|
| ORIGINAL ARTICLE |
|
| Year : 2009 | Volume
: 18
| Issue : 1 | Page : 43-46 |
 |
|
Study of prevalence of depression in adolescent students of a public school
Vivek Bansal, Sunil Goyal, Kalpana Srivastava
Armed Forces Medical College, Pune 411 040, India
| Date of Web Publication | 3-Dec-2009 |
Correspondence Address:
Sunil Goyal
Psychiatry, Department of Psychiatry
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-6748.57859
 Abstract | | |
Background: Three to nine per cent of teenagers meet the criteria for depression at any one time, and at the end of adolescence, as many as 20% of teenagers report a lifetime prevalence of depression. Usual care by primary care physicians fails to recognize 30-50% of depressed patients. Materials and Methods: Cross-sectional one-time observational study using simple screening instruments for detecting early symptoms of depression in adolescents. Two psychological instruments were used: GHQ-12 and BDI. Also sociodemographic data (e.g. academic performance, marital harmony of parents, bullying in school, etc) was collected in a separate semi-structured performa. Statistical analysis was done with Fisher's Exact Test using SPSS17. Results: 15.2% of school-going adolescents were found to be having evidence of distress (GHQ-12 score e"14); 18.4% were depressed (BDI score e"12); 5.6% students were detected to have positive scores on both the instruments. Certain factors like parental fights, beating at home and inability to cope up with studies were found to be significantly (P <0.05) associated with higher GHQ-12 scores, indicating evidence of distress. Economic difficulty, physical punishment at school, teasing at school and parental fights were significantly (P <0.05) associated with higher BDI scores, indicating depression. Conclusion: The study highlights the common but ignored problem of depression in adolescence. We recommend that teachers and parents be made aware of this problem with the help of school counselors so that the depressed adolescent can be identified and helped rather than suffer silently. Keywords: Depression, Students, Public school
How to cite this article:
Bansal V, Goyal S, Srivastava K. Study of prevalence of depression in adolescent students of a public school. Ind Psychiatry J 2009;18:43-6 |
| Introduction | |  |
Just 40 years ago, many physicians doubted the existence of significant depressive disorders in children. However, a growing body of evidence has confirmed that children and adolescents not only experience the whole spectrum of mood disorders but also suffer from the significant morbidity and mortality associated with them.
Despite the high prevalence and substantial impact of depression, detection and treatment in the primary care setting have been suboptimal. Studies have shown that usual care by primary care physicians fails to recognize 30-50% of depressed patients (Simon and Vonkorff, 1995). Because patients in whom depression goes unrecognized cannot be appropriately treated, systematic screening has been advocated as a means of improving detection, treatment, and outcomes of depression.
While improved pediatric diagnosis alone is unlikely to significantly change patient outcomes, recognizing teenagers with depression is the first step to improved depression management. It affects 2% of pre-pubertal children and 5-8% of adolescents. The clinical spectrum of the disease can range from simple sadness to a major depressive or bipolar disorder (Son And Kirchner, 2000). Studies have found that 3-9% of teenagers meet criteria for depression at any one time, and at the end of adolescence, as many as 20% of teenagers report a lifetime prevalence of depression (Zuckerbrotand Jensen, 2006).
Childhood depression, like the depression of adults, can encompass a spectrum of symptoms ranging from normal responses of sadness and disappointment in stressful life events to severe impairment caused by clinical depression that may or may not include evidence of mania (Wolraich et al. 1996, Kovacs et al. 1994, Weller et al. 1996).
Adolescent depression may affect the teen's socialization, family relations, and performance at school, often with potentially serious long-term consequences. Adolescents with depression are at risk for increased hospitalizations, recurrent depressions, psychosocial impairment, alcohol abuse, and antisocial behaviors as they grow up. Of course, the most devastating outcome of concern for adolescent depression is suicide, the third leading cause of death among older adolescents (Centre for Diseases Control, WISQARS).
Corelational and longitudinal studies have shown that depression is associated with higher rates of smoking, alcohol abuse, unhealthy eating, and infrequent exercise (Haarasilta et al., 2004, Franko et al. 2005).
