Housing size, parental socioeconomic status, and associations with depressive symptoms among adolescents: a cross-sectional study in Guangzhou, China.

BACKGROUNDS

Relatively few studies have focused on the associations between family-related factors and adolescents' mental health in China. This study aimed at investigating the associations between per capita living space, parental socioeconomic status, and depressive symptoms among adolescents.

METHODS

We conducted a cross-sectional survey to investigate the mental health of adolescents in Guangzhou, China. Per capita living space was calculated by dividing the total housing size by the number of residents. Parental socioeconomic status included the education and employment status. Depressive symptoms were measured with the Patient Health Questionnaire-9. Mixed logistic regression analyses with school as a random intercept were used to explore the association between per capita living space, socioeconomic status, and depressive symptoms. Restrictive cubic spline (RCS) was used to examine whether the relationship between per capita living space and depression was linear.

RESULTS

Compared with adolescents living in a house with per capita living space less than 10 m, those living in space of 10-20 m, 20-30 m had significantly lower odds of depressive symptoms, with no significant association observed for space over 30 m. RCS analysis identified a non-symmetric U-shaped association. With the increase of per capita living space, the risk of depressive symptoms first decreased sharply, then rose and finally arrived at a plateau. Subgroup analyses stratified by sex and housing ownership showed similar nonlinear patterns that were observed in the full sample. Higher parental educational levels and maternal unemployment were associated with lower odds of depressive symptoms, whereas paternal unemployment was associated with higher depression risk only among girls.

CONCLUSIONS

Our study highlights the significant and complex influence of family-related social determinants including per capita living space and parental socioeconomic status on adolescents' depressive symptoms. Extremely small living spaces are associated with depressive symptoms, moderate spaces are linked to less depression, while excessively large spaces offer no additional benefit. Prevention to promote adolescents' mental health should prioritize adolescents with these socioeconomic disadvantages.

CLINICAL TRIAL NUMBER

not applicable.