Prevalence of Depression Symptoms and its related Factors in School Students

Depression is one of the most common psychiatric disorders in children and adolescents. In the past decade, coinciding with the increased prevalence of depression in younger age, much attention has been attracted to the diagnosis and treatment of depression in children and adolescents.
This study aimed to determine the prevalence of depression symptoms in guidance school children and assessment of its relation with some personal and family factors.
This is a cross-sectional descriptive and analytical study which used random multi-stage cluster sampling. First, educational districts 1 and 2 of Rasht city were considered as the two main clusters. In the next stage, in each cluster separately, according to sex (girl's and boy's schools), school type (public, private) and grades (sixth and seventh in primary and third in secondary school), a total of 24 grades in districts 1 and 2 were calculated. The sample size of 618 students was determined based on results of the pilot study. Given that the entire class was considered as a cluster, the number of samples increased to 775 (31 clusters). 753 of all parents returned the completed form.
The research tool included Children Depression Inventory (CDI) and a questionnaire on demographic characteristics (personal-family) which were given to subjects with answer sheets by the researchers. They were asked to answer the questions honestly and accurately according to what they felt at the moment. CDI psychometrics with cut-off 22 had been determined in Iran. The data were analyzed with descriptive and inferential statistics (chi-square, logistic regression and t-test).
Most of subjects were 13 years old (37.6%). Frequency of the girls and boys were 398 (52.9%) and 355 (47.1%), respectively. Moreover, the frequency of the students in sixth and seventh of primary and third grade of secondary school were 249, 268, 236, respectively.70.8% of the students were at public and 29.2% in private schools. Most of them had educational improvement (64.1%), without parents with history of depression (87% fathers, 87.9% mothers). Results revealed 10% of the subjects with depression symptoms (8.5% in boys, 11.3% in girls) in sixth (11.6%) and seventh grades of primary (5.2%) and third grade of secondary (13.1%) in public (4.5%) and private schools (12.2%). 10.6% of the students had educational improvement. 8.9% lacked it. Depression history was recorded for 2% of fathers and 7.7% of mothers. Moreover, 7.9% of fathers and 10.5% of mothers had chronic diseases. Families with monthly income of less than 150 $ had the highest percent of depression (14.4%). Most symptoms of depression were seen in children whose parents were illiterate (12.3%) and high school graduate (4.8%). 19% of unemployed fathers and 10.3% of homemaker mothers had children with highest depression symptoms. Students living in a rental house (10.9%) as well as those whose mother's was dead showed the most symptoms (33.3%).
Results indicated that depression symptoms were significantly related to grade (p=0.008), type of school (p=0.001), and no history of depression in father (p=0.005). Third grade of secondary school students had the highest symptoms. Most of these students were at public than private schools (95% CI, 1.3-5.1- odd ratio: 2.5). Students with father's history of depression had fewer symptoms (2% vs.11%).
Although depression symptoms based on our tool did not necessarily suggest the depression disorder in terms of severity and duration of the symptoms, a significant association was observed between scores of depression and some personal and family factors which insists on considering the importance of these factors in preventive programs for children depression.