Table A2.
Summary of studies with prevalence and correlates of Depression/Anxiety.
| Authors/Year | Country | Study Design | Sample Size/Population Size (Response Rate) | Teachers/Age Range | Scales Used | Key Findings | |
|---|---|---|---|---|---|---|---|
| Correlates of Depression/Anxiety |
Prevalence of Depression/Anxiety |
||||||
| Jurado et al., 2005 [82] | Spain | Cross-sectional | 498/602/ (82.7%) | Primary/secondary (women, 45.3 ± 9.8; men, 44.7 ± 9.7). | Spanish version of Epidemiologic Studies Depression scale (CES-D). | Depressive symptoms: female gender, age, low job satisfaction, high job stress, desire to change jobs, working at a public school, personality dimensions of harm avoidance (high), novelty seeking (high) and verbal insults from pupils. | Depressive symptoms 35.3% of the teachers. |
| Al-Gelban 2008 [96] | Saudi Arabia. | Cross-sectional | 189/195 (96.9) | Male 28–57 | Depression, Anxiety and stress DASS-42 scale. | Depression, anxiety, and stress were strongly, positively, and significantly correlated. | 25% percent had depression 43% had anxiety. |
| Fimian et al., 1983 [44] | US | Survey | 365/800 (47%) | Special education | Emotional and Behavioral Manifestations of Stress (24 items); and Physiological Manifestations of Stress (16 items). | Depressed/anxious: teaching special needs. | Not mentioned. |
| Lee et al., 2020 [120] | Malaysia | Cross-sectional | SS = 150 | Female primary/secondary | DASS-21 inventory. | Depression: gender, years of work. Female teachers who suffered depression are those who have been working about 11–15 years. |
15.3% depression; 30.7% anxiety. |
| Ratanasiripong et al., 2020 [88] | Japan | Cross-sectional | 174/200 (87%) | Primary/secondary 41.65 | Japanese version of depression, Anxiety, and Stress scale (DASS-42. Japanese version of the Connor-Davidson Resilience Scale (CD-RISC). Japanese version of the Rosenberg Self-Esteem Scale (RSE). | Depression and anxiety: resiliency and self-esteem, grade taught. Strength significantly predicted anxiety. |
Anxiety in secondary school teachers significantly lower than elementary school teachers. |
| Schonfeld 1992 [90] | New York, US | Longitudinal | SS = 255 | Women 27 | Center for Epidemiologic Studies– Depression Scale (CES-D). | Depressive symptoms: work-environment, job satisfaction. Whites but not among principally Black and Hispanic subsample, motivation has negative affectivity. | Not mentioned. |
| Vladut, et al., 2011 [69] | Romania | Cross-sectional | SS = 177 | Primary/secondary/high | The Depression, Anxiety and Stress Scale. | Anxiety/depression: burnout dimensions, demographic variables, mismatches between work-conditions gender, perception of reward and community. | Higher levels of emotional exhaustion. EE or DP and PA had significantly higher levels of depression, anxiety, and stress. |
| Bianchi et al., 2014 [60] | France | Analytical | SS = 5575 | Teacher, mean 41 | Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). | Depression: burnout: | 90% of the teachers identified as burned out met diagnostic criteria for depression, mainly major depression (85%). 3% (n = 19) of the no-burnout group were identified as depressed, mainly minor depression or depression not otherwise specified (2%). |
| Hammen et al., 1982 [10] | US | Cross-sectional | SS = 75 | Secondary | The Center for Epidemiological Studies-Depression (CES-D) scale. | Depressive symptomatology: stress, stress-related, cognitions regarding the consequences of the stressful circumstances, days off work. | 8% reported major depression. 12% teachers met criteria for possible minor depression. 20% debilitating array of symptoms approximating a clinically significant depression syndrome. |
| Baka 2015 [73] | Poland | Survey | 316/400 (79%) | Elementary/secondary 22–60 | Depression (the Beck Hopelessness Scale). | Depression: 16% high organizational constraints predict depression. Interpersonal conflict, organizational constraints and 2% workload predicts depression. | Not mentioned. |
| Lee et al., 2020 [120] | Malaysia | Cross-sectional | SS = 150 | female primary/secondary | DASS-21 inventory. | Depression: gender, years of work. Female teachers who suffered depression are those who have been working about 11 -15 years. |
