Marmara University School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey; Marmara University, Institute of Health Sciences, Turkey; Istanbul Medipol University School of Medicine, Department of Pediatrics, Istanbul, Turkey.
Marmara University School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey; Marmara University, Institute of Health Sciences, Turkey.
J Affect Disord. 2025 Jan 15;369:110-117. doi: 10.1016/j.jad.2024.09.083. Epub 2024 Sep 23.
Depression is a significant public health concern, with severe adolescent morbidity and mortality. Promoting adolescents' mental health is increasingly recognized, and schools are proposed as screening and preventive intervention sites. This cross-sectional study aimed to screen self-reported elevated depressive symptom prevalence among secondary school students in Istanbul, Turkey. The secondary objectives were determining behavioral problems, resilience, positive attitudes, and risk factors associated with depressive symptoms.
Data collection was conducted between April-June 2022. Six thousand one hundred ten students from nine randomly selected schools from different city districts were approached. Depression was screened by the Centre for Epidemiological Studies Depression Scale for Children (CES-DC). The Strengths and Difficulties Questionnaire (SDQ) was used for screening behavioral problems and positive attitudes. Resilience was evaluated by the Child and Youth Resilience Measure (CYRM).
The final study sample comprised 2780 participants (response rate 47.7 %) with a mean age of 12.4 ± 1.1 years (females:52.7 %). Elevated depressive symptoms were detected in 31.2 % of the students. Female students exhibited higher scores in CES-DC and total difficulties but lower resilience scores in CYRM than male students. In a multiple regression analysis, female gender, higher total difficulties score, lower resilience score, and lower perceived academic performance significantly predicted CES-DC [F(6,2279) = 421, p < 0.01].
Our findings showed high rates of elevated self-reported depressive symptoms in a city sample among Turkish adolescents at middle schools, in addition to coexisting behavioral difficulties and decreased resilience indicating poor psychosocial functioning. Given the prevalent depressive symptoms, screening and intervention programs involving resilience promotion may involve school systems to prevent adolescent depression.
抑郁症是一个严重的公共卫生问题，会给青少年带来严重的发病率和死亡率。促进青少年的心理健康越来越受到重视，学校被提议作为筛查和预防干预的场所。本横断面研究旨在筛查土耳其伊斯坦布尔中学生自我报告的抑郁症状高发率。次要目标是确定与抑郁症状相关的行为问题、适应力、积极态度和风险因素。
数据收集于 2022 年 4 月至 6 月进行。从不同城市地区随机选择的 9 所学校中抽取了 6110 名学生。采用儿童流行病学研究抑郁量表（CES-DC）筛查抑郁。采用长处和困难问卷（SDQ）筛查行为问题和积极态度。采用儿童和青少年适应力量表（CYRM）评估适应力。
最终研究样本包括 2780 名参与者（应答率为 47.7%），平均年龄为 12.4±1.1 岁（女性占 52.7%）。31.2%的学生出现了抑郁症状升高。与男性学生相比，女性学生在 CES-DC 和总分方面的得分较高，但在 CYRM 中的适应力得分较低。在多元回归分析中，女性性别、总分较高、适应力得分较低、感知学业成绩较低均显著预测 CES-DC[F（6,2279）=421，p<0.01]。
我们的研究结果显示，在土耳其中学城市样本中，青少年自我报告的抑郁症状发生率较高，同时存在行为困难和适应力下降，表明社会心理功能较差。鉴于普遍存在的抑郁症状，涉及提高适应力的筛查和干预计划可能需要学校系统来预防青少年抑郁。
