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. 2015 Dec 18;94(50):e2071. doi: 10.1097/MD.0000000000002071

Prevalence of Depression Among College-Goers in Mainland China

A Methodical Evaluation and Meta-Analysis

Cai Xiao Jiang 1, Zhan Zhan Li 1, Peng Chen 1, Li Zhang Chen 1
Editor: Trudie Somberg1
PMCID: PMC5058888  PMID: 26683916

Abstract

There are no proper statistics available to assess how much of a burden it is to them. This study was conducted to gauge the pooled prevalence and offer evidence in support of few prevention and regulation strategies.

A methodical literature search was conducted with the help of the Web of Knowledge, PubMed, Chinese Web of Knowledge, Wanfang, and Chongqing VIP databases. Furthermore, articles published from 2000 to 2014, reporting about the estimated prevalence of depression among college students in mainland China, were covered as well. In this study, a meta-analysis was deployed to approximate the overall prevalence of depression among college-goers in mainland China.

A total of 45 studies were conducted on 50,826 participants. The average pooled prevalence of depression was 30.39% (26.38–34.55%). Subgroup analyses showed that 29.45% (22.88–36.48%) were men and 28.65% (23.44–34.16%) were women. Furthermore, 28.10% (22.83–33.70%) were from the northern part and 32.44% (26.67–38.48%) were from the southern. The prevalence of depression was 30.45% (23.96–37.36%) for sample sizes of <500 subjects, 30.99% (25.08–37.23%) for samples with 500 to 1000 people, and 29.54% (33.32–37.33%) in case of samples with >1000 people. Publications between 2000 and 2006 showed a depression prevalence of 8.45% (22.34–35.00%), whereas 30.52% (21.30–40.61%) and 31.79% (27.31–36.45%) were the corresponding values according to publications during 2007 to 2011 and 2012 to 2014.

The prevalence of depression among college students in mainland China had reached the world's epidemic level.

INTRODUCTION

Symptoms of depression are quite prevalent. Severe mental illness is typically characterized by sad, nervous, hopeless, or anxious feelings.1 According to the World Health Organization,2 depression is now a health issue faced by people worldwide,3 particularly college students.4,5 A study by Ibrahim et al observed that the prevalence level of depression was 10 to 85%, with a weighted mean prevalence of 30.6% in case of university students all over the world.6 Depression prevalence is higher among college students compared to the general populace.7 This is because the time in university constitutes a special transitory period in terms of social interactions, changing of habitation, and financial circumstances.8 Also, during this period, the students have to make numerous vital decisions, which amplifies pressure on them. Symptoms of depression disturb the students’ tasks in day-to-day life, such as scholarly performance and social functioning.9 Additionally, the students’ activity and productivity may be devastated by depression.3

With the economic and cultural development in the modern-day China, an increasing number of people are getting the opportunities to join university. As a matter of fact, the current number of college students in mainland China is at an all-time high. Meanwhile, the competition has become stiffer and stiffer. Unfortunately, depression among college students too has become exceedingly prevalent and widespread.10 Without proper and prompt treatment, depression may lead to adverse effects in life. Numerous studies have reported that teenage depression heightens the depressive mood in adults,11 and extreme cases may even lead to suicide. It is, therefore, essential to study the status of depression among college-goers in mainland China, although there is a lack of a national survey to gauge the burden of depression on the said population. This study carried out a systematic review and meta-analysis of depression among college students in mainland China to approximate the pooled prevalence and come up with evidence in support of depression prevention and regulation strategies.

METHODS

Ethical Approval

The ethical approval was not necessary in the review articles.

Literature Search

Written works on depression among students in mainland China were obtained by perusing through the PubMed, Wanfang, Web of Knowledge, Chinese Web of Knowledge, and Chongqing VIP databases. The literature was restricted to the Chinese and/or English language and articles published during the period between January 2000 and September 2014. The following are the keywords that were used during the search in all the databases: depression, depressive disorders, depressive symptoms, university students, prevalence, college students, undergraduate students, adolescents, and/or young adults. Two independent reviewers (PC and ZZL) went through all the identified titles and abstracts. The study exempted clinical trials.

