Prevalence of depression among school going adolescents in India: a systematic review and meta-analysis of cross-sectional studies

Abstract

The objective of this systematic review was to estimate the pooled prevalence of depression among schoolgoing adolescents in India by using Beck’s Depression Inventory (BDI 1 or BDI 2). A systematic literature search was conducted in PubMed, Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, PsycINFO and Google Scholar to identify cross-sectional school-based studies published during 1990-2020. Studies with pre-identified mental illness were excluded. Heterogeneity between studies were examined and estimates were pooled using a random-effects model. Subgroup and sensitivity analysis were performed. Publication bias was evaluated using funnel plot and Egger’s test. We included 13 studies in the meta-analysis. The random effect meta-analysis revealed that the pooled prevalence of depression among school going adolescents was 53% (95% CI: 41% - 65%). By gender, the prevalence was 50% (95 % CI: 38%–62%) in males and 57% (95% CI: 46% - 69%) in females. The subgroup analysis revealed that the pooled prevalence increased with the education levels (High school: 42%; High school and pre-university: 55%; and Pre-university: 67%). In this review we found that more than half of the school going adolescents in India suffered from depression that ranged from mild to severe. These results draw attention to re-look at the mental health policy and newer public health approaches to address depression. Further, strengthening school-based mental health services, along with the community and center-based care is crucial to prevent and effective management of depression among adolescents.