{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:40:03Z","timestamp":1792456803455,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"This study is funded by Fujian province high level personnel project","award":["2023.NO.16.Sanming"],"award-info":[{"award-number":["2023.NO.16.Sanming"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Discov Ment Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The mental health of adolescents is a critical global public health priority. This large-scale, cross-sectional study investigated the prevalence of depression, anxiety, and stress, along with their key associated risk factors, among school-attending adolescents in South China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online anonymous survey utilizing the validated Depression Anxiety Stress Scales-21 (DASS-21) and the Mental Health Test (MHT) was administered to 23,856 students (mean age\u2009=\u200913.57\u2009\u00b1\u20091.94 years) from primary, middle, and high schools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results revealed concerning prevalence rates of mild-to-extreme symptoms: 27.9% for anxiety, 25.15% for depression, and 7.63% for stress. Severe study pressure (reported by 52%), loneliness (59%), and poor social relationships (50%) were identified as the predominant risk factors, with multivariate logistic regression confirming their significant associations with worse mental health outcomes (ORs ranging from 1.74 to 1.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This large-scale study quantifies high anxiety and depression prevalence among South Chinese adolescents, identifying study pressure, loneliness, social difficulties, and self-harm as key modifiable risk factors. This study calls for school-based mental health interventions and provides timely empirical evidence to promote student well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44192-026-00557-7","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:34:38Z","timestamp":1784828078000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and risk factors of mental disorders in a cross-sectional study of adolescents in South China"],"prefix":"10.1007","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7781-8722","authenticated-orcid":false,"given":"Feifei","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andor","family":"Bodn\u00e1r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Pednekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Cortright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Overby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaspal","family":"Mahal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"issue":"6","key":"557_CR1","doi-asserted-by":"publisher","first-page":"e102278","DOI":"10.1136\/gpsych-2025-102278","volume":"38","author":"J Tian","year":"2025","unstructured":"Tian J, Yan N, Hu X, Tian S, Wang Y, Mackay LE, et al. Global burden of mental disorders among adolescents and young adults, 1990\u20132021: a systematic analysis of the Global Burden of Diseases Study 2021. Gen Psychiatr. 2025;38(6):e102278. https:\/\/doi.org\/10.1136\/gpsych-2025-102278.","journal-title":"Gen Psychiatr"},{"issue":"14","key":"557_CR2","doi-asserted-by":"publisher","first-page":"7257","DOI":"10.3390\/ijerph18147257","volume":"18","author":"X Zhu","year":"2021","unstructured":"Zhu X, Haegele JA, Liu H, Yu F. Academic stress, physical activity, sleep, and mental health among Chinese adolescents. Int J Environ Res Public Health. 2021;18(14):7257. https:\/\/doi.org\/10.3390\/ijerph18147257.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"557_CR3","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s40359-023-01166-7","volume":"11","author":"RMS Santos","year":"2023","unstructured":"Santos RMS, Mendes CG, Sen Bressani GY, de Alcantara Ventura S, de Almeida Nogueira YJ, de Miranda DM, Romano-Silva MA. The associations between screen time and mental health in adolescents: a systematic review. BMC Psychol. 2023;11(1):127. https:\/\/doi.org\/10.1186\/s40359-023-01166-7.","journal-title":"BMC Psychol"},{"issue":"7","key":"557_CR4","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.11817\/j.issn.1672-7347.2023.230065","volume":"48","author":"G Yang","year":"2023","unstructured":"Yang G, Chen Y, Ye M, Cheng J, Liu B, Cheng J. Relationship between family risk factors and adolescent mental health. \u5bb6\u5ead\u98ce\u9669\u56e0\u7d20\u4e0e\u9752\u5c11\u5e74\u5fc3\u7406\u5065\u5eb7\u4e4b\u95f4\u7684\u5173\u7cfb(The relationship between family risk factors and adolescent mental health). Zhong nan da xue xue bao. Yi xue ban. J Cent South Univ Med Sci. 2023;48(7):1076\u201385. https:\/\/doi.org\/10.11817\/j.issn.1672-7347.2023.230065.","journal-title":"Med Sci"},{"issue":"43","key":"557_CR5","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1037\/fam0000651","volume":"34","author":"C Hatem","year":"2020","unstructured":"Hatem C, Lee CY, Zhao X, Reesor-Oyer L, Lopez T, Hernandez DC. Food insecurity and housing instability during early childhood as predictors of adolescent mental health. J Fam Psychol JFP J Div Family Psychol Am Psychol Assoc (Divis) 2020;34(43):721\u201330. https:\/\/doi.org\/10.1037\/fam0000651.","journal-title":"J family psychology: JFP : J Div Family Psychol Am Psychol Association (Division"},{"issue":"7","key":"557_CR6","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.3390\/ijerph16071107","volume":"16","author":"K Morgan","year":"2019","unstructured":"Morgan K, Melendez-Torres GJ, Bond A, Hawkins J, Hewitt G, Murphy S, Moore G. Socio-economic inequalities in adolescent summer holiday experiences, and mental wellbeing on return to school: analysis of the school health research network\/health behaviour in school-aged children survey in wales. Int J Environ Res Public Health. 