Health Psychology Research / HPR / Volume 13 / Issue 3 / DOI: 10.14440/hpr.2696189
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RESEARCH ARTICLE

Prevalence and Related Factors of Subthreshold Depression among Chinese Residents: A National Cross-sectional Study

Jiaxin Liu1† ,  Pu Ge2† ,  Yingbing Lu3 ,  Qin Han4 ,  Ke Lyu5 ,  Chen Hu6 ,  Lutong Pan7 ,  Yuqian Deng1 ,  Ying Tang8 ,  Yuan Luo9 ,  Haiye Ran1 ,  Qiyu Li10 ,  Wenying Hong11 ,  Xiangle Zeng12 ,  Yibo Wu13* ,  Liping Zhao1*
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1 Department of Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
2 School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
3 School of Management, Beijing University of Chinese Medicine, Beijing 100029, China
4 College of Health Management, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
5 China Medical University, Shenyang 110122, Liaoning, China
6 Zijin College of Nanjing University of Technology, Nanjing 210048, Jiangsu, China
7 Tsinghua Shenzhen International Graduate School, Shenzhen 518055, Guangdong, China
8 School of Pediatrics, Chongqing Medical University, Chongqing 400016, China
9 School of Nursing, Capital Medical University, Beijing 100069, China
10 School of Medical Humanities Medical University, Shenyang 110122, Liaoning, China
11 Faculty of Health Sciences, University of Macau, Macau 999078, China
12 School of Management, Hubei University of Chinese Medicine, Wuhan 430065, Hubei, China
13 Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, Zhejiang, China
HPR 2025 , 13(3), e81240036; https://doi.org/10.14440/hpr.2696189
Submitted: 29 March 2025 | Accepted: 5 April 2025 | Published: 7 October 2025
© 2025 by the Author(s). Licensee Health Psychology Research, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background

Subthreshold depression (SD) impairs quality of life and escalates the risks of progression to major depression. However, it is frequently overlooked in primary healthcare settings.

Objective

This study investigates the prevalence of SD and its associated factors among Chinese residents.

Methods

In this cross-sectional study, we recruited 9,546 residents over the age of 18 from 120 cities across China. Data from sociodemographic questionnaires and validated scales (SD, self-efficacy, social support, family health, self-rated quality of life, and health literacy) were analyzed using Chi-square, Mann–Whitney U tests, and logistic regression. Model performance was assessed through receiver operating characteristic curves.

Results

The prevalence of SD was 34.4%. SD was less likely to occur among residents who were male and older and had better perceived social support, greater family health, better self-rated quality of life, and higher levels of health literacy. In contrast, individuals with debt, siblings, or chronic diseases, and those who were unmarried, divorced, or widowed were at higher risk. The model showed moderate predictive accuracy (area under the curve = 0.68, 95% confidence interval: 0.67–0.70).

Conclusion

The study highlights a high prevalence of SD (34.4%) among Chinese residents, influenced by sociodemographic and psychosocial factors. Protective factors included male gender, older age, stronger social support, better family health, greater self-rated quality of life, and higher levels of health literacy. Conversely, having debts, being unmarried/divorced/ widowed, having chronic diseases, and having siblings increased the risk. Targeted prevention strategies should address modifiable factors, such as social support and health literacy. The moderate predictive efficacy of the model suggests potential for early screening but warrants further exploration of additional predictors.

Keywords
Prevalence
Related factors
Subthreshold depression
Mental health
Primary prevention
Funding
This work was supported by the Natural Science Foundation of Hunan province (Grant number 2021JJ70068) and the Social Science Foundation of Hunan Province (Grant num¬ber 23YBA022).
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Conflict of interest
The authors declare that they have no conflicts of interest.
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