2010~2020中国内地大学生心理健康问题检出率的元分析

doi:10.3724/SP.J.1042.2022.00991

摘要/Abstract

摘要：

估计我国大学生心理健康问题的检出率, 能够为心理健康政策完善和教育活动开展提供证据支持。对2010~2020年我国大学生主要心理健康问题检出率及影响因素进行元分析, 结果表明, 睡眠问题、抑郁、自我伤害在大学生中较为突出; 近10年, 大学生焦虑、抑郁、睡眠问题和自杀未遂的检出率显著上升, 自我伤害的检出率显著下降; 测量工具、检出标准和检出时间是导致检出率大小不一的关键因素; 整体而言, 东北和中部地区大学生的心理健康情况优于西部和东部大学生; 性别、生源地、独生与否对大学生心理健康问题检出率的影响均不显著。未来应重视研制适合我国大学生的心理健康测评工具并确定检出标准, 同时据此积极开展心理行为问题的筛查与控制。

关键词: 心理健康, 大学生, 检出率, 元分析

Abstract:

College students are a huge part and an important member of the young people. Their physical and mental health not only directly affects their own long-term development, but also has a significant influence on the future of the nation. Therefore, the mental health of college students has become the focus of families, schools and even the whole society. In recent years, some studies have conducted meta-analyses on the prevalence of a certain mental health problem (such as depression and sleep problem) among college students in China, but such studies cannot reflect the mental health status of college students comprehensively. And some of the previous studies cannot reflect the current status of contemporary college students’ mental health. Furthermore, the selection of moderator variables was not comprehensive enough to reveal the key factors affecting the prevalence. Therefore, we employed a meta-analysis in this study to estimate the prevalence of typical mental health problems among college students in mainland China from 2010 to 2020, and the moderating effects of publication year, measurement tools and detection standards, detection time, region, birthplace, only child or not were further analyzed. For the selection of indicators, mental health problems were divided into two categories: internalizing problems and externalizing problems. The indicators of internalizing problems include anxiety, depression, sleep problem, somatization, and suicidal ideation, while the indicators of externalizing problems include nonsuicidal self-injury and suicide attempt.
Through the process of literature search and selection, 128 studies (136 effect sizes) of anxiety, 237 studies (244 effect sizes) of depression, 56 studies (58 effect sizes) of sleep problem, 49 studies (49 effect sizes) of somatization, 31 studies (31 effect sizes) of nonsuicidal self-injury, 51 studies (51 effect sizes) of suicide ideation, and 8 studies (8 effect sizes) of suicide attempt were included in this study. Homogeneity test indicated that random effects model was appropriate for the meta-analysis. The p-curve analysis illustrated no publication bias. Ultimately, the results of the main effect test showed that the prevalence rates of sleep problem, depression, nonsuicidal self-injury, anxiety, suicidal ideation, somatization, and suicide attempt were 23.5%, 20.8%, 16.2%, 13.7%, 10.8%, 4.5%, and 2.7%, respectively. The results indicate that internalizing problems, especially sleep problem and emotional problem, are more serious among Chinese college students compared to externalizing problems.
The results of the moderating effect indicated that (1) The prevalence of anxiety, depression, sleep problem and suicide attempt among college students has increased significantly in the last decade, while the prevalence of self-harm has declined significantly; (2) The prevalence of anxiety, depression, sleep problem, and somatization varied significantly between measurement tools and detection standards, and the prevalence of suicidal ideation differed to a significant extent depending on the detection time. Therefore, the fluctuation of prevalence was accounted by measurement tools, detection standards and detection time. (3) There existed obvious regional differences in the prevalence of sleep problem and suicidal ideation, with the feature of the worst mental health among college students in western China and better mental health among college students in northeastern and central China. (4) The prevalence of mental health problems among demographical variables including gender, only child or not, and birthplace showed no significant difference, which indicated that gender, only child or not, urban or rural areas were not the critical factors influencing college students’ mental health.
In summary, by employing the method of meta-analysis, this study is the first study to systematically investigate the prevalence of the typical mental health problems of college students in mainland China from 2010 to 2020. The results clarified the controversy over the inconsistent prevalence in previous studies and explored the main reasons for the inconsistent findings. Thus, this meta-analysis is conducive to promoting subsequent studies and educational practice.

Key words: mental health, college students, prevalence, meta-analysis

陈雨濛, 张亚利, 俞国良. (2022). 2010~2020中国内地大学生心理健康问题检出率的元分析. 心理科学进展 , 30(5), 991-1004.

CHEN Yumeng, ZHANG Yali, YU Guoliang. (2022). Prevalence of mental health problems among college students in mainland China from 2010 to 2020: A meta-analysis. Advances in Psychological Science, 30(5), 991-1004.

