{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:29Z","timestamp":1788416009649,"version":"build-2803163510"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Numerous meta-analyses have evaluated Tai Chi, Qigong and related traditional Chinese mind\u2013body practices (TCMBPs) for depressive symptoms across broader populations; however, to our knowledge, no previous meta-analysis has focused specifically on university students. We therefore aimed to estimate the average effect of TCMBPs on depressive symptoms in this population using a three-level model that explicitly accounts for dependent effect sizes, and to explore nonlinear dose\u2013response patterns and Bayesian cumulative exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Web of Science, PsycINFO, the Cochrane Library and CNKI were searched from inception to 29 December 2025 for randomized controlled trials. Effect sizes were synthesized with a three-level random-effects model. Heterogeneity, small-study effects and influential estimates were examined using prespecified diagnostics, sensitivity analyses and cluster-robust variance estimation. Subgroup, meta-regression and Bayesian dose\u2013response analyses were treated as exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen randomized controlled trials met the eligibility criteria. After influence diagnostics, the pooled estimate indicated lower depressive-symptom scores after traditional Chinese mind\u2013body practice (SMD\u202f=\u202f\u22120.56, 95% CI\u202f\u2212\u202f0.84 to \u22120.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), although heterogeneity was substantial and the certainty of evidence was moderate. The estimate was similar with cluster-robust variance estimation. Subgroup patterns differed by practice, comparator and participant characteristics, but most contrasts were supported by few studies. Bayesian models placed the lowest fitted effect near a cumulative dose of 33.7\u202fh; this estimate arose from sparse and uneven exposure data and should not be interpreted as a prescriptive optimum.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Traditional Chinese mind\u2013body practices were associated with a moderate average reduction in depressive symptoms and may be feasible complements to university mental-health programs. Because the evidence was heterogeneous, concentrated in China and of moderate certainty, the findings do not establish equivalent benefits across practices or a recommended dose. Larger, better-reported randomized trials are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251275476<\/jats:ext-link>\n                      , identifier PROSPERO (CRD420251275476).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1939249","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:22:34Z","timestamp":1788412954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Traditional Chinese mind\u2013body practices and depressive symptoms in university students: a multilevel dose\u2013response meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuming","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Physical Education, Beijing University of Chemical Technology","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoyang","family":"Hu","sequence":"additional","affiliation":[{"name":"Fujian Institute of Education","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghua","family":"Liu","sequence":"additional","affiliation":[{"name":"Xinyang Normal University","place":["Xinyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"He","sequence":"additional","affiliation":[{"name":"Capital University of Physical Education and Sports","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Lan","sequence":"additional","affiliation":[{"name":"Capital University of Physical Education and Sports","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhikai","family":"Qin","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Science, Fujian Normal University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"154","DOI":"10.20982\/tqmp.12.3.p154","article-title":"Fitting three-level meta-analytic models in R: a step-by-step tutorial","volume":"12","author":"Assink","year":"2016","journal-title":"Quant. Methods Psychol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2955","DOI":"10.1017\/S0033291716001665","article-title":"Mental disorders among college students in the World Health Organization world mental health surveys","volume":"46","author":"Auerbach","year":"2016","journal-title":"Psychol. Med."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1037\/abn0000362","article-title":"WHO world mental health surveys international college student project: prevalence and distribution of mental disorders","volume":"127","author":"Auerbach","year":"2018","journal-title":"J. Abnorm. Psychol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1186\/s12888-020-02994-2","article-title":"A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders","volume":"20","author":"Chan","year":"2020","journal-title":"BMC Psychiatry"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/S2215-0366(18)30227-X","article-title":"Association between physical exercise and mental health in 1\u00b7 2 million individuals in the USA between 2011 and 2015: a cross-sectional study","volume":"5","author":"Chekroud","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.16835\/j.cnki.1000-9817.2019.07.029","article-title":"Effects of Taijiquan exercise on depression and serum inflammatory factors in female college students","volume":"40","author":"Chen","year":"2019","journal-title":"Chin. J. Sch. Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.3969\/j.issn.1673-4254.2016.11.04","article-title":"Health qigong Wuqinxi improves hydrogen proton magnetic resonance spectra in prefrontal cortex and hippocampus in college students with mild depression","volume":"36","author":"Cheng","year":"2016","journal-title":"J. South. Med. Univ."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1177\/001316446002000104","article-title":"A coefficient of agreement for nominal scales","volume":"20","author":"Cohen","year":"1960","journal-title":"Educ. Psychol. Meas."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v072.c01","article-title":"Multivariate dose-response meta-analysis: the dosresmeta R package","volume":"72","author":"Crippa","year":"2016","journal-title":"J. Stat. Softw."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"CD007146","DOI":"10.1002\/14651858.cd007146.pub3","article-title":"Interventions for preventing falls in older people living in the community","volume":"2012","author":"Gillespie","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1284632","DOI":"10.3389\/fpubh.2023.1284632","article-title":"Mindfulness to improve the mental health of university students. A systematic review and meta-analysis","volume":"11","author":"Gonz\u00e1lez-Mart\u00edn","year":"2023","journal-title":"Front. Public Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1001\/jamainternmed.2013.13018","article-title":"Meditation programs for psychological stress and well-being: a systematic review and meta-analysis","volume":"174","author":"Goyal","year":"2014","journal-title":"JAMA Intern. Med."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1177\/0962280220982643","article-title":"A Bayesian dose\u2013response meta-analysis model: a simulations study and application","volume":"30","author":"Hamza","year":"2021","journal-title":"Stat. Methods Med. Res."},{"key":"ref15","volume-title":"Statistical Methods for Meta-Analysis","author":"Hedges","year":"2014"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"103094","DOI":"10.1016\/j.ctim.2024.103094","article-title":"Effects and safety of the traditional Chinese exercise baduanjin on depression and anxiety in COVID-19 patients: a systematic review and meta-analysis","volume":"86","author":"Huang","year":"2024","journal-title":"Complement. Ther. Med."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1517350","DOI":"10.3389\/fpubh.2025.1517350","article-title":"The effectiveness of tai chi in improving depressive mood among young individuals aged 15\u201324 years: a systematic review and meta-analysis","volume":"13","author":"Huang","year":"2025","journal-title":"Front. Public Health"},{"key":"ref18","volume-title":"The Healing Promise of Qi: Creating Extraordinary Wellness through Qigong and Tai Chi","author":"Jahnke","year":"2002"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.16835\/j.cnki.1000-9817.2021.09.011","article-title":"Effects of traditional Wuqinxi on physical fitness and mental health of female college students","volume":"9","author":"Jiao","year":"2021","journal-title":"Chin. J. Sch. Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.19787\/j.issn.1008-1879.2019.02.005","article-title":"Influence of health Gigong Baduanjin on psychological characteristics of college students with neck-shoulder syndrome","volume":"10","author":"Ke","year":"2019","journal-title":"Chin. Manip. Rehabil. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1111\/jcpp.13606","article-title":"Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis","volume":"63","author":"Li","year":"2022","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s40359-025-02688-y","article-title":"Prevalence of depression among university students in China: a systematic review and meta-analysis","volume":"13","author":"Lin","year":"2025","journal-title":"BMC Psychol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/j.ctim.2015.05.001","article-title":"A systematic review and meta-analysis of the effects of qigong and tai chi for depressive symptoms","volume":"23","author":"Liu","year":"2015","journal-title":"Complement. Ther. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"746975","DOI":"10.3389\/fpsyg.2021.746975","article-title":"The effects of tai chi and Qigong exercise on psychological status in adolescents: a systematic review and meta-analysis","volume":"12","author":"Liu","year":"2021","journal-title":"Front. Psychol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"62","DOI":"10.13932\/j.cnki.sctykx.2017.05.15","article-title":"The regulation of the stress state by shadow boxing on qi depression student during date of examination","volume":"36","author":"Liu","year":"2017","journal-title":"Sichuan Sports Sci."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.13517\/j.cnki.ccm.2021.12.004","article-title":"Study on the intervention effect of Taijiquan on sleep disorders in college students","volume":"30","author":"Luo","year":"2021","journal-title":"Chin. J. Convalescent Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jbct.2022.05.002","article-title":"Mindfulness-informed (ACT) and mindfulness-based programs (MBSR\/MBCT) applied for college students to reduce symptoms of depression and anxiety","volume":"32","author":"Ma","year":"2022","journal-title":"J. Behav. Cogn. Ther."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1111\/j.1469-185X.2007.00027.x","article-title":"Effect size, confidence interval and statistical significance: a practical guide for biologists","volume":"82","author":"Nakagawa","year":"2007","journal-title":"Biol. Rev."