Abstract
BACKGROUND/PURPOSE: Alexithymia exhibits a high incidence rate and exerts adverse effects during adolescence. This systematic review and meta-analysis sought to systematically evaluate the prevalence and characteristics of alexithymia among Chinese adolescents. METHOD: A comprehensively search was conducted across several databases, including PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, China National Knowledge Infrastructure, Weipu Database, Wanfang Database, and Chinese Biomedical Database to identify cross-sectional studies published from database inception up to June 2024, focusing on the detection rate of alexithymia among Chinese adolescents. Two reviewers independently performed literature screening, data extraction, and risk of bias assessment for the included studies. Statistical analyses were performed using the metafor package in R software (version 4.4.1). RESULTS: The search and subsequent review yielded 11 articles that encompassed data from 9,037 Chinese adolescents. The pooled prevalence of alexithymia among Chinese adolescent students was 25.17% (95% CI, 21.37%–29.41%). Five studies reported a pooled mean alexithymia score of 54.60 (95% CI: 52.43–56.77) in Chinese adolescents. Subgroup analysis revealed significant variations in the prevalence of alexithymia across different demographic and geographic strata. Specifically, the prevalence rates were 33.38% for males and 32.51% for females. Geographically, the highest prevalence was observed in western China (28.60%), followed by central China (27.27%), with the lowest prevalence in eastern China (21.93%). In terms of educational background, secondary vocational students exhibited the highest prevalence (29.54%), whereas higher vocational freshmen demonstrated the lowest prevalence (20.56%). CONCLUSIONS: These findings indicate a notably high prevalence of alexithymia among Chinese adolescents, with significant variations observed across different subgroups. CLINICAL TRIAL REGISTRATION: The protocol was registered in PROSPERO [CRD42024587374]. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07651-0.