Effects of Tai Chi on Mental Health in college students: a systematic review and meta-analysis of randomized controlled trials

Objective To systematically evaluate and quantitatively synthesize the effects of Tai Chi interventions on the mental health of college students. Methods This study was conducted in accordance with the PRISMA 2020 guidelines for systematic reviews and meta-analyses and was registered in PROSPERO (CRD420261329121). PubMed, Web of Science, Scopus, Cochrane Library, EBSCO, CNKI, Wanfang Database, and the China Science and Technology Journal Database were systematically searched from database inception to February 1, 2026. Randomized controlled trials (RCTs) investigating the effects of Tai Chi interventions on the mental health of college students were included. Statistical analyses were performed using Review Manager 5.4. For continuous outcomes, standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated. A random-effects model was used to pool the effect sizes. Between-study heterogeneity was assessed using Cochran’s Q test and the I 2 statistic. Sensitivity analyses and subgroup analyses were also conducted. Results A total of 12 randomized controlled trials involving 1,057 college students were included (554 in the intervention group and 503 in the control group). The meta-analysis showed that Tai Chi intervention significantly reduced depression symptoms among college students (SMD = −0.67, 95% CI [−0.90, −0.43], p < 0.00001). Tai Chi also demonstrated significant effects in alleviating anxiety (SMD = −0.79, 95% CI [−1.42, −0.15], p = 0.02) and stress (SMD = −0.40, 95% CI [−0.65, −0.14], p = 0.002). In addition, Tai Chi significantly improved sleep quality among college students (MD = −2.14, 95% CI [−4.13, −0.15], p = 0.03), although substantial heterogeneity was observed across studies. Conclusion The present meta-analysis provides quantitative evidence that Tai Chi interventions have beneficial effects on improving mental health among college students, particularly in reducing depression, anxiety, and stress. Although Tai Chi also appears to improve sleep quality, the relatively high heterogeneity across studies indicates that further high-quality randomized controlled trials are needed to confirm these findings and to determine optimal intervention protocols. Systematic review registration PROSPERO: CRD420261329121, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261329121 .