Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study

Background: Although many studies have analyzed the mental health problems (MHP) of Chinese adolescents, the associations of Chinese high school students' MHP with personal and family circumstances, parents' educational level, physical activity, and school adaptation are rarely discussed. Methods: The participants were 9398 students who were randomly recruited from 30 high schools in Shandong, China. Self-reported questionnaires were used to collect data. Multivariate logistic regression models were used to investigate associations between MHP and related factors. Results: The positive rate of MHP among high school students was 27.0%. Female, intimate friends of the opposite sex, poor family economic status, father's educational level of primary school or below, low social competence, and high antisocial behavior were significantly associated with higher odds of having MHP (p < 0.05). Students' self-reported odds of having obsessive-compulsive disorder, interpersonal sensitivity, and depression were inversely related to their mother's educational level. Compared with students who did not exercise, students who engaged in more than 30 min of physical activity 5-6 times per week had 60% lower self-reported odds of depression. Conclusions: We recommend strengthening the prevention, early detection, and treatment of MHP in high school students, especially those whose parents have low educational attainment, inactivity, and high disruptive behaviors.