Abstract
Background: The prevalence of depression rises sharply during adolescence.1,2 Understanding health correlates of adolescent depression may provide descriptive information with regard to which adolescents are more likely to be depressed. Health determinants have been found to have associations with depression in adult populations, but have never been investigated concurrently with depression in a national sample of adolescents in Canada. Therefore, the aim of the present investigation was to understand which health determinants would be significantly associated with adolescent depression.
Methods: A sample of 17,557 adolescents was used from the Canadian Community Health Survey (CCHS) 1.1 to determine the health correlates of adolescent depression among males and females. To understand the relationship between health determinants, logistic regressions were conducted.
Results: The survey had an 84.7% response rate. The past 12-month prevalence of depression among the sample of adolescents was 6.5% ± 0.4% (3.4% ± 0.27% for males and 9.8% ± 0.44% for females). Reporting fair/poor perceived health, smoking, alcohol dependence, food allergies, migraine headaches, chronic bronchitis, and having physical health conditions had positive associations with depression for males and females. However, gender differences in the relationship between health correlates and depression were found. Even after controlling for all variables, females were still more likely to be depressed.
Conclusions: Several health determinants were associated with depression in adolescents in Canada. However, the relationship between some health determinants and depression functioned differently for males and females.
MeSH terms: Adolescent, depression, health, Canada
Résumé
Contexte: La prévalence de la dépression est plus élevée pendant l’adolescence. Il est donc important d’étudier les déterminants de la santé associés à la dépression pour pouvoir décrire quels adolescents sont les plus susceptibles d’être déprimés. On a constaté que certains déterminants de la santé sont associés à la dépression chez l’adulte, mais ce phénomène n’a pas été étudié auprès d’un échantillon d’adolescents canadiens. Le but de notre étude était d’identifier les déterminants de la santé associés de façon significative à la dépression chez les adolescents.
Méthode: Nous avons utilisé un échantillon de 17 557 adolescents tiré de l’Enquête sur la santé dans les collectivités canadiennes (ESCC) — Cycle 1.1 afin de dégager les déterminants de la santé associés à la dépression chez les adolescents. Nous avons procédé par régressions logistiques pour comprendre le rapport entre les déterminants de la santé et la dépression.
Résultats: Les résultats ont démontré que la perception d’avoir une santé mauvaise ou médiocre, le tabagisme, les problèmes d’alcool et les maladies chroniques (entre autres) étaient associés à la dépression chez les hommes et les femmes. Cependant, nous avons découvert des différences entre les sexes à cet égard. Même compte tenu de toutes les variables, le taux de dépression était plus élevé chez les femmes.
Conclusions: Plusieurs déterminants de la santé étaient associés à la dépression chez les adolescents canadiens, mais les liens entre certains déterminants de la santé et la dépression étaient différents selon le sexe.
Footnotes
Acknowledgements: Tracie O. Afifi is supported by the graduate student fellowship from the Manitoba Health Research Council. Brian J. Cox is supported by the Canada Research Chairs program and by the Canadian Institutes of Health Research. Patricia J. Martens is supported by a CIHR New Investigator’s Award.
References
- 1.McGee R, Feehan M, Williams S, Anderson J. DSM-III disorders from age 11 to age 15 years. J Am Acad Child Adolesc Psychiatry. 1992;31:50–59. doi: 10.1097/00004583-199201000-00009. [DOI] [PubMed] [Google Scholar]
- 2.Scourfield J, Rice F, Thapar A, Harold GT, Martin N, McGuffin P. Depressive symptoms in children and adolescents: Changing aetiological influences with development. J Child Psychol Psychiatry. 2003;44:968–76. doi: 10.1111/1469-7610.00181. [DOI] [PubMed] [Google Scholar]
- 3.Wade TJ, Cairney J, Pevalin DJ. Emergence of gender differences in depression during adolescence: National panel results from three countries. J Am Acad Child Adolesc Psychiatry. 2002;41:190–98. doi: 10.1097/00004583-200202000-00013. [DOI] [PubMed] [Google Scholar]
- 4.Patten SB. Incidence of major depression in Canada. CMAJ. 2004;163(6):714–15. [PMC free article] [PubMed] [Google Scholar]
- 5.Rushton JL, Forcier M, Schectman RM. Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health. J Am Acad Child Adolesc Psychiatry. 2002;41:199–205. doi: 10.1097/00004583-200202000-00014. [DOI] [PubMed] [Google Scholar]
- 6.Martens P, Fransoo R, McKeen N T N t K T, Burland E, Jebamani L, et al. Patterns of regional mental disorder diagnoses and service use in Manitoba: A population-based study. Winnipeg, MB: Manitoba Centre for Health Policy; 2004. [Google Scholar]
