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The aim of the study was to investigate the mental health status of Chinese medical students in response to dramatic changes in their society and to assess its relationship to life events and family socio-economic status (SES). This was a cross-sectional study of 568 second year medical students in Guangxi Zhuang Autonomous Region. They completed the Symptom Checklist-90-Revised (SCL-90-R) to assess their mental health status, Adolescent Self-Rating Life Events Check List (ASLEC), family SES items and parental divorce. A total of 552 students (262 males and 290 females) completed the questionnaires. The means of six SCL-90-R scales were significantly lower than the previously reported data on Chinese university students. Scores on four subscales were significantly higher for male compared with female students. Multivariate regression analysis indicated that the occupation and education of the fathers of female students were significantly associated with the summary index of SCL-90-R (General Symptomatic Index or GSI) and also with ASLEC scores. For male students, only the relationship with ASLEC scores was statistically significant. Seven of 27 life events measured by the ASLEC were significantly associated with GSI for males, and nine events were associated with GSI for females. The events were related to family financial status, academic stress and interpersonal relationships for both genders. In conclusion, our data underscore the importance of considering family history in addition to academic stressors, interpersonal relationships and gender differences, in attempts to secure the psychological well-being of Chinese medical students. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]