Criteria for Incorporation and Exclusion

In the methodical review and meta-analysis, the selected studies had to meet the following criteria for inclusion: (1) cross-sectional study; (2) the study samples had to be college-goers in mainland China; (3) the studies’ objectives were to assess the prevalence of depression; (4) depression had to be monitored using a self-rating depression scale (SDS).

Exclusion criteria were (1) utilizing other scales other than SDS to screen depression; (2) repetitive study and review; (3) insufficient reporting of results; (4) clinical trials.

Extraction of Data

Data was extracted by 2 investigators who separately used a standardized data extraction form from the selected studies. In case of a dispute between the 2 investigators, a discussion was held to arrive at an agreement. Information obtained from each study included: author's first name, year of publication, region, type of study, age, gender ratio (male/female), size of sample, number of students suffering from depression, and prevalence.

Statistical Analysis

The pooled prevalence of depression and subgroups were computed using StatsDirect. The models used were the fixed-effects model or random-effects model. The model to be used was determined by whether or not there existed heterogeneity among studies. If I2 exceeded 50%, the random model was used. Subgroup analyses were also conducted based on gender, geographical location, size of sample, and year of publication. Cochran's Q statistic and the I2 statistic were used to evaluate heterogeneity among studies. In the Q test, P < 0.10 indicated lack of heterogeneity among studies. P < 0.10 rather than 0.05 was deemed as significant heterogeneity for the χ2-based Q testing. A value of 0% for I2 indicated lack of heterogeneity, whereas an increasing percentage was an indicator of higher heterogeneity. In other words, I2 was used to estimate total variation across studies that were due to heterogeneity rather than chance (<25% was to be considered low heterogeneity, 25–50% as moderate, and > 50% as high-level heterogeneity). The funnel plot was used to examine potential publication bias. Funnel plot asymmetry was evaluated using Egger's linear regression test, where P < 0.05 was considered to be illustrative of statistically significant publication bias.

RESULTS AND DISCUSSION

Search Result

A thorough search of available databases yielded 1848 related articles, and after a careful examination of each article's titles and abstracts, a total of 197 articles were retrieved. Of the retrieved articles, an additional 152 articles were deemed ineligible after careful reading and were therefore excluded. Finally, 45 articles whose dates of publication were from January 2000 to September 2014 were deemed eligible and were thus included in the meta-analysis. Figure 1 showcases the flow diagram of the search process.

FIGURE 1.

FIGURE 1

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Flow diagram of included/excluded studies.

Features of Included Studies

The reviewed articles documented population sizes ranging from 176 to 6009, with a total sample size of 50,826. Twenty-one of these articles documented results from Northern China (n = 14,968), whereas 24 articles documented results from Southern China (n = 35,858). Additionally, 26 of the included articles provided individual data for both men and women. Table 1 indicates the characteristics of each study on the prevalence of depression.

TABLE 1.

Characteristics of Studies on the Prevalence of Depression

graphic file with name medi-94-e2071-g002.jpg

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Prevalence of Depression

College students in mainland China showed an overall depression prevalence value that ranged between 3.02% and 55.80% and an overall meta-analysis prevalence of 30.39% (95% CI: 26.38–34.55%, Fig. 2). The prevalence of depression in college-goers of mainland China also showed indication of high-level heterogeneity between the studies (I2 = 99%, P < 0.001). The population of college students is further subgrouped according to gender, geographical location, sample size, and publication year, and the pooled prevalence of these subgroups is presented in Table 2. The summarized prevalence of depression in men (29.45%, 95% CI: 22.88–36.48%, Fig. 3) was found to be higher (OR = 1.02, 95% CI: 0.95–1.10) than that of females (28.65%, 95% CI: 23.44–34.16%, Fig. 4). It was also apparent that the pooled prevalence estimate increased over time. For example, the pooled prevalence estimate was 28.45% (95% CI: 22.34–35.00%) from 2000 to 2006, increasing to 30.52% (95% CI: 21.30–40.61%) during 2007 to 2011, and further increasing to 31.79% (95% CI: 27.31–36.45%) during 2012 to 2014. Information regarding the heterogeneity of the data as well as the publication bias is depicted in Table 2.

FIGURE 2.

FIGURE 2

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Forest plot of prevalence of depression for total college students.

TABLE 2.

