Factors Influencing Psychological Distress in Adolescents: A Cross-Sectional Study on Gender, Grade, and Family Structure

This study investigates the current status of psychological pressure and psychological symptoms among Chinese primary and secondary school students, as well as the factors influencing these issues. Data from 190,513 students were analyzed using descriptive statistics to examine the effects of gender, grade level, family structure, and economic status on students' psychological pressure and symptoms. The results indicate that male students experience higher levels of psychological pressure and an increased risk of psychological symptoms compared to female students (OR = 1.176, 95% CI: 1.153–1.199, p < 0.0001). Regarding grade level, primary school students exhibit significantly higher psychological pressure and symptoms than high school students, with the risk of psychological symptoms being 4.468 times greater among primary school students (OR = 4.468, 95% CI: 4.353–4.586, p < 0.0001). Additionally, students from lower-income households (2.0% of the sample) demonstrate a reduced risk of psychological pressure and symptoms (OR = 0.499, 95% CI: 0.465–0.536, p < 0.0001), whereas students from wealthier households show similar levels of psychological pressure (OR = 1.842, 95% CI: 1.738–1.952, p < 0.0001). Multi-factor regression analysis confirms the significant impact of gender, grade level, and family economic status on students' mental health, emphasizing the importance of considering the combined effects of these factors over time. These findings provide empirical support for the development of school-based mental health education and policies, offering valuable insights, particularly in guiding interventions tailored to students of different grade levels and family backgrounds.