图/表 9

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心理健康问题种类	k	被试数	效应值及95% 的置信区间			异质性检验
心理健康问题种类	k	被试数	检出率	下限	上限	I²	p
焦虑	136	209000	0.137	0.12	0.16	99.29	< 0.001
抑郁	244	407026	0.208	0.19	0.23	99.44	< 0.001
睡眠问题	58	137418	0.235	0.20	0.27	99.46	< 0.001
躯体化	49	83437	0.045	0.03	0.06	98.81	< 0.001
自杀意念	51	334070	0.108	0.10	0.12	99.15	< 0.001
自我伤害	31	126130	0.162	0.13	0.20	99.52	< 0.001
自杀未遂	8	36512	0.027	0.02	0.04	96.80	< 0.001

心理健康问题种类	k	被试数	效应值及95% 的置信区间			异质性检验
心理健康问题种类	k	被试数	检出率	下限	上限	I²	p
焦虑	136	209000	0.137	0.12	0.16	99.29	< 0.001
抑郁	244	407026	0.208	0.19	0.23	99.44	< 0.001
睡眠问题	58	137418	0.235	0.20	0.27	99.46	< 0.001
躯体化	49	83437	0.045	0.03	0.06	98.81	< 0.001
自杀意念	51	334070	0.108	0.10	0.12	99.15	< 0.001
自我伤害	31	126130	0.162	0.13	0.20	99.52	< 0.001
自杀未遂	8	36512	0.027	0.02	0.04	96.80	< 0.001

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具+检出标准	206.89	7	< 0.001	BAI (45)	3	0.067	0.03	0.13
				CCSMHS (68)	3	0.016	0.01	0.03
				DASS (8)	5	0.469	0.34	0.61
				SAS (>50)	4	0.148	0.09	0.25
				SAS (≥50)	58	0.181	0.16	0.21
				SCL-90(2)	21	0.170	0.14	0.21
				SCL-90(2.5)	3	0.026	0.01	0.05
				SCL-90(3)	20	0.039	0.03	0.05
检出时间	0.001	1	0.98	1周	124	0.141	0.12	0.16
检出时间	0.001	1	0.98	2周	3	0.142	0.06	0.31
性别	0.26	1	0.61	男生	45	0.151	0.12	0.19
性别	0.26	1	0.61	女生	45	0.138	0.11	0.17
独生与否	0.24	1	0.62	独生	14	0.205	0.14	0.29
独生与否	0.24	1	0.62	非独生	14	0.180	0.12	0.26
生源地	0.18	1	0.67	城镇	18	0.154	0.11	0.22
生源地	0.18	1	0.67	农村	18	0.171	0.12	0.24
区域	5.43	3	0.14	东北	9	0.108	0.06	0.19
				东部	41	0.154	0.12	0.20
				中部	36	0.159	0.12	0.21
				西部	30	0.106	0.08	0.14

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具+检出标准	206.89	7	< 0.001	BAI (45)	3	0.067	0.03	0.13
				CCSMHS (68)	3	0.016	0.01	0.03
				DASS (8)	5	0.469	0.34	0.61
				SAS (>50)	4	0.148	0.09	0.25
				SAS (≥50)	58	0.181	0.16	0.21
				SCL-90(2)	21	0.170	0.14	0.21
				SCL-90(2.5)	3	0.026	0.01	0.05
				SCL-90(3)	20	0.039	0.03	0.05
检出时间	0.001	1	0.98	1周	124	0.141	0.12	0.16
检出时间	0.001	1	0.98	2周	3	0.142	0.06	0.31
性别	0.26	1	0.61	男生	45	0.151	0.12	0.19
性别	0.26	1	0.61	女生	45	0.138	0.11	0.17
独生与否	0.24	1	0.62	独生	14	0.205	0.14	0.29
独生与否	0.24	1	0.62	非独生	14	0.180	0.12	0.26
生源地	0.18	1	0.67	城镇	18	0.154	0.11	0.22
生源地	0.18	1	0.67	农村	18	0.171	0.12	0.24
区域	5.43	3	0.14	东北	9	0.108	0.06	0.19
				东部	41	0.154	0.12	0.20
				中部	36	0.159	0.12	0.21
				西部	30	0.106	0.08	0.14

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具+检出标准	402.07	15	< 0.001	BDI-Ⅰ(14)	4	0.219	0.13	0.34
				BDI-Ⅰ(5)	3	0.459	0.30	0.63
				BDI-Ⅱ(14)	6	0.184	0.12	0.27
				CES-D (16)	19	0.435	0.37	0.50
				CES-D (20)	5	0.231	0.15	0.34
				DASS (10)	5	0.286	0.19	0.41
				PHQ-9(10)	3	0.126	0.07	0.22
				SCL-90(>2)	5	0.195	0.12	0.29
				SCL-90(≥2)	45	0.179	0.15	0.21
				SCL-90(2.5)	4	0.039	0.02	0.07
				SCL-90(3)	29	0.044	0.04	0.06
				SDS (>50)	4	0.213	0.13	0.33
				SDS (>53)	3	0.282	0.16	0.44
				SDS (≥50)	36	0.322	0.28	0.37
				SDS (≥53)	41	0.282	0.25	0.32
				CCSMHS(69)	3	0.050	0.03	0.10
检出时间	0.16	1	0.69	1周	213	0.209	0.19	0.23
检出时间	0.16	1	0.69	2周	22	0.222	0.17	0.29
性别	0.10	1	0.75	男生	90	0.258	0.23	0.29
性别	0.10	1	0.75	女生	90	0.250	0.22	0.28
独生与否	0.51	1	0.48	独生	31	0.318	0.28	0.36
独生与否	0.51	1	0.48	非独生	31	0.297	0.26	0.34
生源地	0.02	1	0.90	城镇	41	0.280	0.24	0.32
生源地	0.02	1	0.90	农村	41	0.284	0.25	0.33
区域	2.81	3	0.42	东北	17	0.190	0.13	0.26
				东部	71	0.191	0.16	0.22
				中部	60	0.231	0.19	0.27
				西部	62	0.207	0.17	0.25