Prevalence of Depression According to Different Categories

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FIGURE 3.

FIGURE 3

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Forest plot of prevalence of depression for men.

FIGURE 4.

FIGURE 4

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Forest plot of prevalence of depression for women.

Publication Bias

Begg's test and Egger's test were used to give value to the publication bias. No significant bias in the included studies (P = 0.6198) was revealed using the modified Begg's linear regression test. However, a significant publication bias in the included studies was observed using Egger's test (P < 0.0001) (Table 2).

DISCUSSION

A total of 45 studies covering >50,000 college students were included in this systematic study. The meta-analysis, conducted as part of this study, found that 30.39% (26.38–34.55%) of mainland Chinese college students suffered from depression. The rate is higher than the 22.8% incidence found in the older adult population of China.57 The study's observation of depressive symptoms was higher than the rate in the Chinese general population (7.2%).58 The results indicated the following: there are certain unique characteristics of college students, such as increased social interactions and changing residential and financial situations, which may increase the occurrence of depression.8 Furthermore, the students have to deal with a very difficult period of transition. This creates additional stress in both their future employment situations and lives in general. During this period, college students are forced to make key decisions that would increase the stress and pressure that is placed on them. Thus, it can be said that their student status may make them prone to depression.6

The prevalence of depression in college students over time has been noted to have increased by many studies.59,60 These findings are consistent with our results. The following reasons are cited to explain these trends. First, the cultural and economic development of the modern Chinese society has given more people the opportunity to get a university education. The rise in college enrollment expansion in China has created a serious problem with respect to the creation of adequate employment opportunities for Chinese college graduates. The surplus of underemployed college graduates means increased stress and pressure in finding adequate employment. Second, the major lifestyle and economic changes in China may impact interpersonal communication styles, further increasing pressure on college students. This could also be the result of increasing numbers of publications.

There are differences observed in the occurrence of depression between different countries as well as within the same country. A possible reason for these differences could be race. Steptoe et al found that there were highly significant differences in the prevalence of depression between countries. The highest levels were found in Korea, Taiwan, South Africa, Japan, and Thailand, and the lowest values in the Netherlands, Venezuela, and Belgium.61 The overall prevalence ranged between 3.02% and 55.80% in the systematic review. The overall meta-analysis prevalence was 30.39%. This was higher than in Korea,62 Turkey,63,64 US,65 Germany,66 and the UK,67 and lower than in India,68 Thailand,69 Poland,66 Iran,4 Ghana,70 and Bulgaria.66 The prevalence rates of depression found in a world-wide systematic review of university students ranged from a low of 10% to a high of 85% with a weighted mean prevalence of 30.6%. As these results are similar to our results,6 it is clear that the prevalence of depression among mainland China's college students was at the world's epidemic level. Also, as different appraisal standards and measurement tools were utilized in these studies, there could have been the difference in prevalence rates.4

Among college students, gender has been indicated to have a very important influence on the depression epidemic. Female students face greater degrees of depression,61,71,72 and the depression is more prevalent among women than men. Women have more tendencies to have moderate to serious depression (18.0% vs 9.0%)73 than men, according to Thomas L. Schwenk. The divergence may be due to social and cultural aspects. Another element that plays a significant role in the difference is biological conditions. In mainland China, male students have greater level of depression as researched by Tang et al. The following scenarios are the defined reasons for the difference: in old culture, the family and society have greater expectations from men; thus, men are more vulnerable to greater stress than women. Also, it might further intensify depression to overpower the depression mood74 because men are more prone to take the negative course. However, our investigation revealed that 29.45% of men and 28.65% of women experienced depression and we did not find any difference among gender. It does not have any effect on the development of depression on college students. Other past research too did not find difference due to gender.6,67,75 Sarokhani discovered that the prevalence of depression in a subgroup in Iran, which includes male and female students, was 28% (95% CI: 26–30%) and 23% (95% CI: 22–24%). Furthermore, no difference was found between the genders.4 In China, the idea of equality among men and women is becoming more and more accepted, which is the possible reason for the outcome of the study. Men and women tend to experience equal rights, and so the stress experienced by the college students may be the same.

