Mental health challenges among Chinese international students during COVID-19

A systematic review and meta-analysis of depression and anxiety

Authors

DOI:

https://doi.org/10.32674/4mzv0c33

Keywords:

COVID-19, Chinese international students, Systematic Review, Meta-Analysis, mental health, depression, anxiety

Abstract

The COVID-19 pandemic has disproportionately impacted the mental health of international students, particularly Chinese international students (CISs), who have faced heightened sociocultural stressors and racial discrimination. This review examines the prevalence of depression and anxiety among CISs and explores associated factors via the socioecological model. Nine electronic databases were searched from January 2020 to July 2023. A proportional meta-analysis using random effects models estimated the prevalence of depression in nine studies (n = 4,784 CISs) and that of anxiety in nine studies (n = 5,701 CISs). The pooled prevalence was 51% (95% CI: 36%–65%) for depression and 48% (95% CI: 35%–62%) for anxiety. A qualitative synthesis of associated factors included 23 studies involving 19,802 cases of CIS. Related factors included fear of infection, family conflicts, sociocultural dilemmas, and discrimination. Institutional support and Chinese cultural beliefs. 

Author Biographies

  • Zhexi Ying, Institute of Science Tokyo, Japan

    Zhexi Ying, PhD Candidate, is a doctoral student at the Graduate School of Health Care Sciences at the Institute of Science Tokyo, Japan. Her major research interests include international students’ mental health, international nurse education, collaborative online international learning and intercultural sensitivity. She is also interested in the use of innovative technology, such as virtual reality (VR), in undergraduate medical education.

  • Akiko Kondo, Institute of Science Tokyo, Japan

    Akiko Kondo, RN, PhD, is a Professor at the Graduate School of Health Care Sciences at the Institute of Science Tokyo, Japan. Her research focuses on public health, health policy, international comparative studies, and global nursing education. Currently, we are conducting research in collaboration with the University of Washington on support for nursing faculty to provide globalized education in Japan and research on evaluating the results of joint lectures for undergraduate students with Cardiff University in the UK and the University of Waikato in New Zealand.

  • Meihui Piao, Institute of Science Tokyo, Japan

    Meihui Piao, PhD Candidate, is a doctoral student at the Graduate School of Health Care Sciences at the Institute of Science Tokyo, Japan. Her research focuses on public health and nursing education. She is also interested in disaster preparedness for foreign residents in Japan, exploring ways to enhance self-efficacy and emergency response strategies among multicultural communities. 

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2025-09-13

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Ying, Z., Kondo, A., & Piao, M. (2025). Mental health challenges among Chinese international students during COVID-19: A systematic review and meta-analysis of depression and anxiety. Journal of International Students, 15(8), 209-230. https://doi.org/10.32674/4mzv0c33