15.3% depression; 30.7% anxiety. |
| Pressley et al., 2021 [56] | US | Survey | SS = 329 | Elementary | The COVID Anxiety Scale. A teacher burnout subscale of stress. | Anxiety: stress and communication within the school, and with parents, providing instruction in a virtual environment. Anxiety: COVID-19 pandemic. online teaching was positively related to anxiety in communications. |
56.2% no change in anxiety. 38.9% of participants reported reduced anxiety, 4.9% of teachers felt more anxiety than their baseline at the 1st week of school. Almost 40% had a decrease in anxiety during the 1st month of the 2020–2021 school year. |
| Besse et al., 2015 [31] | US | Survey single-stage sample cluster |
3003/3361 (89%) | Elementary, middle, or high school, mean = 43.9 years |
Occupational health survey and Patient Health Questionnaire. | MDD: Hispanic, divorced, years of experience, taught at elementary level, low job satisfaction and higher absenteeism and increased likelihood of leaving the profession, perceived stress, anxiety. | Teachers with MDD had higher levels of perceived stress, anxiety. |
| Peele et al., 2020 [121] | Ghana | Randomized control trial | SS = 444 | Kindergarten | Goldberg Anxiety and Depression Questionnaire. | Anxiety and depressive symptoms: poor workplace environment, social support, lack of parental support was associated with more anxiety (b = 0.12, p = 0.002), new to the local community. Depressive symptom: household food insecurity. |
Poor workplace environment led to increased anxiety and depressive symptoms. |
| Beer and Beer 1992 [53] | US | Survey | 86/92 (93) | Grade and high school | Beck’s Depression Scale, the Coopersmith Self-esteem Inventory—Adult Form, Stress Profile for Teachers, and the Staff Burnout Scale. | Depression: self-esteem, negative association. Teachers in an institutional setting, there is no significant difference for teaching level or sex on depression. |
Not mentioned. |
| Proctor et al., 1992 [45] | UK | Survey | 256 (93%) | Primary 39.68 | Zigmond and Snaith’s 6 Hospital Anxiety and Depression (HAD) Scale and Moos and Insel’s7 Work Environment Scale (WES). | Anxiety/depression: stressors intrinsic to teaching and related to organizational factors within schools, ensuring pupil progress, work overload, time pressures, role conflict. | 79% low or normal level of depression. 44 (17%) borderline scores and 10 (4%) clinical depression. Anxiety: 92 (36%) had normal scores and 67 (26%) borderline, 97 (38%) scored at a clinical level. |
| Liu et al., 2021 [98] | China. | Survey convenient sampling method |
907/1004 (90.3%) |
Primary and secondary 20 ± 50 | Generic Scale of Phubbing, Ruminative Response Scale, and the Center for Epidemiological Studies Depression Scale. | Depression: phubbing. Combination of phubbing and rumination had no significant effect on depression. |
Not mentioned. |
| Shin et al., 2013 [95] | Korea | Survey | SS = 499 | Middle and high school | Maslach Burnout Inventory–Educator Survey Center for Epidemiological Studies Depression Scale. |
Depression: burnout. Positive relationship between baseline status of teacher burnout and depression. |
Not mentioned. |
| Genoud and Waroux 2021 [41] | Switzerland | Cross-sectional | SS = 470 | Secondary 24–63 | French: Depression Anxiety Stress Scales (DASS). | Anxious profile: emotional exhaustion. Depressive profile: sense of personal accomplishment, no negative affective trait. |
66% (two-thirds) (N = 308) below average for the three dimensions (depression, anxiety, and stress). |
| Pohl et al., 2022 [48] | Hungary | Cross-sectional | 1817//2500 (72.7%) | High 18–65 | Beck Depression Inventory (BDI-SF). Problematic Internet Use Questionnaire. | Depression: internet addiction. | No depression 37.1% (673/1817), 58.9% (1070/1817) had mild, 3.5% (65/1817) had moderate and 0.6% (9/1817) had severe depression. |
| Steinhardt et al., 2011 [68] | US | Cross-sectional | /267 (26%) | High/elementary/middle, mean 45 | The Center for Epidemiological Studies Depression Scale (CES-D). | Depressive symptoms: EE. Positive relationships with DP and reduced PA. Chronic work stress, experienced. | High school teachers reported greater depressive symptoms. |