The regional conflict might also affect the epidemiology of depression. Our research shows that the combined prevalence of depression in China's southern part was 32.44% (95% CI: 26.67–38.48%), whereas the combined prevalence in China's northern part was 28.10 (95% CI: 22.83–33.70%). The prevalence is more significant in the south than in the north. This analysis might be due to the difference in the economic status and medical conditions of the different regions. The southern region has a better economic status and medical condition compared to the north, which results in the depression being more distinguishable in the south. In other words, social, economic, and cultural environments are significant factors that influence students’ mental health.10

Only the outcome from the self-rating depression scale (SDS) was covered in this research. The SDS was developed in 1965 by Zung. It is a 20-item self-report assessment of depressive symptom severity that would reveal symptoms of depression and its severity entirety. The SDS is not be influenced by aspects such as age, gender, and economic situations, and is easy to complete. The scale is applicable to all sorts of professional and cultural traditions, typical age groups, or all types of mental patients. The SDS is a broadly used and a well-certified self-report instrument. We exclusively selected SDS in this meta-analysis to ensure that the measure of study was consolidated and the outcome was trustworthy.

There are some probable restrictions the meta-analysis may come across that might affect the outcome. First, the research that we did was limited to articles that were published in English and Chinese, and the unpublished studies that were not included may have caused an oversight. In other words, this action might have resulted in the exclusion of few articles about the prevalence of depression on college students. Second, as the study samples of the covered studies were not chosen in random, there might have been some preference while choosing and confounding, which could not be avoided. Third, this research involves publication bias. Lastly, extreme heterogeneity occurred in this research and when the study of the subgroup was done, heterogeneity still persisted. In addition, there was a dearth of essential data to search for the root of heterogeneity.

CONCLUSIONS

To conclude, the prevalence of depression among college students in mainland China was assessed by meta-analysis, and the results indicate that the prevalence is at an epidemic level observed worldwide.

ACKNOWLEDGMENTS

We thank all our colleagues working in the Department of Epidemiology and Health Statistics, School of public health of Central South University.

Footnotes

Abbreviations: CI = confidential interval, OR = odds ratio, SDS = self-rating depression scale.

Competing interests: the authors declare that they have no competing interests.

Authors’ contributions: LC designed the experiments and drafted the manuscript. CJ designed the experiments, performed the experiments, analyzed the data, and drafted the manuscript. ZZL performed the experiments and helped to draft the manuscript. PC analyzed the data and helped to draft the manuscript. All authors read and approved the final manuscript.

The authors have no conflicts of interest to disclose.

