Depressive symptoms prevalence, associated family factors, and gender differences: A national cohort study of middle school students in China

Abstract

BackgroundThis study examined prevalence and change in depressive symptoms in Chinese adolescents, and roles of inter-parental (I-P) relationship and parent-child (P-C) relationships in its etiology and gender differences. MethodsSurvey data on depressive symptoms, I-P relationship, and indicators of P-C relationships were collected in China Education Panel Survey (2013-2015) from a nationally representative sample of adolescents (n=9,869) at 7th (at baseline), 8th and 9th (follow-up) grades. ResultsPrevalence of depressive symptoms was 17.9% in 7th graders and higher at 25.7% for 9th graders, more remarkably in girls. Better I-P relationship could reduce the risk of depressive symptoms among all (OR=0.53, 95%CI: 0.48, 0.58), girls (OR=0.61, 95%CI: 0.54, 0.69), and boys (OR=0.54, 95%CI: 0.49, 0.61). Greater mother-child (M-C) and father-child (F-C) closeness were protective of depressive symptoms in all and girls (ORs=0.94 to 0.96, p<0.01). More P-C interactions was associated with reduced risk of depressive symptoms among all (OR=0.91, 95%CI: 0.89, 0.93), boys (OR=0.91, 95%CI: 0.89, 0.94), and girls (OR=0.93, 95%CI: 0.91, 0.96). Better I-P relationship increased M-C closeness, F-C closeness, and P-C interactions, which in turn reduced depressive symptoms risk (indirect effects: β=-0.03, 95% CI: -0.04, -0.03). LimitationsThe brief depressive inventory was only able to capture higher depressive symptoms, not clinical depression. ConclusionsDepressive symptoms are prevalent in Chinese adolescents with increases from early to middle adolescence. I-P and P-C relationships reduce depressive symptoms risk. P-C relationships mediated associations between I-P relationship and depressive symptoms. Future interventions may target these family factors to reduce depression among Chinese adolescents.