- 7.Pelkonen M, Marttunen M, Aro H. Risk for depression: A 6-year follow-up of Finnish adolescents. J Affect Disord. 2003;77:41–51. doi: 10.1016/S0165-0327(02)00098-8. [DOI] [PubMed] [Google Scholar]
- 8.Kmett Danielson C, Overholser JC, Butt ZA. Association of substance abuse and depression among adolescent psychiatric inpatients. Can J Psychiatry. 2003;48:762–65. doi: 10.1177/070674370304801109. [DOI] [PubMed] [Google Scholar]
- 9.Patton GC, Coffey C, Posterino M, Carlin JB, Wolfe R. Adolescent depressive disorder: A population-based study of ICD-10 symptoms. Aust N Z J Psychiatry. 2000;34:741–47. doi: 10.1080/j.1440-1614.2000.00825.x. [DOI] [PubMed] [Google Scholar]
- 10.Dahl RE, Lewin DS. Pathways to adolescent health sleep regulation and behavior. J Adolesc Health. 2002;31:175–84. doi: 10.1016/S1054-139X(02)00506-2. [DOI] [PubMed] [Google Scholar]
- 11.Gagnon LM, Patten SB. Major depression and its association with long-term medical conditions. Can J Psychiatry. 2002;47:149–52. doi: 10.1177/070674370204700204. [DOI] [PubMed] [Google Scholar]
- 12.Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med. 2003;36:698–703. doi: 10.1016/S0091-7435(03)00042-2. [DOI] [PubMed] [Google Scholar]
- 13.Kulbok PA, Cox CL. Dimensions of adolescent health behavior. J Adolesc Health. 2002;31:394–400. doi: 10.1016/S1054-139X(02)00422-6. [DOI] [PubMed] [Google Scholar]
- 14.Moldin SO, Scheftner WA, Rice JP, Nelson E, Knesevich MA, Akiskal H. Association between major depressive disorder and physical illness. Psychol Med. 1993;23:755–61. doi: 10.1017/S0033291700025526. [DOI] [PubMed] [Google Scholar]
- 15.Patten SB. Long-term medical conditions and major depression in the Canadian population. Can J Psychiatry. 1999;44:151–57. doi: 10.1177/070674379904400205. [DOI] [PubMed] [Google Scholar]
- 16.Wells KB, Golding JM, Burnam MA. Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry. 1988;145:976–81. doi: 10.1176/ajp.145.8.976. [DOI] [PubMed] [Google Scholar]
- 17.Last JM. A Dictionary of Epidemiology. 4th. New York, NY: Oxford University Press; 2001. [Google Scholar]
- 18.Ustun TB, Kessler RC. Global burden of depressive disorders: The issue of duration. Br J Psychiatry. 2002;181:181–83. doi: 10.1192/bjp.181.3.181. [DOI] [PubMed] [Google Scholar]
- 19.Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60:837–44. doi: 10.1001/archpsyc.60.8.837. [DOI] [PubMed] [Google Scholar]
- 20.Greden JF. The burden of recurrent depression: Causes, consequences, and future prospects. J Clin Psychiatry. 2001;62(Suppl22):5–9. [PubMed] [Google Scholar]
- 21.Cairney J. Gender differences in the prevalence of depression among Canadian adolescents. Can J Public Health. 1998;89:181–82. doi: 10.1007/BF03404470. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Statistics Canada. CCHS cycle 1.1 (2000-2001) 2003. [Google Scholar]
- 23.Statistics Canada. Information for survey participants. 2003. [Google Scholar]
- 24.Statistics Canada. Canadian Community Health Survey CCHS cycle 1.1 derived variable (DV) specification. 2003. [Google Scholar]
- 25.Walters EE, Kessler RC, Nelson CB, Mroczek D. Scoring the World Health Organization’s Composite International Diagnostic Interview short form (CIDI-SF) 2002. [Google Scholar]
- 26.Brooks JS, Schuster E, Zhang C. Cigarette smoking and depressive symptoms: A longitudinal study of adolescents and young adults. Psychol Rep. 2004;95:159–66. doi: 10.2466/pr0.95.1.159-166. [DOI] [PubMed] [Google Scholar]
- 27.Haarasilta LM, Marttunen MJ, Kaprio JA, Aro HM. Correlates of depression in a representative nationwide sample of adolescents (15-19 years) and young adults (20-24 years) European J Public Health. 2004;14:280–85. doi: 10.1093/eurpub/14.3.280. [DOI] [PubMed] [Google Scholar]
- 28.Huebner AJ, Shettler L, Matheson JL, Meszaros PS, Piercy FP, Davis SD. Factors associated with former smokers among female adolescents in rural Virginia. Addicitve Behaviors. 2005;30:167–73. doi: 10.1016/j.addbeh.2004.04.004. [DOI] [PubMed] [Google Scholar]
- 29.Akeakaya N, Aydogan M, Hassanzadeh A, Camcioglu Y, Cokugras H. Psychological problems in Turkish asthmatic children and their families. Allergol Immunopathol. 2003;31:282–87. doi: 10.1016/S0301-0546(03)79197-6. [DOI] [PubMed] [Google Scholar]
- 30.Gillaspy SR, Hoff AL, Van Mullins LL, Pelt JC, Chaney JM. Psychological distress in high-risk youth with asthma. J Pediatric Psychol. 2002;27:363–71. doi: 10.1093/jpepsy/27.4.363. [DOI] [PubMed] [Google Scholar]
- 31.Ortega AN, McQuaid EL, Canino G, Goodwin RD, Fritz GK. Comorbidity of asthma and anxiety and depression in Puerto Rican children. Psychosomatics. 2004;45:93–99. doi: 10.1176/appi.psy.45.2.93. [DOI] [PubMed] [Google Scholar]
- 32.Motl RW, Birnbaum AS, Kubik MY, Dishman RK. Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosom Med. 2004;66:336–42. doi: 10.1097/01.psy.0000126205.35683.0a. [DOI] [PubMed] [Google Scholar]