From East to West: Regional Disparities in Depressive and Anxious Symptoms Among Chinese Adolescents

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Abstract
Background: To explore the prevalence and determinants of depressive and anxious symptoms among adolescents in China, focusing on regional disparities, cognitive function, psychological resilience, and family functioning. Methods: A total of 39854 adolescents, aged 12– 18 years, participated in this survey. Data were collected using SoJump software between January 8 and January 25, 2023. The Patient Health Questionnaire-9, Generalized Anxiety Disorder Questionnaire-7, Cognitive Deficits Questionnaire-5, Connor–Davidson Resilience Scale-10, and Family APGAR Questionnaire were completed. Statistical analyses, including descriptive statistics, correlation analysis, and multivariate linear regression, were conducted to explore the relationships between variables. Results: Significant regional differences were observed in depression (6.16 ± 6.16 versus [vs] 5.18 ± 5.77; P < 0.001) and anxiety symptoms (4.15 ± 5.18 vs 3.34 ± 4.82, P < 0.001), with adolescents in the western regions exhibiting higher scores. Depressive symptoms were positively correlated with cognitive function (r = 0.577, P < 0.05), as were anxious symptoms (r = 0.533, P < 0.05). Both depressive (r = – 0.339, P < 0.05) and anxious symptoms (r = – 0.321, P < 0.05) were negatively correlated with psychological resilience, as well as with family functioning (r = – 0.302 and r = – 0.284, respectively; P < 0.05). In addition, compared to adolescents who lived with their parents, those who lived with others had more severe depressive and anxious symptoms. Conclusion: Our study revealed significant regional disparities in depressive and anxious symptoms among Chinese adolescents, with higher levels observed in Western China. Cognitive function showed a positive association, while psychological resilience and family functioning were negatively linked to these symptoms. By comprehending and targeting these factors through specific interventions and policies, we can ease the mental health burden on this vulnerable population.

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