2019;16(7):1107. https:\/\/doi.org\/10.3390\/ijerph16071107.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"557_CR7","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1515\/ijamh-2022-0058","volume":"35","author":"SH Alamolhoda","year":"2022","unstructured":"Alamolhoda SH, Zare E, Atena HakimZadeh, Zalpour A, Vakili F, Chermahini RM, Ebadifard R, Masoumi M, Niayesh Khaleghi, Malihe Nasiri. Adolescent mental health during covid-19 pandemics: a systematic review. Int J Adolesc Med Health. 2022;35(1):41\u201360. https:\/\/doi.org\/10.1515\/ijamh-2022-0058.","journal-title":"Int J Adolesc Med Health"},{"key":"557_CR8","doi-asserted-by":"publisher","first-page":"1408991","DOI":"10.3389\/fpubh.2024.1408991","volume":"12","author":"C Yang","year":"2024","unstructured":"Yang C. Research on China\u2019s adolescent mental health policies\u2013\u2013analysis based on PMC index model. Front Public Health. 2024;12:1408991. https:\/\/doi.org\/10.3389\/fpubh.2024.1408991.","journal-title":"Front public health"},{"issue":"1","key":"557_CR9","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1186\/s12888-023-05068-1","volume":"23","author":"Z Chen","year":"2023","unstructured":"Chen Z, Ren S, He R, Liang Y, Tan Y, Liu Y, Wang F, Shao X, Chen S, Liao Y, He Y, Li J-G, Chen X, Tang J. Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students. BMC Psychiatry. 2023;23(1):580. https:\/\/doi.org\/10.1186\/s12888-023-05068-1.","journal-title":"BMC Psychiatry"},{"issue":"4","key":"557_CR10","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1080\/21620555.2020.1776600","volume":"52","author":"Y Lu","year":"2020","unstructured":"Lu Y, Yeung W-JJ, Treiman DJ. Parental migration and children\u2019s psychological and cognitive development in China: differences and mediating mechanisms. Chin Sociol Rev. 2020;52(4):337\u201363. https:\/\/doi.org\/10.1080\/21620555.2020.1776600.","journal-title":"Chin Sociol Rev"},{"key":"557_CR11","doi-asserted-by":"publisher","first-page":"611","DOI":"10.4236\/jss.2024.125033","volume":"12","author":"S Luo","year":"2024","unstructured":"Luo S, Li Y, Lin Y-J. IRT analysis of the mental health test for elementary school students. Open J Social Sci. 2024;12:611\u201322. https:\/\/doi.org\/10.4236\/jss.2024.125033.","journal-title":"Open J Social Sci"},{"key":"557_CR12","doi-asserted-by":"publisher","unstructured":"Wang X, Zhang T. The relationship between the meaning of life and mental health of junior middle school students of Tujia and Hmong in Xiangxi, China. 2016;4:179\u2013184. https:\/\/doi.org\/10.4236\/jss.2016.44026","DOI":"10.4236\/jss.2016.44026"},{"issue":"11","key":"557_CR13","doi-asserted-by":"publisher","first-page":"4079","DOI":"10.3390\/ijerph17114079","volume":"17","author":"X Wen","year":"2020","unstructured":"Wen X, Lin Y, Liu Y, Starcevich K, Yuan F, Wang X, Xie X, Yuan Z. A latent profile analysis of anxiety among junior high school students in less developed rural regions of China. Int J Environ Res Public Health. 2020;17(11):4079. https:\/\/doi.org\/10.3390\/ijerph17114079.","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"557_CR14","doi-asserted-by":"publisher","first-page":"183","DOI":"10.54097\/ajmss.v2i3.8841","volume":"2","author":"Q Zhang","year":"2023","unstructured":"Zhang Q. Research progress of mental health status of secondary vocational students. Acad J Manage Social Sci. 2023;2(3):183\u20136. https:\/\/doi.org\/10.54097\/ajmss.v2i3.8841.","journal-title":"Acad J Manage Social Sci"},{"issue":"6","key":"557_CR15","doi-asserted-by":"publisher","first-page":"e0321523","DOI":"10.1371\/journal.pone.0321523","volume":"20","author":"J Zhou","year":"2025","unstructured":"Zhou J, Toikko T. Reliability and validity of mental health measurement of young people in a Chinese urban context. PLoS ONE. 2025;20(6):e0321523. https:\/\/doi.org\/10.1371\/journal.pone.0321523.","journal-title":"PLoS ONE"},{"issue":"Pt 2","key":"557_CR16","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1348\/014466505X29657","volume":"44","author":"JD Henry","year":"2005","unstructured":"Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005;44(Pt 2):227\u201339. https:\/\/doi.org\/10.1348\/014466505X29657.","journal-title":"Br J Clin Psychol"},{"issue":"3","key":"557_CR17","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-u","volume":"33","author":"PF Lovibond","year":"1995","unstructured":"Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335\u201343. https:\/\/doi.org\/10.1016\/0005-7967(94)00075-u.","journal-title":"Behav