, A., Torales, J. C., Bhugra, D. K., & Петрова, Н. Н. (2025) · Academic Psychiatry · doi:10.1007/s40596-025-02173-z · Cited by 1
Self-Compassion and Ikigai
Kotera, Y., Wilkes, J., & Colman, R. D. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009407427.013 · Cited by 1
Mobile phone addiction as a mediator in the association between alexithymia and self-directed learning among Chinese nursing students: a structural equation modeling analysis
Guo, M., Wang, Q., Chen, X., Liu, Q., Chen, M., Fu, Y., Wang, J., & Su, J. J. (2026) · BMC Medical Education · doi:10.1186/s12909-026-08635-8 · Cited by 1
Pathways from AI-assisted learning experience to psychological resilience: The role of stress perception in medical students
Xu, C., Pan, H., Huang, X., Liu, J., Bao, Y., Song, X., & Fang, L. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.106658 · Cited by 4
Saúde Mental de Estudantes da Universidade Federal da Bahia: Relações com Variáveis Acadêmicas e Sociodemográficas
Barros, L. D. O., & Muniz, A. E. (2026) · Psicologia Ciência e Profissão · doi:10.1590/1982-3703003287425 · Cited by 1
Academic stress and its psychosocial and behavioral determinants in medical students: Findings from a cross-sectional study
Karim, M. R., Haque, S. A. S., Rumeen, F., & Aruneema, P. (2026) · PLoS ONE · doi:10.1371/journal.pone.0347306 · Cited by 1
“Additionally, we employed a conditional dependence network with centrality analysis [Fig 5].”
Contemporary Issues in Well-being of Undergraduate Clinical Students: A Systematic Review
Lin, C. T., Ming, L. W., & Kyi, T. K. (2021) · Education in Medicine Journal · doi:10.21315/eimj2021.13.1.2 · Cited by 1
The prevalence of chronic fatigue syndrome and depression in Guilan medical students in 2020
Abdollahi, E., Soleimani, R., Taherzadeh, H., & Eslamdoust-Siahestalkhi, F. (2021) · Research and Development in Medical Education · doi:10.34172/rdme.2021.025 · Cited by 1
Social anxiety and eating disorders in medical students
Афанасьев, С. О., Ширяев, О. Ю., & Махортова, И. С. (2021) · Neurology Bulletin · doi:10.17816/nb71580 · Cited by 1
Prevalence and factors associated with depressive symptoms among medical students in their first and final year of study
Čanković, S., Mijatović-Jovanović, V., Harhaji, S., Šušnjević, S., Ukropina, S., Kvrgić, S., & Čanković, D. (2022) · Vojnosanitetski pregled · doi:10.2298/vsp220209046c · Cited by 1
Level of Anxiety among Medical Students of the Preclinical and the Clinical Years in Saudi Arabia
Alrubayii, M. A., Elsaid, O., Zakaria, O. M., Alhashim, L. A., Alateeq, S. K., Almulhim, S. A., & Almulhim, A. Y. (2022) · Journal of Pharmaceutical Research International · doi:10.9734/jpri/2022/v34i627279 · Cited by 2
Frequency of Anxiety and Depression Among Medical Students During Viva Exam
Rafi, M. A., Shahzadi, N., Imtiaz, I., Fatima, M., Batool, M., Gul, S., & Naeem, A. (2023) · Pakistan Journal of Health Sciences · doi:10.54393/pjhs.v4i03.559 · Cited by 1
Nursing students perspectives and academic performance in anatomy and physiology before, during and after a stability period of COVID-19
Narnaware, Y., & Cuschieri, S. (2023) · Indian Journal of Clinical Anatomy and Physiology · doi:10.18231/j.ijcap.2023.005 · Cited by 1
A Process Evaluation of a Mobile App for Medical Students Aimed at Increasing Resilience and Decreasing Stigma in Mental Health
Fadel, N. M., Stoner, A. M., Berreta, K., Wilson, A., Ridgeway, L. M., Biber, D., & Garner, H. R. (2024) · Cureus · doi:10.7759/cureus.63054 · Cited by 1
“This epidemic of mental illness among medical students is present in schools across the United States and extends internationally [9,10].”
Background
Mental Health Factors and Learning Adaptability Among Nursing Students During the COVID-19 Pandemic: A Structural Equation Modelling Study
Li, L., Meng, W., Wang, L., Jiang, Y., Qingfang, K., & Shi, Z. (2024) · Teaching and learning in nursing · doi:10.1016/j.teln.2024.11.017 · Cited by 3
Levels and influencing variables of adaptation of students in medical university
Zhu, L.-Y., Huang, H., Kuang, Y., Huang, D., & Tang, C. (2024) · Work · doi:10.1177/10519815241289680 · Cited by 1
Unveiling the hidden struggles: A cross-sectional study on the mental health crisis among Chinese medical residents
Su, P., Zhu, X., Zheng, X. R., Liu, N., Li, R., & Wang, A. (2025) · Medicine · doi:10.1097/md.0000000000045500 · Cited by 1
“[19,20] For instance, a meta-analysis by Zeng et al reported pooled prevalence rates of 29% for depression and 21% for anxiety among medical students in China, [19] while studies focusing on residents during the COVID-19 pandemic also documented elevated but comparatively lower psychological…”
Anthropometric characteristics and health self-assessment of female university students
Spasojević, O. P., Ponorac, N., Spremo, M., & Radojčić, T. (2020) · Scripta Medica · doi:10.5937/scriptamed51-23360 · Cited by 1
Early warning analysis of mental health based on spatial density and rapid clustering
Gao, J., & Shi, G. (2021) · International Conference on Measuring Technology and Mechatronics Automation (ICMTMA) · doi:10.1109/icmtma52658.2021.00110 · Cited by 1
Factors predicting participation in higher education in Malaysia
Hashim, I. H. M., Alvani, S. R., Bono, S. A., Zaharim, N. M., Karupiah, P., Selamat, N. H., & Taib, F. M. (2022) · International Review of Education · doi:10.1007/s11159-022-09943-z · Cited by 1
Application of Latent Class Analysis in Assessing the Mental Health of Medical Students During the COVID-19 EpidemicPreprint
Liu, Z., Zhang, Y., Zhang, R., Liu, R., Liang, L., Wang, Y., Wei, Y., Zhu, R., & Wang, F. (2021) · Research Square · doi:10.21203/rs.3.rs-209660/v1 · Cited by 1

