The mediating role of self-esteem in the relationship between big five personality traits and depressive symptoms among Chinese undergraduate medical students

• Neuroticism is positively related to depression in medical students.
• Agreeableness and openness are negatively related to depression in the students.
• Self-esteem mediates the relationship between agreeableness and depression.
• Self-esteem mediates the relationship between openness and depression.
• Self-esteem mediates the relationship between neuroticism and depression.

The objectives of this study were to examine the correlations between big five personality traits and depressive symptoms among Chinese undergraduate medical students, and to explore the mediating role of self-esteem on the correlations. Self-reported questionnaires, including Big Five Inventory, the Center for Epidemiologic Studies Depression Scale, Rosenberg’s Self-Esteem scale, and socio-demographic section were distributed to 2000 undergraduate medical students at four medical colleges and universities in Liaoning province, China, in June 2014. 1738 students became the final subjects. After adjustment for age and gender, agreeableness (β = −0.329) and openness (β = −0.096) were negatively related to depressive symptoms, while neuroticism (β = 0.245) was positively related to the symptoms. Self-esteem functioned as a mediator in the relationship between agreeableness (a * b = −0.154, 95% CI: −0.182, −0.127)/openness (a * b = −0.097, 95% CI: −0.124, −0.069)/neuroticism (a * b = 0.031, 95% CI: 0.007, 0.058) and depressive symptoms. Therefore, identifying at-risk students and undertaking appropriate intervention strategies that focus on both personality traits and self-esteem may be effective in preventing and reducing depressive symptoms among Chinese medical students.