REFERENCES

  • 1.Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003; 23:3095–3105. [DOI] [PubMed] [Google Scholar]
  • 2.Chen L, Wang L, Qiu XH, et al. Depression among Chinese university students: prevalence and socio-demographic correlates. PLOS ONE 2013; doi:10.1371/journal.pone.0058379. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Diana S, Ali D, Yousef V, et al. Prevalence of depression among university students: a systematic review and meta-analysis. Depress Res Treat 2013; doi:10.1155/2013/373857. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Bostanci M, Ozdel O, Oguzhanoglu NK, et al. Depressive symptomatology among university students in Denizli, Turkey: prevalence and sociodemographic correlates. Croat Med J 2005; 1:96–100. [PubMed] [Google Scholar]
  • 5.Eller T, Aluoja A, Vasar V, et al. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety 2006; 4:250–256. [DOI] [PubMed] [Google Scholar]
  • 6.Mikolajczyk RT, Maxwell AE, Ansari W, et al. Prevalence of depressive symptoms in university students from Germany, Denmark, Poland and Bulgaria. Soc Psychiatry Psychiatr Epidemiol 2008; 2:105–112. [DOI] [PubMed] [Google Scholar]
  • 7.Ovuga E, Boardman J, Wasserman D. Undergraduate student mental health at Makerere University, Uganda. World Psychiatry 2006; 1:51–55. [PMC free article] [PubMed] [Google Scholar]
  • 8.Kessler RC, Walters EE. Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depress Anxiety 1998; 1:3–14. [DOI] [PubMed] [Google Scholar]
  • 9.Tang H, Ding LL, Song XL, et al. Meta-analysis of detection rate of depressed mood among Chinese college students from 2002 to 2011. J Jilin Univ (Medicine Edition) 2013; 5:965–969. [Google Scholar]
  • 10.Reinherz HZ, Paradis AD, Giaconia RM, et al. Childhood and adolescent predictors of major depression in the transition to adulthood. Am J Psychiatry 2003; 12:2141–2147. [DOI] [PubMed] [Google Scholar]
  • 11.Chen XQ, Zhang JF. The relationship between depressive mood and coping style of college students from normal university. Chin J School Health 2011; 12:1510–1511. [Google Scholar]
  • 12.Yang YF, Wu D, Guan MJ, et al. An analysis of depression among 331 medical college students. J Baotou Medical College 2012; 5:29–30. [Google Scholar]
  • 13.Yang XH. An epidemiological investigation of depression among 3744 freshmen. China J Health Psychol 2007; 6:499–501. [Google Scholar]
  • 14.Cui R, Shi P, Shen GM, et al. Binary logistic regression analysis of risk factors of undergraduate depression in Anhui district. J Bengbu Med Coll 2013; 4:455–458. [Google Scholar]
  • 15.Jiang DQ, Yao RY, Yuan CJ, et al. Analysis of status of depression and anxiety and influencing factors for college students in Bengbu district. J Hyg Res 2011; 4:541–543. [Google Scholar]
  • 16.Zhang QJ. Incidence rate of depression and related factors analysis in undergraduates of different crowd from normal university. Chin J Clin Rehabil 2005; 32:92–93. [Google Scholar]
  • 17.Xu Y, Zhu XX, Zhao JB, et al. An epidemiological investigation of mental health status among 1750 college students. Chin J Primary Med Pharm 2003; 10:1073. [Google Scholar]
  • 18.Fu GF. The relationship between undergraduate students’ social supports and depression. Med Soc 2010; 8:83–84.90. [Google Scholar]
  • 19.Zheng YF, Zhou QY. Study on mental health status of college student and its influential factors. Mod Prev Med 2008; 24:4825–4827. [Google Scholar]
  • 20.Wei YM, Zhang J. Relationship between undergraduate students’ life events and cognitive emotion regulation and depression. Chin J Clin Psychol 2008; 6:582–583. [Google Scholar]
  • 21.Wang H, Hao JH, Fu JL, et al. Association between physical activity and depressive symptoms among college students. Chin J School Health 2013; 5:540–543.546. [Google Scholar]
  • 22.Hao LN, Hao WP. Depressive emotion and correlation factors in college students. J Clin Psychosom Dis 2011; 4:342–344. [Google Scholar]
  • 23.Cui QX, Wang ZX. Study on depression status and its Influencing factors among college students. Chin Health Service Manage 2014; 8:629–630.633. [Google Scholar]
  • 24.Ye ZY, Zhang XY. Investigation on influencing factor of depression in university student. Health Med Res Pract 2013; 4:56–57. [Google Scholar]
  • 25.Shi JF. Incidence rate of depression and physical quality correlation analysis in undergraduates. Chin J Manag Chin Med 2006; 11:21–22. [Google Scholar]
  • 26.Liao L. The research on college students’ depression and related factors. J Zunyi Normal Coll 2013; 1:97–99.104. [Google Scholar]
