School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
Department of Public Policy, City University of Hong Kong, Hong Kong, 999077, China.
BMC Med Educ. 2019 Sep 2;19(1):327. doi: 10.1186/s12909-019-1744-2.
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.
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.
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.
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.
中国医学生由于学业时间长、学术压力大、临床实习压力大等困难处境，面临着严重的抑郁和焦虑。尽管已有许多关于中国医学生抑郁或焦虑的实证研究，但以前没有关于这一主题的英文系统评价。本分析可以将中国的一般发现传达给世界其他地区。
对医学生的抑郁或焦虑及其相关决定因素进行了系统评价和荟萃分析。对三个中文数据库和三个英文数据库进行了检索，对语言没有限制。纳入的文献发表时间为 2000 年 1 月 1 日至 2018 年 4 月 1 日。
本综述共纳入了 21 篇研究中国医学生共 35160 人的文章。抑郁的患病率为 13.10%至 76.21%，平均为 32.74%，焦虑的患病率为 8.54%至 88.30%，平均为 27.22%。基于荟萃分析，性别、年级、居住地、对当前专业的满意度和人均月家庭收入与抑郁显著相关。年级和对当前专业的满意度与焦虑显著相关。其他风险因素则通过叙述性方法进行了描述。
中国医学生的抑郁平均患病率为 32.74%，焦虑平均患病率为 27.22%。抑郁和焦虑的决定因素包括个体因素、社会经济因素和环境因素。应根据确定的风险因素，对高危医学生采取更多措施。