| Pressley 2021 [58] | US | Survey | 359 | Primary/secondary | COVID Anxiety Scale. | Anxiety: stress, COVID-19, communicating with parents, administrative support, providing instruction in a virtual environment. Anxiety about online teaching was positively related to anxiety in communications. | Virtual instruction teachers have the most increase in anxiety. |
| Ratanasiripong et al., 2020 [88] | Japan | Cross-sectional | 174/200 (87%) | Primary/secondary 41.65 | Japanese version of depression, Anxiety, and Stress scale (DASS-42). Japanese version of the Connor-Davidson Resilience Scale (CD-RISC). Japanese version of the Rosenberg Self-Esteem Scale (RSE). | Resilience and self-esteem significantly predicted depression and anxiety. | Not mentioned. |
| Ptacek et al., 2019 [54] | Czech Republic | Survey | SS = 2394 | Primary 18–72 | Beck Depression Inventory II (BDI II). | Depression: burnout. There is a strong and significant correlation between burnout and depressive symptomatology. |
15.2% mild to severe depression. |
| Bianchi et al., 2016 [92] | New Zealand | Cross-sectional | SS = 184 | School teacher, mean 43 | Depression was assessed with the PHQ-9. | Depressive symptoms: burnout, dysfunctional attitudes, ruminative responses, and pessimistic attributions. | Depression” low burnout-depression,” (n = 56; 30%), “medium burnout-depression” (n = 82; 45%), and “high burnout-depression” (n = 46; 25%). 14/184 (about 8%) reported. |
| Mahan et al., 2010 [71] | US | Cross-sectional | 168/756 (23.9%) | High, mean 42.6 | Ongoing Stressor Scale (OSS) and the Episodic Stressor Scale (ESS), the Co-worker and Supervisor Contents of Communication Scales (COCS), the State Anxiety inventory (S-Anxiety), and the Center for Epidemiological Studies Depression Scale (CES-D). | Anxiety and depression: ongoing and episodic stressors and support, 28% (adjusted 25%) of the variability in anxiety and 27% (adjusted 24%) of the variability in depression. Co-worker support had an inverse relationship to anxiety and depression, work environment stressor. | Higher levels of ongoing stressors, leads to higher levels of anxiety and depression, higher levels of co-worker support related to lower levels of anxiety and depression. |
| Desouky et al., 2017 [28] | Egypt | Cros-sectional | SS = 568 | High | Arabic version of the Occupational Stress Index (OSI), the Arabic validated versions of Taylor manifest anxiety scale and the Beck Depression Inventory. | Anxiety and depression: occupational stress, OS), age, female teachers, primary school teachers, higher teaching experience, higher qualifications and higher workload. | OS anxiety and depression (100%, 67.5% and 23.2%), respectively. Mild, moderate and severe depressive symptoms among teachers was (19.7%, 2.8% and 0.7%), respectively, and little, mild, severe and very severe anxiety was (17.6%, 23.2%, 7.0% and 19.7%), respectively. |
| Jones-Rincon et al., 2019 [65] | US | Cross-sectional | 3003/3361 (89.3%) | Elementary, middle/junior high or high | Patient Health Questionnaire. Job satisfaction was measured with 10 items. | Anxiety disorder: absenteeism, MDD, panic disorder, and somatization disorder and higher intent to quit, Hispanic, subject taught, job satisfaction and job control, years taught. teaching (p = 0.009). | 65.8% major depression in the anxiety group and 11.2% major depression in the no anxiety group. Other depressive disorder among anxiety disorder group 8.4% and no-anxiety group 7.2%. |
| Borrelli et al., 2014 [133] | Italy | Cross-sectional | 113/180 (63%) | Primary/middle | The Karasek Job Content Questionnaire, the Self-Rating Anxiety Scale (SAS) and the Center for Epidemiologic Studies Depression Scale (CES-D). | Depression and anxiety: Job demand and low social support. | About 50% scored above the threshold for depression and for anxiety on self-rating questionnaires. |
| Kinnunen et al., 1994 [51] | Finland | Survey | 1012/1308/ (77%) | High/vocational/special/physical/secondary 45–59 | Anxiety-contentment and depression-enthusiasm; six-item, six-point scales. | Job-related anxiety and depression: subject taught, age, job competence, and job aspiration, lack of PA. Physical education teachers, sex, poor work ability. | Not mentioned. |
