Objective  To investigate the association of systemic family dynamics with mental health among adolescents in Shaanxi province and to provide references for improving family environment and promoting mental health in the adolescents.

  Methods  Using stratified multistage cluster sampling, we conducted a self-administered questionnaire survey among 5 188 urban and rural students aged 12 – 23 years in 7 high schools and 2 universities in Shaanxi province from August 2014 to May 2015. A general information questionnaire, Self-Rating Scale of Systemic Family Dynamics (SSFD), and Symptom Checklist-90 (SCL-90) were adopted in the study.

  Results  For all the participants, the average overall SSFD score was 2.50 ± 0.43 and the highest and the lowest mean dimension score were 2.75 ± 0.68 for systemic logic and 2.22 ± 0.62 for family atmosphere; the overall average score of SCL-90 was 1.52 ± 0.51 and the highest and the lowest mean dimension score were 1.71 ± 0.61 for obsessive compulsive and 1.43 ± 0.52 for somatization. Both the SSFD and SCL-90 score of the participants differed significantly by gender, census register, family income, education stage, the number of family members, parental education level, and parental occupation (P < 0.05 for all). Multivariate stepwise regression analysis demonstrated that after controlling demographic variables, family atmosphere and individuation were positively correlated with the overall score and all dimension scores of SCL-90; systemic logic was positively correlated with all dimension scores of SCL-90 except for obsessive-compulsive disorder, depression, and hostility; while the concept of disease was inversely correlated with the overall score and all dimension scores of SCL-90.

  Conclusion  Family systemic family dynamics is closely correlated with mental health among adolescent students.