Background: Depressive symptoms are common in 'left-behind children (LBC)' in China, but their prevalence estimates have been inconsistent. This comprehensive meta-analysis examined the pooled prevalence of depressive symptoms in LBC in China and its associated factors.

Methods: Two investigators systematically and independently searched both English (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang Database, CNKI, and SinoMed) databases. Comparative and epidemiological studies reporting the prevalence of depressive symptoms and associated relevant information were included. The prevalence of depressive symptoms was pooled using the random-effects model.

Results: A total of 39 studies covering 31,663 LBC and 20,049 non-LBC controls were included in the meta-analysis. The figures of pooled prevalence of depressive symptoms in LBC and non-LBC were 30.7% and 22.8%, respectively. Subgroup analyses revealed that the use of different scales was significantly associated with the prevalence of depressive symptoms. Compared with non-LBC, LBC were more likely to suffer from depressive symptoms (OR = 1.7, 95% CI: 1.4-1.9).

Conclusions: This meta-analysis confirmed that the prevalence of depressive symptoms in LBC is common in China. In order to reduce the risk of depressive symptoms in this vulnerable segment of the population, the development of screening and therapeutic interventions is urgently needed