| Martínez et al., 2020 [46] | Spain | Random Sampling | 215/300 (71.7%) | Primary 30 to 65 years, M = 44.89 | Zung Self-Rating Depression Scale (SDS), Coping with Stress Questionnaire. | Depressive symptomatology: quality of interpersonal relationships at school, dimensions of burnout. | Not mentioned. |
| Hadi et al., 2008 [94] | Malaysia | Cross-sectional | 565/580 (97.4%) | Secondary M = 40.5 | Depression, Anxiety and Stress Scale (DASS 21) and Job Content Questionnaire (JCQ). | Depression: decision latitude, psychological job demand and job insecurity. | The prevalence of depression was 49.1% (45.0, 53.2). Mild level of depression (21.0%). |
| Ali et al., 2021 [66] | Fiji. | Cross-sectional | SS = 375 | Physical education 20 to 55 years | The Stress with COVID-19 Scale (SCS). The Coronavirus Anxiety Scale (CAS). | Anxiety: social support, and sexual satisfaction during the COVID-19 lockdown, marital status. Married physical education teachers experience more stress. | Married couples scored higher on stress. Anxiety and social support, single teachers scored high. |
| Capone et al., 2019 [70] | Italy | Cros-sectional | SS = 609 | High school, middle school, elementary and primary school. 27 to 65, mean = 48.35 | The Center for Epidemiologic Studies Depression Scale (Italian version. The Teacher Self-Efficacy Scale. | Depression: collective efficacy, all the dimensions of school climate were negatively related to depression, sex. | Women displayed higher depression and exhaustion than men. |
| Aydogan 2009 [84] | Turkey N = 83 Germany N = 78 Cyprus N = 74 |
Cross-sectional | SS = 235 | High M = 38 ± 6.96, 37.9 ± 6.74, 45.8 ± 10.42 | Depression, Anxiety stressTurkish version scale DASS-42. | Depression: burnout, country of origin, job satisfaction. | Not mentioned. |
| Kidger et al., 2016 [81] | Bristol, England | Cross-sectional | 555/708/ (78.4%) | Secondary | Warwick Edinburgh Mental Wellbeing Scale-WEMWBS) Depressive symptoms (Patient Health Questionnaire-PHQ-9). Copenhagen Psychosocial Questionnaire and the Bristol Stress and Health at Work. | Depressive symptoms: sickness absence, student attendance, dissatisfaction with work and high presenteeism, gender, supporting a colleague. Teachers’ wellbeing. | 19.4% moderate to severe depressive symptoms. |
| Bianchi et al., 2015 [99] | France | Survey | SS=627 | Primary/secondary | Depression was assessed with the 9-item depression module. | Baseline depressive symptoms predicted cases of major depression. | T1 baseline MDD 14% T 2 MDD 7%. |
| Soria-Saucedo et al., 2018 [61] | Mexico | Cross-sectional | SS = 43,845 | Female 25–74 | Patient Health Questionnaire (PHQ9). | Severe depression: family and work stress, physical activity, alcohol consumption, and smoking, rural/urban residents. | 7026 teachers (16%) severe depression. |
| Gluschkoff et al., 2016 [80] | Finland | Randomized selection | SS = 76 | Primary/25–63 | PHQ9. | Depressive symptoms: positive associations with effort–reward imbalance and job strain showed with depressive symptoms. Non-restorative sleep. | Not mentioned. |
| Ramberg et al., 2021 [91] | Sweden | Cross-sectional | Year 2014/16 3948/7147 (55.2%) Final SS = 2732 | Teachers | Stockholm Teacher Survey. | Depressed mood: high SOC among colleagues and stress. High SOC was linked with lower levels of stress and depressed mood variation of 4.8% for perceived stress and 2.1% for depressed mood. | Not mentioned. |
| Pohl et al., 2022 [48] | Hungary | Cross-sectional | 1817/2500 (72.7%) | High school/18–65 | BDI. | Moderate and severe depression: internet addiction. | 37.1%: no depression, 58.9% mild, 3.5% moderate and 0.6% severe depression. |
| Papastylianou et al., 2009 [3] | Greece | Cross-sectional | 562/985 (57.1%) | Primary/30–45 | The Centre for Epidemiologic Studies Depression scales. | Depressed affect: (positive) correlation emotional exhaustion (EE). | Depressed affect: 17.86%. |
