ABSTRACT Importance Urbanization significantly shapes the psychological health of children and adolescents. Objective To apply network analysis to explore psychological problems among students aged 6–16 years from rural and urban areas of China. Methods Using data from a multi‐stage stratified epidemiological survey, we analyzed 19 711 students (9566 urban; 10 145 rural). Among them, 3003 had mental disorders. Screening was conducted using the Child Behavior Checklist (CBCL), followed by the Mini International Neuropsychiatric Interview for Children and Adolescents and psychiatrist interviews. Network analysis was used to compare rural and urban CBCL networks. Results In the entire sample, social problems, thought problems, rule‐breaking behavior, and aggressive behavior were more pronounced in the rural group, while the urban group showed elevated somatic complaints. The rural and urban networks exhibited significant differences in edge weights ( M = 0.186, P < 0.001), but showed no significant difference in global network strength ( S = 1.608, P = 0.086). Among participants with mental disorders, withdrawn/depressed, social problems, thought problems, rule‐breaking behavior, and aggressive behavior were more prominent in the rural group, while the urban group showed more somatic complaints and aggressive behavior. The rural and urban networks exhibited significant differences in edge weights ( M = 0.223, P = 0.001) but showed no significant difference in global network strength ( S = 3.245, P = 0.358). Interpretation Urbanization is a significant environmental determinant affecting youth mental health in China, linked to distinct psychological patterns. Rural students tended to show more emotional problems, whereas urban students demonstrated more behavioral issues.
Liang et al. (Tue,) studied this question.