Tracing two decades: Non-linear temporal trends in mental health among Chinese university students (2005-2024)

The mental health of university students has increasingly become a critical public health concern. Although numerous studies have investigated the prevalence of mental health issues among Chinese university students, mental health shifts over time and evolves alongside societal changes. This study aims to conduct in-depth research on the mental health trends over an extended period and the related societal factors.

49,573 Chinese university students were surveyed from 2005 to 2024, using the Symptom Checklist-90 to assess psychological distress. Logistic regression and non-linear regression models were employed to examine temporal trends and gender differences in mental health problems. Some societal indexes were investigated as related factors.

Inconsistent with previous studies, the results showed that mental health exhibited a non-linear trend over two decades, with significant periods of increase and decrease. Gender difference was significant, with female students generally reporting lower distress levels than males. Gender differences were also reflected in the heterogeneity of temporal trends in certain symptoms (e.g. suicidal ideation). The prevalence of overall mental health problems was negatively correlated with GDP per capita, proportion of tertiary school enrollment and number of mental-health-related policies.

The findings reveal complex non-linear trends, gender heterogeneity and societal-related factors in mental health among Chinese university students over past 20 years, highlighting the importance of continuous monitoring, gender-specific and socio-cultural-focused interventions.