No perfect depression screening/assessment tool exists, but a number of adolescent depression assessment instruments do possess adequate psychometric properties to commend their use in depression detection and assessment. Optimal diagnostic procedures should combine the use of depression-specific screening tools as diagnostic aids buttressed by follow-up clinical interviews in which one obtains information from other informants (e.g., parents) and reconciles discrepant information to arrive at an accurate diagnosis and impairment assessment before treatment (Laasa et al. 2000).
| Materials and Methods | | |
Study design
It is a cross-sectional one-time observational study using simple screening instruments for detecting early symptoms of depression in adolescents.
Adolescents studying in a public school constituted the study material. All the 125 students studying in 9th standard of the school were evaluated so as to eliminate any selection bias. Questionnaires were given in the class and students were instructed how to fill them in English or Hindi language.
Students were instructed not to write their names to maintain confidentiality. Written consent was taken from everyone and they were explained about the study project.
Inclusion criteria
- Adolescents studying in 9 th standard of the school.
- All were overtly healthy.
Exclusion criteria
- All students suffering from any kind of chronic disease requiring prescribed medication.
- All students who had taken any such screening tests before.
- Any past history of diagnosed mental illness.
The following two instruments were administered:
- GHQ 12 (General Health Questionairre-12)
- BDI (Becks Depression Inventory)
The General Health Questionnaire (GHQ) is a subjective measure of psychological wellbeing and Stress Measurement. It has been used in a variety of studies to represent the stress response.
We have used Likert method of scoring in our study. Score of 14 and above is taken as evidence of distress (Goldberg and Williams 1991).
The Beck Depression Inventory (BDI) is a series of questions developed to measure the intensity, severity, and depth of depression in patients with psychiatric diagnoses. The sum of all BDI item scores indicates the severity of depression. Score of 12 and above is taken as Depression. Predictive value of the selected cut-off point, 100% sensitivity, 99% specificity, 0.72 PPV, 1 NPV, and 98% overall diagnostic value (Laasa et al. 2000).
Also socio-demographic data (e.g. academic performance, marital harmony of parents, bullying in school, etc) was collected in a separate semi-structured performa.
Statistical analysis was done with Fisher's Exact Test using SPSS 17.
| Results | | |
In GHQ-12, out of 125 adolescents, 106 did not had any evidence of stress (score <14) and 19(15.2%) were found to be having evidence of distress (score e"14). In BDI, out of 125, 102 were not depressed (score<12) and 23 (18.4%) were depressed (scoree"12).
There were in all 35 students who were detected to have positive scores either in GHQ-12 or BDI. There were seven students who had positive scores on GHQ and BDI [Table 1] and [Table 2].
| Discussion | | |
The present study found that 15.2% of the adolescents had evidence of distress and 18.4% were found to be depressed. We tried to find the factors responsible and association of the same with the prevalent stress. We found certain factors like parental fights, beating at home and inability to cope up with studies, to be significantly (P <0.05) associated with higher GHQ-12 scores indicating evidence of distress.
Economic difficulty, physical punishment at school, teasing at school and parental fights were significantly (P <0.05) associated with higher BDI scores indicating depression.
Factors like bullying in school and parental expectations also are responsible to adding to the stress of an adolescent though it did not reach a statistically significant level in the present study.
The generalizability of the current results is limited since the timing of the study was when the students had just entered 9 th standard and were in a jovial mood with comparatively lesser study load but this problem is unavoidable unless multiple studies are done at different times of the year and averaged out.
Cut-off score for BDI ranges from 10-12 depending upon different studies. We took the cut-off score for BDI as 12 thereby increasing the specificity to 99%.
Also, other class students and other schools should also be included in the study for increased generalizability. More extensive studies are required with greater diversity of students, schools and done at different times of the year.
In spite of the limitations, this study points towards the issue of prevalence of depression in adolescence and the purpose of the study is well served to highlight the common but ignored problem.