  • 27.Xiao WZ, Zhou H, Xia Y, et al. Depression status and its risk factors among the college students. Chin J Behav Med Sci 2006; 7:647–649. [Google Scholar]
  • 28.Gu FF, Guo WH, Tao GS. Relationship between college students’ self-esteem, locus of control, social support and depression. Chin J Health Psychol 2012; 5:771–773. [Google Scholar]
  • 29.Niu RH, Jiang GL, Fang ZY. Status of coping style, anxiety and depression of college freshmen and their relationship. Chin J Health Educ 2010; 7:548–550. [Google Scholar]
  • 30.Wei YY, Yan YW, Lin RM, et al. Correlation between depression and sleep quality among college students in Fuzhou City. Chin J School Doctor 2011; 3:172–173.175. [Google Scholar]
  • 31.Shi XL, Liu YY, Liu SY, et al. Analysis of suicidal ideation and relationship with depressive disorder of Guangxi college students and countermeasures research. Popular Sci Technol 2013; 164:114–117. [Google Scholar]
  • 32.Zhou R, Yang CH, Pan JY. Depression status and its related factors among the medical college students in Guangzhou. Nerv Dis Ment Hygiene 2003; 5:367–368. [Google Scholar]
  • 33.Chen JS, Peng DY, Liang YB, et al. Investigation and analysis on smiling depression of college students in Guangzhou City. Chin J Gen Pract 2009; 2:191–193. [Google Scholar]
  • 34.Ye QH, Tang K, Chen ZB, et al. Investigation on depression of Guilin university students and intervention. Chin J Health Psychol 2012; 8:1185–1187. [Google Scholar]
  • 35.Zeng Q, Li L, Tang SY, et al. Analysis on influential factors and prevention way of depression among college students in a certain university. Practical Prevent Med 2006; 6:1412–1413. [Google Scholar]
  • 36.Qu W, Ding N, Pan FM, et al. Depression and anxiety status and related factors of medical college students in a vocational college of Anhui province. Anhui Med Pharm J 2014; 1:71–74. [Google Scholar]
  • 37.Zhang YS. The research of status of depression and anxiety and coping modes for medical college students. Chin J School Health 2001; 2:157. [Google Scholar]
  • 38.Han L, Li MF. Relationship among the rural college student's depression, social support and resilience. Chin J School Health 2014; 3:385–387.390. [Google Scholar]
  • 39.Zhang FM, Chen JW, Xu HJ. Analysis on the status of anxiety and depress of students in a university in Shandong. Mod Prev Med 2014; 13:2399–2400.2425. [Google Scholar]
  • 40.Zeng ZF, Zhang H. Investigation on depression of university students in northern Shanxi district. J Yan’an Vocational Tech Inst 2013; 1:3–5. [Google Scholar]
  • 41.Zhang RH. Investigation on depression of Shangrao normal college students. J Baotou Med Coll Med 2012; 3:23–26. [Google Scholar]
  • 42.Chen XQ, Zhang JF. The research on depression and coping mode of normal college students. Chin J School Health 2011; 12:1510–1511. [Google Scholar]
  • 43.Chai XR. Study on depression status of college students. J Yangtze Univ (Nat Sci Edit) 2011; 1:198–200. [Google Scholar]
  • 44.Zou FR, Wang Y, Zhang JX, et al. A study of psychological education on anxiety and depression of university students. Chin J Clin Psychol 2007; 5:557–558. [Google Scholar]
  • 45.Xi MJ. Depression status of the students in Xingtai University and its cause analysis. J Xingtai Univ 2010; 1:12–13. [Google Scholar]
  • 46.Zhai DC, Pan XD, Li HY, et al. Survey on psychological and social factors of depression in medical college students. Chin J Public Health 2005; 4:392–393. [Google Scholar]
  • 47.Wang T, Wang NW, Hu HQ, et al. Relationship of depression, automatic thoughts and personality in medical college students. J Third Med Univ 2007; 5:442–444. [Google Scholar]
  • 48.Huang CF, Zhong P, Zhang GY, et al. Study on the depression and its related factor s among the medical students. Int Chin Appl Psychol J 2004; 1:66–67. [Google Scholar]
  • 49.Yang BF, Liu DG, Zhang QM. Analysis of sleep quality and correlative factors in medical college students. Chin J School Doctor 2000; 6:404–406. [Google Scholar]
  • 50.Ren XH, Liu ZX, Sun HW. Depression epidemiological studies of college students. J Harbin Med Univ 2013; 5:471–472.474. [Google Scholar]
  • 51.Mei L, Zhang FY, Liang Y, et al. Analysis of the mental health status between medical and non- medical students. China Med Equipment 2006; 3:46–48. [Google Scholar]
  • 52.Wei XQ, Guang WP, Li WY, et al. Analysis of psycho logical test of anxiety, depression and psychiatric symptom s in medical college students. J Chin Med Univ 2005; 1:47–48. [Google Scholar]
