ORIGINAL RESEARCH article

Front. Public Health

Sec. Public Mental Health

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1531431

This article is part of the Research TopicEnvironmental Risk Factors for Depression: Unveiling Pathways to Resilience and Public Mental Health EquityView all 21 articles

The Improvement Path of Depression and Anxiety Among Adult Women in Shanxi Province, China: A Fuzzy-Set Qualitative Comparative Analysis

Provisionally accepted
Dahong  WuDahong WuGuanxian  ZengGuanxian ZengJing  ChengJing ChengJie  LiuJie LiuSitian  LiSitian LiQin  MengxiaQin MengxiaLu  HeLu He*Qilong  FengQilong Feng*
  • Shanxi Medical University, Taiyuan, China

The final, formatted version of the article will be published soon.

Background: Depression and anxiety (D&A) are currently recognized as complex and prevalent mental disorders that pose major threats to mental health. Women are more susceptible to D&A than men.We collected data from female participants in Shanxi Province between November 2021 and March 2022 through on-site investigations and an online survey. The survey collected information on sociodemographic traits, lifestyle factors, and physical and mental health. The degree of D&A was evaluated using the Center for Epidemiological Studies Depression Scale (CESD-10) and the Generalized Anxiety Disorder Assessment Scale (GAD-7). We assessed the impact of these factors on D&A symptoms among women using regression and fuzzy-set qualitative comparative analysis (fsQCA).Results: D&A symptoms had many common influencing factors. Regression analysis identified key protective factors against D&A, including better self-rated health (Depression: OR = 0.11, 95% CI = 0.03-0.47; Anxiety: OR = 0.11, 95% CI = 0.02-0.57) and the absence of recent illness (Depression: OR = 0.56, 95% CI = 0.38-0.83; Anxiety: OR = 0.49, 95% CI = 0.35-0.70). Age exhibited marginal protective effects for both conditions (OR = 0.99, 95% CI = 0.98-1.00). In contrast, occupational stress constituted a significant risk factor, substantially increasing the likelihood of depression (OR = 2.66, 95% CI = 1.43-4.96) and anxiety (OR = 2.99, 95% CI = 1.43-4.96). FsQCA analysis did not identify the conditions for ideal mental health (all consistency < 0.9). However, it did identify eight condition configurations predicting mental health (absence of depression symptoms), each achieving consistency ≥0.87. Additionally, two distinct configurations explained resilience to anxiety (consistency ≥0.80). All configurations met fsQCA's consistency requirements, with self-rated health (present in 10/10 pathways), social support (9/10), and marital status (9/10) playing important roles in most configurations.Women's mental health faces significant challenges, with D&A being closely intertwined. FsQCA did not identify any specific condition for the absence of D&A symptoms. However, it revealed multiple pathways to mental well-being, highlighting the need for personalized, multifactorial interventions rather than a one-size-fits-all approach. Regression and fsQCA complement each other, offering unique strengths, and their combined insights should be widely applied to broader research and practice.

Keywords: Depression, Anxiety, Adult women, Fuzzy-set qualitative comparative analysis, regression

Received: 20 Nov 2024; Accepted: 01 May 2025.

Copyright: © 2025 Wu, Zeng, Cheng, Liu, Li, Mengxia, He and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Lu He, Shanxi Medical University, Taiyuan, China
Qilong Feng, Shanxi Medical University, Taiyuan, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.