Depression among adolescent students in South India: How serious is the issue?

Sir,

An adolescent student experiences several biological, cognitive, social, and psychological changes. These developments, coupled with peer pressure, parental pressure, and the students’ own expectations of themselves, make this a very volatile and turbulent phase. As teenaged undergraduate medical students ourselves, we felt that we could reach out to high-school students in a way that adults may not be able to as they would relate better to us and be more forthcoming in their responses. Hence, we conducted this study in an attempt to understand the issues that could lead to depression among adolescent students.

We distributed 392 copies of the Beck's depression inventory[1] and a semi-structured questionnaire to the students of classes seven, eight, and nine from three unaided schools. The questionnaire contained questions pertaining to the social factors that could lead to depression. The Chi-square test and SPSS version 17.0 were used for analysis.

We found that 88 (22.45%) students were depressed. There were 27 (6.9%) students with borderline depression, 35 (8.9%) with moderate depression, 16 (4.1%) with severe depression, 10 (2.6%) with extreme depression, and mood disturbances among 71 (18.1%). Depression was detected among a significant number (P = 0.012) of older adolescents (ages 14 and 15 years), and girls were significantly more depressed (P = 0.016). Students who were comfortable with friends and those who received moral support from their families were significantly less depressed (P = 0.022 and P = 0.014, respectively). Moderately and severely depressed students displayed abnormal eating habits (P = 0.014) and those whose families did not spend enough time with them were more susceptible to get depressed (P < 0.001).

Prior studies aimed at assessing the prevalence of depression among adolescent students found relatively lesser numbers of students depressed.[23] Our study found that 22.45% of the students were depressed, and girls were significantly more depressed.

The 2007 India Global School-based Student Health Survey found that high levels of reported parental involvement were significantly associated with a decreased likelihood of poor mental health.[4] Negative life events and parent-adolescent attachment relationship quality were associated with mental health problems in adolescents.[5] A retrospective chart review studied the prevalence in psychiatric comorbidity among juveniles with eating disorders and found that the prevalence of eating disorders was 1.25%. The most common comorbidities were depression, intellectual disability, and dissociative disorder.[6] Our findings were consistent with these.

Adolescents with depression are at risk for increased hospitalizations, recurring depressions, psychosocial impairment, alcohol abuse, and antisocial behavior as they grow up. Some of them also commit suicide.[3] No perfect screening tool for depression exists. However, a simple questionnaire administered either by peers or by persons nearer in age to the adolescent age group might be able to provide valuable information on the state of an adolescent's mind. Being teenagers ourselves, we were able to establish a rapport quite easily with the participants. There is limited information on the prevalence of depression among school-going adolescents in India. Our study, in a small way, attempts to address this issue.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.