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"106244","DOI":"10.1016\/j.neubiorev.2025.106244","article-title":"Prevalence of mental disorder symptoms among university students: an umbrella review","volume":"175","author":"Paiva","year":"2025","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1381009","DOI":"10.3389\/fpsyg.2024.1381009","article-title":"The effects of mindfulness enhanced tai chi Chuan training on mental and physical health among beginners: a randomized controlled trial","volume":"15","author":"Qu","year":"2024","journal-title":"Front. Psychol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1089\/acm.1999.5.383","article-title":"Therapeutic benefits of qigong exercises in combination with drugs","volume":"5","author":"Sancier","year":"1999","journal-title":"J. Altern. Complement. Med."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1136\/bjsports-2022-106195","article-title":"Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews","volume":"57","author":"Singh","year":"2023","journal-title":"Br. J. Sports Med."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3389\/fpsyt.2019.00820","article-title":"The neurophysiological and psychological mechanisms of qigong as a treatment for depression: a systematic review and meta-analysis","volume":"10","author":"So","year":"2019","journal-title":"Front. Psych."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1002\/sim.1040","article-title":"Advanced methods in meta-analysis: multivariate approach and meta-regression","volume":"21","author":"Van Houwelingen","year":"2002","journal-title":"Stat. Med."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1002\/jrsm.11","article-title":"Outlier and influence diagnostics for meta-analysis","volume":"1","author":"Viechtbauer","year":"2010","journal-title":"Res. Synth. Methods"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"88","DOI":"10.13804\/j.cnki.2095-6991.2021.04.017","article-title":"Effects of body-building exercise and tai chi on body composition, physical function and psychological indicators of female college students","volume":"35","author":"Wang","year":"2021","journal-title":"J. Lanzhou Univ. Arts Sci."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1047544","DOI":"10.3389\/fpsyg.2023.1047544","article-title":"Tai chi exercise improves working memory capacity and emotion regulation ability","volume":"14","author":"Wang","year":"2023","journal-title":"Front. Psychol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/s41043-024-00691-4","article-title":"The effects of Baduanjin exercise on the psychological condition and heart rate variability of sports-disadvantaged college students: a randomised trial","volume":"43","author":"Wang","year":"2024","journal-title":"J. Health Popul. Nutr."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"104","DOI":"10.16655\/j.cnki.2095-2813.2024.17.029","article-title":"Experiment research on regulating the depression and sleep of college students with Baduanjin exercise","volume":"14","author":"Wei","year":"2024","journal-title":"Contemp. Sports Technol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"654","DOI":"10.16295\/j.cnki.0257-358x.2017.08.009","article-title":"Study of Yi Jin Jing on mental health and body constitution in college students","volume":"36","author":"Wei","year":"2017","journal-title":"Shandong J. Tradit. Chin. Med."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/s40798-023-00637-w","article-title":"Effect of tai chi on young adults with subthreshold depression via a stress\u2013reward complex: a randomized controlled trial","volume":"9","author":"Wu","year":"2023","journal-title":"Sports Med. Open"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1176\/appi.focus.20170042","article-title":"Qigong and tai-chi for mood regulation","volume":"16","author":"Yeung","year":"2018","journal-title":"Focus"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.mhpa.2014.08.001","article-title":"The effect of tai chi and Qigong practice on depression and anxiety symptoms: a systematic review and meta-regression analysis of randomized controlled trials","volume":"7","author":"Yin","year":"2014","journal-title":"Ment. Health Phys. Act."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"131","DOI":"10.13293\/j.cnki.wskx.009327","article-title":"An empirical study on the effect of health qigong Baduanjin on college students\u2019 depression and anxiety","volume":"6","author":"Zhang","year":"2021","journal-title":"Wushu Stud."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1036010","DOI":"10.3389\/fphys.2023.1036010","article-title":"The effect of Bafa Wubu of tai chi on college students\u2019 anxiety and depression: a randomized, controlled pilot study","volume":"14","author":"Zhang","year":"2023","journal-title":"Front. Physiol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e34897","DOI":"10.1097\/MD.0000000000034897","article-title":"The effect of Baduanjin exercise on the physical and mental health of college students: a randomized controlled trial","volume":"102","author":"Zhang","year":"2023","journal-title":"Medicine"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"2313","DOI":"10.2147\/NDT.S173255","article-title":"A randomized controlled trial of mindfulness-based tai chi Chuan for subthreshold depression adolescents","volume":"14","author":"Zhang","year":"2018","journal-title":"Neuropsychiatr. Dis. Treat."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1939249\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:22:42Z","timestamp":1788412962000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1939249\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":49,"alternative-id":["10.3389\/fpsyg.2026.1939249"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1939249","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1939249"}}