Res Ther"},{"key":"557_CR18","doi-asserted-by":"publisher","first-page":"106479","DOI":"10.1016\/j.chiabu.2023.106479","volume":"168","author":"N Racine","year":"2025","unstructured":"Racine N, Deneault AA, Thiemann R, Turgeon J, Zhu J, Cooke J, Madigan S. Intergenerational transmission of parent adverse childhood experiences to child outcomes: a systematic review and meta-analysis. Child Abuse Negl. 2025;168:106479. https:\/\/doi.org\/10.1016\/j.chiabu.2023.106479.","journal-title":"Child Abuse Negl"},{"issue":"11","key":"557_CR19","doi-asserted-by":"publisher","first-page":"3629","DOI":"10.1007\/s00787-025-02779-6","volume":"34","author":"F Zoellner","year":"2025","unstructured":"Zoellner F, Erhart M, Sch\u00fctz R, Napp A-K, Devine J, Reiss F, Ravens-Sieberer U, Kaman A. Two decades of loneliness among children and adolescents: longitudinal trends, risks and resources\u2013results from the German BELLA and COPSY studies. Eur Child Adolesc Psychiatry. 2025;34(11):3629\u201341. https:\/\/doi.org\/10.1007\/s00787-025-02779-6.","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"6","key":"557_CR20","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1007\/s10597-017-0182-z","volume":"54","author":"S Yu","year":"2018","unstructured":"Yu S, Kowitt SD, Fisher EB, Li G. Mental health in China: stigma, family obligations, and the potential of peer support. Commun Ment Health J. 2018;54(6):757\u201364. https:\/\/doi.org\/10.1007\/s10597-017-0182-z.","journal-title":"Commun Ment Health J"},{"issue":"1","key":"557_CR21","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/s13034-022-00530-6","volume":"16","author":"D Wang","year":"2022","unstructured":"Wang D, Chen XY, Ma Z, Liu X, Fan F. Has the double reduction policy relieved stress? A follow-up study on Chinese adolescents. Child Adolesc Psychiatry Mental Health. 2022;16(1):91. https:\/\/doi.org\/10.1186\/s13034-022-00530-6.","journal-title":"Child Adolesc Psychiatry Mental Health"},{"key":"557_CR22","doi-asserted-by":"publisher","first-page":"898675","DOI":"10.3389\/fpsyg.2022.898675","volume":"13","author":"S Liu","year":"2022","unstructured":"Liu S, Wang G. Exploration of sports participation and curriculum resource utilization in primary schools before and after the double reduction. Front Psychol. 2022;13:898675. https:\/\/doi.org\/10.3389\/fpsyg.2022.898675.","journal-title":"Front Psychol"},{"key":"557_CR23","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.2147\/PRBM.S527697","volume":"12","author":"R Yang","year":"2025","unstructured":"Yang R, Yang XJ, Wan JL, Wang LL, Deng H, Chen JX, Zhou SJ. From east to west: regional disparities in depressive and anxious symptoms among chinese adolescents. Psychol Res Behav Manag. 2025;12:18:1359\u201369. https:\/\/doi.org\/10.2147\/PRBM.S527697.","journal-title":"Psychol Res Behav Manag"},{"key":"557_CR24","doi-asserted-by":"publisher","first-page":"1525651","DOI":"10.3389\/fpsyt.2025.1525651","volume":"16","author":"J Niu","year":"2025","unstructured":"Niu J, Fang J, Qi Z. Family socio-economic status and parental education anxiety: the mediating role of perception of the double reduction policy and the moderating role of parental education expectations. Front Psychiatry. 2025;16:1525651. https:\/\/doi.org\/10.3389\/fpsyt.2025.1525651.","journal-title":"Front Psychiatry"},{"issue":"1\u20132","key":"557_CR25","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s10488-010-0299-7","volume":"37","author":"MS Atkins","year":"2010","unstructured":"Atkins MS, Hoagwood KE, Kutash K, Seidman E. Toward the integration of education and mental health in schools. Adm Policy Ment Health. 2010;37(1\u20132):40\u20137. https:\/\/doi.org\/10.1007\/s10488-010-0299-7.","journal-title":"Adm Policy Ment Health"}],"container-title":["Discover Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44192-026-00557-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00557-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00557-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:58:24Z","timestamp":1792454304000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44192-026-00557-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["557"],"URL":"https:\/\/doi.org\/10.1007\/s44192-026-00557-7","relation":{},"ISSN":["2731-4383"],"issn-type":[{"value":"2731-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"assertion":[{"value":"11 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was approved by the Research Ethics Committee of Jiaxing University (Approval ID: YX-2025008) and the local Education Bureau. All methods were carried out in accordance with relevant guidelines and regulations, including the principles of the Declaration of Helsinki. Written informed consent was obtained from the parents or legal guardians of all adolescent participants included in this study. Student assent was also obtained at the start of the online survey. Participation was voluntary, anonymous, and without financial compensation.","order":1,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"<b>Consent to publish<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"204"}}