Depression in Children and Adolescents on the Qinghai-Tibet Plateau: Associations with Resilience and Prosocial Behavior

Buzohre Eli,Changbing Huang,Yiming Liang,Zhengkui Liu,Jin Cheng,Xi Xuan,Jiazhou Wang,Yueyue Zhou

doi:10.3390/ijerph18020440

Abstract

Depression in children and adolescents has become a serious public health problem worldwide. The objectives of this study were twofold: first, to investigate the status of depression among children and adolescents on the Qinghai-Tibet Plateau, the highest plateau in the world, with an average altitude of more than 4200 m (13,776 feet), and second, to examine the associations among prosocial behavior, resilience, and depression. A cross-sectional study was conducted among children and adolescents from Yushu Prefecture on the Qinghai-Tibet Plateau. A total of 11,160 participants aged 10–17 years (Mage = 14.34 years, SD = 1.77; 51.4% girls) were included. Self-reported depression, resilience, and prosocial behavior were assessed. The prevalence of depression was 29.2% in the current study. Higher levels of prosocial behavior were significantly associated with lower levels of depression (β = −0.25, p < 0.001). Furthermore, resilience significantly moderated the relationship between prosocial behavior and depression (β = −0.08, p < 0.001); that is, resilience enhanced the protective role of prosocial behavior in depression. These findings indicate that resilience may play an important role in the associations between prosocial behavior and depression, which suggests that improving resilience is essential for the prevention and intervention of depression among children and adolescents on the Qinghai-Tibet Plateau.

Highlights

Depression is common among children and adolescents worldwide and is the third leading cause of disability in adolescents globally [1]
Y-axis represents the z-score of depression; resilience was divided into two represents the level of prosocial behavior; the Y-axis represents the z-score of depression; resilience was divided into two groups: low groups: low (−1 standard deviation (SD)) and high (+1 SD) levels. This is the first study to examine the prevalence of depression. This is the first study to examine the prevalence of depression and and to explore the associations between prosocial behavior, depression, and resilience in to explore the associations between prosocial behavior, depression, and resilience in a large a large sample of children and adolescents on the Qinghai-Tibet Plateau
Higher levels of prosocial behavior were associated with lower levels of depression

Summary

Introduction

Depression is common among children and adolescents worldwide and is the third leading cause of disability in adolescents globally [1]. A meta-analysis of 52 studies in over 20 countries estimated that the prevalence of depression among children and adolescents was 6–41% [2]. Previous studies have suggested that individuals at high altitudes have a higher prevalence of depression [5,6], as the unique geographical environment and living conditions are associated with high altitudes. For individuals residing at moderate to high altitudes, the resultant hypoxemia and changes in atmospheric pressure, pharmacokinetics, and metabolism could reduce brain levels of serotonin [7], which affect an individual’s mood and emotion regulation [8]. The harsh natural environment and poor environmental and living conditions at high altitudes may exacerbate the vulnerability of children and adolescents to

Objectives

Discussion

Conclusion