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Title: Mental health status of secondary school students : a meta-analysis of comparative studies between one-child and multi-child families in China
Authors: Zhang, W
Chen, P
Rao, SY
Jiang, YY
Su, Z
Cheung, T 
Ng, CH
Xiang, YT
Wang, G
Issue Date: 2025
Source: Frontiers in psychiatry, 2025, v. 16, 1594968
Abstract: Introduction: Mental health problems are common among secondary school students. However, when comparing one-child and multi-child families, the findings on the mental health of students are mixed. Therefore, we conducted a meta-analysis to compare the mental health status between secondary school students from one-child and multi-child families in China.
Methods: Relevant studies using standard instruments on mental health (e.g., the Middle School Student Mental Health Scale; MSSMHS and the Mental Health Test; MHT) were searched in PubMed, Web of Science, PsycINFO, China National Knowledge Infrastructure (CNKI), and Wanfang. A random-effects model was employed to compute the pooled effect size. Subgroup analyses for categorical variables and meta-regression analyses for continuous variables were carried out to examine the potential moderators of group differences.
Results: We identified 39 studies, which included 11,889 secondary school students from one-child families and 13,795 from multi-child families. No significant difference in mental health was found between students from one-child and multi-child families. However, significant group differences were observed in certain MHT domains, including Learning Anxiety [95% confidence interval (CI): -0.19; 0.00, I² = 0.0%, P = 0.04], Social Anxiety (95% CI:-0.25; 0.00, I² = 45.8%, P = 0.04), Tendency Towards Self-Blame (95% CI: -0.23; -0.07, I² = 0.0%, P < 0.01) and Allergic Tendencies (95% CI: -0.25; -0.01, I² =43.5%, P = 0.04).
Discussion: This meta-analysis did not show significant differences in the mental health between students from one-child and multi-child families. Future research should investigate the influence of socio-demographic factors, such as gender and place of residence, on the mental health of this population.
Keywords: Mental health
Meta-analysis
Multi-child families
One-child families
Secondary school students
Publisher: Frontiers Research Foundation
Journal: Frontiers in psychiatry 
EISSN: 1664-0640
DOI: 10.3389/fpsyt.2025.1594968
Rights: © 2025 Zhang, Chen, Rao, Jiang, Su, Cheung, Ng, Xiang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
The following publication Zhang W, Chen P, Rao S-Y, Jiang Y-Y, Su Z, Cheung T, Ng CH, Xiang Y-T and Wang G (2025) Mental health status of secondary school students: a meta-analysis of comparative studies between one-child and multi-child families in China. Front. Psychiatry 16:1594968 is available at https://doi.org/10.3389/fpsyt.2025.1594968.
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