Interactive influences of family and school ecologies on the depression status among children in marital immigrant families.

The incidence of transnational marriage has increased significantly in Taiwan in recent years. Children born in immigrant families are predisposed to acculturation and learning problems. We aimed to determine if the children of marital immigrants are more depressed than children from native families, and examine the individual and joint effects of various factors on their depression risk. A cross-sectional study was performed to investigate the depression status of elementary school children in MiaoLi County, Taiwan. A total of 676 participants, including 157 children from families in which the mother was an immigrant and the father native to Taiwan, were recruited from 29 schools. A modified depression scale "Depression Screen Scale for Children and Adolescents" for domestic school children was used to determine depression status. Data which might relate to depression, including demographic, family and school variables, were collected with a structured questionnaire and analyzed with multivariate and stratification methods. The results show that 20.4% of children from immigrant mother families and 17.1% of children from native families exhibited depressive symptoms. The child-parent relationship, peer relationship and academic performance in school were found by logistic regression to be the main predictors of depression in immigrant family children. With further stratification analysis, synergistic effects in immigrant families were found between child-parent relationship and family climate and between peer relationship and academic performance, raising the risk of depression in children of marital immigrants by 7.26- and 7.71-fold, respectively. This synergistic effect was not observed in native families. This study provides significant evidence of synergistic effects between family variables and school variables which increase, up to more than 7-fold, the risk of depression in children of marital immigrants. The results provide hints to parents and teachers for improving the mental health of children in immigrant families by reducing the occurrence of depression.