We recommend that teachers and parents be made aware of this problem with the help of school counselors so that the depressed adolescent can be identified and helped rather than suffer silently.[11]
| References | | |
| 1. | Centers for Disease Control and Prevention National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS).  |
| 2. | Franko, D.L., Striegel-Moore, R.H., Bean, J., Tamer, R., Kraemer, H.C., Dohm, F.A., et al. (2005). Psychosocial and health consequences of adolescent depression in black and white young adult women. Health Psychol, 24:586-93. |
| 3. | Goldberg, D. and Williams, P. (1991). A User's Guide to the General Health Questionnaire. London: NFER Nelson) |
| 4. | Haarasilta, L.M., Marttunen, M.J., Kaprio, J.A., Aro, H.M. (2004). Correlates of depression in a representative nationwide sample of adolescents and young adults. Eur J Public Health, 14:2805. |
| 5. | Kovacs, M., Akiskal, H.S., Gatsonis, C., Parrone, P.L. (1994). Childhood-onset dysthymic disorder Clinical features and prospective naturalistic outcome. Arch Gen Psychiatry, 51:365-74. |
| 6. | Lasaa, L., Ayuso-Mateos, J.L., Vazquez-Barqueroa, J.L., Diez-Manriquea, E.J. and Dowrickb, C.E. (2000). The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis. Journal of Affective Disorders. 57(1-3):261-265. |
| 7. | Zuckerbrot, R.A., Jensen, P.S. (2006). Improving recognition of adolescent depression in primary. Care Arch Pediatr Adolesc Med, 160:694-704. |
| 8. | Simon, G.E., VonKorff, M. (1995). Recognition, management, and outcomes of depression in primary care. Arch Fam Med, 4:99105. |
| 9. | Son, S.E., Kirchner, J.T. (2000). Depression in children and adolescents. Am Fam Physician, 62:22972308,2311-2. |
| 10. | Weller, E.B., Weller, R.A., Svadjian, H. (1996). Mood disorders. In: Lewis M, ed. Child and adolescent psychiatry: A comprehensive textbook. Baltimore: Williams and Wilkins: 650-5. |
| 11. | Wolraich, M., Felice, M.E., Drotar, D. (1996). The classification of child and adolescent mental diagnoses in primary care: diagnostic and statistical manual for primary care (DSM-PC) child and adolescent version. American Academy of Pediatrics Elk Grove Village, Ill. |
[Table 1], [Table 2]
| This article has been cited by | | 1 |
Digital solutions for sleep problems in children: A pilot study |
|
| Stephanie E. Tedford, Lindsay Romano, David Gozal, Lisa Medalie | | Pediatric Pulmonology. 2021; | | [Pubmed] | [DOI] | | | 2 |
Mediating Role of Emotional Neglect and Self-Injurious Behaviors in the Relationship Between Family Satisfaction and Depression |
|
| Sadia Saleem, Anum Karamat, Sayyeda Taskeen Zahra, Sara Subhan, Zahid Mahmood | | The Family Journal. 2021; : 1066480721 | | [Pubmed] | [DOI] | | | 3 |
Psychosocial determinants of stress among adolescents in an urban slum in a city of Western Maharashtra: a cross-sectional study |
|
| C.S. Aishwarya, Indranil Samanta, Puja Dudeja | | International Journal of Adolescent Medicine and Health. 2021; 33(2) | | [Pubmed] | [DOI] | | | 4 |
STUDY ON LEVELS OF SERUM IRON AND SERUM FERRITIN IN ADOLESCENT DEPRESSION IN A TERTIARY CARE HOSPITAL |
|
| Madhurima Bora, Sherin Gogoi, Puja Bora | | INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH. 2020; : 1 | | [Pubmed] | [DOI] | | | 5 |
Common mental disorders prevalence in adolescents: A systematic review and meta-analyses |
|
| Sara Araújo Silva, Simoni Urbano Silva, Débora Barbosa Ronca, Vivian Siqueira Santos Gonçalves, Eliane Said Dutra, Kęnia Mara Baiocchi Carvalho, Joel Msafiri Francis | | PLOS ONE. 2020; 15(4): e0232007 | | [Pubmed] | [DOI] | | | 6 |
