Mental health problems and associated school interpersonal relationships among adolescents in China: a cross-sectional study

BACKGROUND: During adolescence, middle school students facing psychophysical changes are vulnerable to psychological problems. The present study aimed to investigate mental health status and associated school interpersonal relationships among adolescents in China, which may help to inform effective prevention strategies to reduce the prevalence of mental health problems. METHODS: In the cross-sectional study, a total of 10,131 middle school students were selected from three cities in eastern China by stratified random sampling. The Symptom Checklist-90 (SCL-90), Teacher–Student Relationship Questionnaire (TSRQ) and Peer Relationship Scale (PRS) were used to evaluate psychological symptoms, the quality of relationship with teachers and the quality of relationship with peers, respectively. Multivariable logistic regression analysis was conducted to explore the association between school interpersonal relationships and mental health problems in adolescents. RESULTS: 36% of the middle school students reported positive in mental health problems assessed by the SCL-90. The most prevalent dimensional symptom was obsessive–compulsive (43.3%). The risk of all types of psychological symptoms was significantly associated with school interpersonal relationships. Moreover, a higher risk of mental health problems was associated with poorer school interpersonal relationships. CONCLUSIONS: Mental health problems were prevalent among adolescents and highly associated with school interpersonal relationships. Our findings underscore the pressing need for school administrators to make efforts to improve school interpersonal relationships among adolescents.