| Ratanasiripong et al., 2021 [40] | Thailand | Cross-sectional | SS = 267 | Primary/secondary | Depression, Anxiety and Stress Scale Thai Version (DASS). | Depression: family economics status, marital status, classroom size, relationship quality and resilience. Anxiety: family economics status, classroom size and resilience. |
3.2% of teachers had severe to extremely severe depression, 11.2% had severe to extremely severe anxiety. |
| Szigeti et al., 2017 [50] | Hungary | Cross-sectional | SS = 211 | Primary/secondary | Epidemiological Studies-Depression scale. | Depressive symptoms: teaching children with special needs, general burnout factor. | Not mentioned. |
| Baka 2015 [73] | Poland | Cross-sectional | 316/400 (79%) | Primary/secondary 22–60 | The Beck Hopelessness Scale. | Depression: work hours, job demands, general job burnout. High level of depression: interpersonal conflicts, organizational constraints and quantitative workload. |
Not mentioned. |
| Othman et al., 2019 [42] | Malaysia | Cross-sectional | SS = 356 | Secondary | Malay Depression Anxiety Stress Scales (DASS). | Depression, anxiety, and stress: socio-demographic and work-related characteristics such as female, spousal help, educational status, having 1–3 children. | Depression (43.0%), anxiety (68.0%), severe to extremely severe depression 9.9%, anxiety 23.3%. 84.6% depression among those educated up to secondary or diploma level. 45% and 47.6% teachers with longest teaching experience and highest income, respectively. Lack of spousal help (55%) depressed. |
| Skaalvik et al., 2020 [18] | Norway | Longitudinal | SS = 262 | High school | Depressed mood was measured by means of a five-item scale. | Depressed mood: positively associated with emotional exhaustion. | Not mentioned. |
| Li et al., 2020 [55] | China | Cross-sectional | 1741/1795 (97%) | Preschool 18 to 48 | Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale-14. | Depression: teacher weight. Depression (p < 0.001, OR = 3.08, 95% CI: 2.34–4.05) is significantly associated with burnout. | Depression was 39.9%. |
| Gosnell et al., 2021 [57] | Malaysia | Cross-sectional | 124/400 (31%) | Primary/secondary | Depression Anxiety Stress Scales-21 self-care strategy questionnaire. | Depression/anxiety—self-care, being a refugee. Depression and anxiety: negative correlation with age. Younger teachers experienced higher rates of depression and anxiety than older teachers. |
14.4% depression in the severe or extremely severe clinical ranges. 41.2% anxiety levels in the severe or extremely severe clinical ranges. 10.5% nonrefugees reported anxiety at this level. |
| Capone et al., 2020 [59] | Italy | Cross-sectional | SS = 285 | High school 29–65 |
The Center for Epidemiologic Studies Depression Scale (CES-D; Italian version. | Depression: flourishing or languishing. | 23.9% depression “flourishing” group, 38.7% low depression and burnout, 85.7% “languishing” had severe rating of depression. |
| Chan et al., 2002 [74] | China | Survey | SS = 83 | Secondary 22–42 | The shortened 20-item Teacher Stressor Scale (TSS). Chinese shortened version of the General Health Questionnaire (GHQ-20). | Anxiety: support, stress. | New teachers’ highest levels of symptoms in anxiety. |
| Zhang et al., 2014 [52] | China | Survey | SS = 590 | Primary/secondary 34 ±8.11 | Self-reported mental health was measured by the Symptom Checklist-90 (SCL-90). | Anxiety: burnout (EE and DP). | Not mentioned. |
| Nakada et al., 2016 [87] | Japan | Cross-sectional | 1006 (66.7%) | School teachers 39.7 ± 11.6 |
The Japanese version of Zung’s Self-Rating Depression Scale (SDS), Job Stress Questionnaire. | Depressive symptoms: role ambiguity, role conflict, high quantitative workload, and social support from family or friends. | (20.1%) in depressive group. (79.9%) in non-depressive group. |
| Georgas et al., 1984 [79] | Greece | Cross-sectional | SS = 129 | Elementary school teachers 28–46 | Greek adaptation of the Schedule of Recent Experiences (SRE) Life Events Scale. The Manifest Anxiety Scale. | Anxiety: women only; psychosocial stress, sex differences, high correlations between psychosocial stress and anxiety, were found only for females. |
Females reported more symptoms and had higher manifest anxiety than males. |
Sample Size: SS; Major Depressive Disorder: MDD.