Eating habits and sleep patterns of adolescents with depression symptoms in Mumbai, India |
|
| Panchali Moitra, Jagmeet Madan, Nida I. Shaikh | | Maternal & Child Nutrition. 2020; 16(S3) | | [Pubmed] | [DOI] | | | 7 |
Sharing information and liking behavior on social networks in relation to depression and anxiety in adolescence |
|
| Ana Munjiza, Milutin Kostic, Željka Košutic | | Psihijatrija danas. 2019; 51(1-2): 33 | | [Pubmed] | [DOI] | | | 8 |
Suicidal behavior and self-harm in adolescents: The perspective of the media and social networks |
|
| Željka Košutic, Ana Munjiza, Ivana Rakovic-Dobroslavic | | Psihijatrija danas. 2019; 51(1-2): 47 | | [Pubmed] | [DOI] | | | 9 |
DEPRESSION AND ASSOCIATED FACTORS AMONG STUDENTS STUDYING IN HIGHER SECONDARY SCHOOLS IN NORTH KERALA |
|
| Liby Mary Victor, Usha Karunakaran | | Journal of Evolution of Medical and Dental Sciences. 2018; 7(35): 3894 | | [Pubmed] | [DOI] | | | 10 |
Exploring the Multivariate Relationships between Adolescent Depression and Social Support, Religiosity, and Spirituality in a Faith-Based High School |
|
| Angela U. Ekwonye,Terrence F. Cahill,Deborah De Luca,Lee Cabell | | Health. 2017; 09(01): 38 | | [Pubmed] | [DOI] | | | 11 |
Prevalence, correlates of major depression: A mental health survey among undergraduates at a mainland Chinese university |
|
| Wenjun Li,Xiangfei Meng,Ziqi Xu,Qiong Yu,Jieping Shi,Yaqin Yu,Carl DćArcy,Yueqin Huang,Changgui Kou | | Asia-Pacific Psychiatry. 2015; : n/a | | [Pubmed] | [DOI] | | | 12 |
The impact of Sleep Time-Related Information and Communication Technology (STRICT) on sleep patterns and daytime functioning in American adolescents |
|
| Peter G. Polos,Sushanth Bhat,Divya Gupta,Richard J. OćMalley,Vincent A. DeBari,Hinesh Upadhyay,Saqib Chaudhry,Anitha Nimma,Genevieve Pinto-Zipp,Sudhansu Chokroverty | | Journal of Adolescence. 2015; 44: 232 | | [Pubmed] | [DOI] | | | 13 |
Evolution of adolescent mental health in a rapidly changing socioeconomic environment: A review of mental health studies in adolescents in India over last 10 years |
|
| Shilpa Aggarwal,Michael Berk | | Asian Journal of Psychiatry. 2014; | | [Pubmed] | [DOI] | | | 14 |
Platelet hyperactivity, neurobehavioral symptoms and depression among Indian women chronically exposed to low level of arsenic |
|
| Bidisha Mukherjee,Banani Bindhani,Hirak Saha,Dona Sinha,Manas Ranjan Ray | | NeuroToxicology. 2014; | | [Pubmed] | [DOI] | | | 15 |
Public attitudes toward depression and help-seeking in four European countries baseline survey prior to the OSPI-Europe intervention |
|
| Evelien Coppens,Chantal Van Audenhove,Gert Scheerder,Ella Arensman,Claire Coffey,Susana Costa,Nicole Koburger,Katrin Gottlebe,Ricardo Gusmăo,Rory O’Connor,Vita Postuvan,Marco Sarchiapone,Merike Sisask,András Székely,Christina van der Feltz - Cornelis,Ulrich Hegerl | | Journal of Affective Disorders. 2013; 150(2): 320 | | [Pubmed] | [DOI] | | | 16 |
Social Determinants of Adolescent Depression: An Examination of Racial Differences |
|
| Brandon N. Respress,Diana L. Morris,Faye A. Gary,Linda C. Lewin,Shelley A. Francis | | Issues in Mental Health Nursing. 2013; 34(7): 539 | | [Pubmed] | [DOI] | | | 17 |
School Nurses as Gatekeepers to Plan, Prepare, and Prevent Child and Youth Suicide |
|
| Adrian Zupp | | NASN School Nurse. 2013; 28(1): 24 | | [Pubmed] | [DOI] | | | 18 |
Cooking with biomass increases the risk of depression in pre-menopausal women in India |
|
| Madhuchhanda Banerjee,Shabana Siddique,Anindita Dutta,Bidisha Mukherjee,Manas Ranjan Ray | | Social Science & Medicine. 2012; 75(3): 565 | | [Pubmed] | [DOI] | |
|
 |
|
|
|
