Effects of Tai Chi on depression, anxiety, and stress in higher education students: a systematic review and meta-analysis

Background Higher education students experience high levels of depression, anxiety, and stress, which can negatively impact their mental well-being and academic performance. Tai Chi has shown potential benefits in improving mental health, but its effects on university students remain inconclusive. This systematic review and meta-analysis aimed to assess the effects of Tai Chi on ameliorating mental health of higher education students. Methods We searched multiple databases and trial registries to identify randomized controlled trials which evaluated Tai Chi interventions in higher education students with elevated symptoms of depression, anxiety, or stress. Review Manager software was used for meta-analyses and subgroup analyses. The risk of bias was evaluated using Cochrane Risk of Bias 2.0, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Ten trials with 598 participants were included in this review. Meta-analysis showed that Tai Chi may reduced depression symptoms compared to no intervention or usual care (SMD= -1.63, 95% CI [-2.21, -1.05], P < 0.00001, I² =82%, 8 studies). For anxiety, a reduction was also observed (SMD = -1.28, 95% CI [-2.36, -0.19], P = 0.002, I^² = 76%, 2 studies). However, the GRADE assessment demonstrated the evidence quality of both depression and anxiety was very low due to high risk of bias and significant heterogeneity. Conclusion Tai Chi may reduce depression and anxiety symptoms in higher education students. However, more high-quality studies are needed to establish its effectiveness.