  • 53.Yang CX, Shi SC, Jia SS, et al. Correlation study of anxiety, depression and suicide idea among medical college students. J Xinxiang Med Coll 2012; 11:840–842. [Google Scholar]
  • 54.Wang J, Jin YL, Chen Y, et al. Correlation analysis between depressed mood and life events among medical college students. J Wannan Med Coll 2013; 2:151–153. [Google Scholar]
  • 55.Xu LM, Guan WP, Wei XQ, et al. A study on anxiety and depression of medical university students in junior grade. Health Psychol J 2002; 1:24–25. [Google Scholar]
  • 56.Yu XF. Depressive symptoms and related factors analysis in English major college students. Chin J Dis Control Prev 2011; 2:145–148. [Google Scholar]
  • 57.Nie XL, Wang HY, Sun F, et al. Detection rate of depression among community-dwelling older adults in China: A systematic review and updated meta-analysis of studies in 2000–2012. Chin Ment Health J 2013; 11:805–814. [Google Scholar]
  • 58.Lin XQ, Zhong WL, Lin SG. The epidemiological investigation on the prevalence of depression among the permanent residents aged 18 and above in Fujian province. Chronic Pathemathol J 2014; 7:523–525. [Google Scholar]
  • 59.Ibrahim AK, Kelly SJ, Adams CE, et al. A systematic review of studies of depression prevalence in university students. J Psychiatr Res 2013; 47:391–400. [DOI] [PubMed] [Google Scholar]
  • 60.Ceyhan A, Ceyhan E, Kurty Y. Investigation of university students’ depression. Eurasian J Educ Res 2009; 36:75–90. [Google Scholar]
  • 61.Denise L, Terrie M, Avshalom C, et al. Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. J Consult Clin Psychol 1996; 64:552–562. [PubMed] [Google Scholar]
  • 62.Andrew S, Akira T, Yoshiyuki T, et al. Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. Int J Behav Med 2007; 2:97–107. [DOI] [PubMed] [Google Scholar]
  • 63.Roh M, Jeon HJ, Kim H, et al. Factors influencing treatment for depression among medical students: a nationwide sample in South Korea. Med Educ 2009; 2:133–139. [DOI] [PubMed] [Google Scholar]
  • 64.Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol 2008; 8:667–672. [DOI] [PubMed] [Google Scholar]
  • 65.Bostanci M, Ozdel O, Oguzhanoglu NK, et al. Depressive symptomatology among university students in Denizli, Turkey: prevalence and sociodemographic correlates. Croatian Med J 2005; 1:96–100. [PubMed] [Google Scholar]
  • 66.American College Health Association. American College Health Association-National College Health Assessment Spring 2008 Reference Group Data Report (abridged): the American College Health Association. J Am Coll Health 2009; 5:477–488. [DOI] [PubMed] [Google Scholar]
  • 67.Mikolajczyk RT, Maxwell AE, Meier VNS, et al. Depressive symptoms and perceived burdens related to being a student: Survey in three European countries. Clin Pract Epidemiol Ment Health 2008; 4:19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Thelma AQ, Diana FW, Richard AP, et al. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open 2012; doi:10.1136/bmjopen-2012-001519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.Jagdish RV, Anusha P, Himanshu S. Depression and stigma in medical students at a private medical college. Indian J Psychol Med 2014; 3:246–254. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Ratanasiripong P. Mental health of Muslim nursing students in Thailand. ISRN Nursing 2012; doi:10.5402/2012/463471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71.Kwaku OA, Johnny AA. Prevalence and determinants of depressive symptoms among university students in Ghana. J Affect Disord 2015; 171:161–166. [DOI] [PubMed] [Google Scholar]
  • 72.Sigmon ST, Pells JJ, Boulard NE, et al. Gender differences in self-reports of depression: the response bias hypothesis revisited. Sex Roles 2005; 5-6:401–411. [Google Scholar]
  • 73.Sokratous S, Merkouris A, Middleton N, et al. The prevalence and socio-demographic correlates of depressive symptoms among Cypriot university students: a cross-sectional descriptive co-relational study. BMC Psychiatry 2014; 14:235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 74.Thomas LS, Lindsay D, Leslie AW. Depression, stigma, and suicidal ideation in medical students. JAMA 2014; 11:1181–1190. [DOI] [PubMed] [Google Scholar]
  • 75.Huang ME, Guo DJ. Emotion regulation and depression of college students. Chin Ment Health J 2001; 6:438–441. [Google Scholar]

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