Religious affiliation and suicidality among college students in China: A cross-sectional study across six provinces

PLoS One. 2021 May 19;16(5):e0251698. doi: 10.1371/journal.pone.0251698. eCollection 2021.


Background: Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in China.

Objective: The current study examines the association between religious affiliation and suicidality among college students in six provinces in China.

Methods: We conducted a cross-sectional study involving 11,407 college students from six universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, and Shaanxi. We collected the data between October 2017 and March 2018 using self-report questionnaires. They included self-report measures of depression, psychache, hopelessness, self-esteem, social support, and life purpose.

Results: Participants with a Christian affiliation had 1.5 times (95% CI: 1.14, 1.99, p = 0.004) higher odds of indicating an elevated suicide risk, 3.1 times (95% CI: 1.90, 5.04, p<0.001) higher odds of indicating a previous suicide attempt, and increased overall suicidality (B = 0.105, p < 0.001) after accounting for demographic and risk/protective factors. Christians also scored the highest in depression, psychache, hopelessness, and the lowest social support, self-esteem, and purpose in life. Muslims reported decreased suicidality (B = -0.034, p = 0.031). Buddhism/Daoism yielded non-significant results in the multivariate analyses.

Conclusions: Christian college students reported increased suicidality levels, perhaps due to public policies on religion. The decreased suicidality levels among Muslims may be attributed to higher perceived social support. The associations between religious affiliation and suicidality, depression, and hopelessness contrast sharply with US samples. This finding may be influenced by interactions between the religious denomination, individual, and social/political factors. This conclusion includes the possibility of anti-religious discrimination, which this paper did not investigate as a possible mediator and therefore remains a conjecture worthy of future investigation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Religion and Psychology*
  • Religion*
  • Risk Factors
  • Self Concept*
  • Students / psychology*
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Surveys and Questionnaires*
  • Universities

Grant support

CCMH acknowledges support from the Universiti Kebangsaan Malaysia grant (DIP-2018-035). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.