Incidence and Risk Factors of Depressive Symptoms in Chinese College Students

Previous surveys have shown an increase in the prevalence of depression among college students. However, knowledge on the incidence and risk factors of depressive symptoms in Chinese college students is limited. The aim of the present study was to determine the two-year cumulative incidence of depressive symptoms in Chinese college freshmen and identified related psychosocial risk factors.

A prospective survey was used to examine the cumulative incidence and risk factors of depressive symptoms (as assessed by the Centre for Epidemiological Study-Depression Scale, CES-D) among undergraduate freshmen. Five times (baseline, 5, 12, 17, and 24 months later) of self-reported data were collected from the students.

Of the initial 758 non-depressed respondents at baseline, 235 developed depressive symptoms (CES-D ≥ 16) during the follow-up period. The two-year cumulative incidence was estimated to be 42% and not significantly different between males and females (χ2=3.138, df =1, p=0.077). Logistic regression model showed that female gender (OR=0.43, 95% CI (0.28-0.64)), high level of self-esteem (OR=0.67, 95% CI (0.52-0.86)), and moderate exercise (OR=0.71, 95% CI (0.55-0.92)) reduced the onset of depressive symptoms; while high levels of baseline anxiety (OR=1.48, 95% CI (1.12-1.94)), Eysenck Personality Questionnaire-Neuroticism (OR=1.40, 95% CI (1.09-1.79)), concern over mistakes (OR=1.35,95% CI (1.07-1.71)), daytime sleepiness (OR=1.28, 95% CI (1.02-1.60)), mild exercise (OR=1.25, 95% CI (1.01-1.55)) increased the new onset of depressive symptoms.

The high two-year cumulative incidence indicates that depressive symptoms are an important mental problem in Chinese college students. The present findings on the risk factors of depressive symptoms in Chinese college students may be useful for the design of student health screening and intervention programs.