ArticleFrontiers in public health2026
Depressive and anxiety symptoms among college students in Anhui Province, China: three repeated cross-sectional surveys.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Depression and anxiety symptoms are prevalent among college students and significantly affect their academic performance, interpersonal functioning, and long-term well-being. Repeated cross-sectional surveys can reveal temporal variations in symptom burden, yet rigorous data harmonization is essential to ensure valid cross-year comparisons. This study aimed to harmonize three waves of questionnaire survey data and provide a comprehensive descriptive summary of depressive and anxiety symptoms among Chinese college students. Methods: Questionnaire submissions were recorded from 9 November 2023 to 3 January 2024, 14 May to 14 June 2024, and 7 April to 5 May 2025. Student identifiers were used to identify repeated within-wave submissions and overlap across administrations. After retaining the earliest response per student within each administration, 4,236 records remained (2023: 1,998; 2024: 1,743; 2025: 495). Depressive and anxiety symptoms were measured using the PHQ-9 and GAD-7. Inter-administration comparisons used Kruskal-Wallis and chi-square tests with effect sizes. Generalized estimating equations accounted for repeated observations of the same student. Internal consistency, PHQ-9/GAD-7 convergence, and multivariable correlates of PHQ-9 Item 9 endorsement were evaluated. Results: The analytic dataset included 4,236 wave-specific records from 2,782 unique students; 240 students participated in all three administrations. Overall mean PHQ-9 and GAD-7 scores were 5.08 ± 4.08 and 3.21 ± 3.70, respectively. Differences across administrations were statistically significant (PHQ-9 epsilon-squared = 0.006; GAD-7 epsilon-squared = 0.007). In age- and sex-adjusted GEE models, the 2024 administration had higher PHQ-9 scores than 2023 (adjusted mean difference 0.49, 95% CI 0.24-0.74), whereas the 2025 difference was not significant. PHQ-9 and GAD-7 demonstrated high internal consistency (alpha = 0.890 and 0.937) and strong convergence (Spearman rho = 0.798). Conclusion: Mild depressive and anxiety symptoms were highly prevalent in this college cohort, while moderate-to-severe symptoms affected a clinically significant minority. The temporal peak in 2024 and the persistent elevation of self-harm ideation in 2025, underscore the necessity of a tiered campus mental health strategy and the critical importance of independent, continuous suicide risk surveillance. The harmonized dataset provides a robust foundation for future longitudinal risk-factor modeling and evidence-based intervention planning.
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