Authors: Zeng, W., Chen, R., Wang, X., Zhang, Q., & Deng, W.
Affiliations: Department of Graduate Medical Education
Department of Neurosurgery
Sichuan University (CN)
Corresponding author: Deng, Wei
ORCID: Chen, Ruiqi
Wang, Xingyue
Zhang, Qin
Deng, Wei
Venue: Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2019-05
Volume: 98
Issue: 18
Pages: e15337
ISSN: 0025-7974 (ISSN-L)
1536-5964
DOI: 10.1097/md.0000000000015337
PMC: PMC6504335
OpenAlex: W2942994841
Cited by: 286
References: 79
Citations by year: 2026: 28 · 2025: 42 · 2024: 49 · 2023: 45 · 2022: 45 · 2021: 46 · 2020: 29 · 2019: 2
FWCI: 5.59
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0 (unspecified)
Locations: Medicine (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: Health and Family Planning Commission of Sichuan Province
Fundamental Research Funds for the Central Universities (2012017yjsy200)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords: mental illness, medical students, depression, anxiety, suicidal ideation, eating disorders, prevalence, Chinese medical students, gender differences, age differences, mental health screening
MeSH terms: Adolescent, Adult, Anxiety, Feeding and Eating Disorders, Mental Disorders, China, Cross-Sectional Studies, Depression, Education, Medical, Female, Humans, Male, Mental Health, Students, Medical, Prevalence, Workplace, Young Adult, Suicidal Ideation

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Prevalence of mental health problems among medical students in China: A meta-analysis

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