Self-reported depressive symptoms among Chinese adolescents

Dataset on the effects of psychological care on depression and suicide ideation in underrepresented children

Massive increases in the risks of depressive disorders and the ensuing suicide have become the overarching menace for children/adolescents. Despite global consensus to instigate psychological healthcare policy for these children/adolescents, their effects remain largely unclear neither from a small amount of official data nor from small-scale scientific studies. More importantly, in underprivileged children/adolescents in lower-middle-economic-status countries/areas, the data collection may not be as equally accessible as in developed countries/areas, thus resulting in underrepresented observations. To address these challenges, we released a large-scale and multi-center cohort dataset (n = 249,772) showing the effects of primary psychological healthcare on decreasing depression and suicidal ideation in these children/adolescents who were underrepresented in previous studies or current healthcare systems, including unattended children/adolescents, orphans, children/adolescents in especially difficult circumstances, and "left-behind" and "single-parenting" children/adolescents. We provided all individual data recording the depressive symptoms and suicide ideation that had been collected at baseline (Oct 2022) and half-year follow-up (May 2023) from practicing this psychological healthcare system.

Independent and joint trajectories of depression and anxiety symptoms among Chinese male sailors throughout a prolonged non-24-h rotating shift schedule at sea: a parallel-process growth mixture modeling approach

BACKGROUND

The predictive and protective effect of hardiness on mental health remains unclear among shift workers on non-24-h working schedules. The present study aimed to investigate the independent and joint trajectories of depression and anxiety symptoms and the role of hardiness during a prolonged period of non-24-h shift working schedule.

METHODS

Four hundred nine Chinese male sailors (working on 18-h watchstanding schedule) were recruited and completed all 5-wave tests through online questionnaires (at Day 1, 14, 28, 42, 55, respectively) during a 55-day sailing. The questionnaires included sociodemographic variables, hardiness, depression and anxiety symptoms. Independent and joint trajectories of depression and anxiety symptoms were estimated by latent growth mixture models. The effect of hardiness on trajectories was examined by logistic regression models.

RESULTS

2 and 3 latent trajectories were identified for depression and anxiety symptoms, respectively. Based on initial levels and development trends, 3 distinct joint trajectories of depression and anxiety were identifed and named as: "Low-Inverted U" group (73.6%), "Moderate-Deterioration" group (6.9%), and "High-Stable" group (9.5%). Sailors with higher levels of hardiness were more likely to follow the "Low-Inverted U" trajectory of depression and anxiety symptoms (all p < 0.001).

CONCLUSIONS

There existed individual differences in the trajectories of depression and anxiety. Hardiness may have a protective effect that can prevent and alleviate depression and anxiety symptoms. Therefore, hardiness-based intervention programs are encouraged among the shift workers on non-24-h working and rest schedules.

Development and validation of the while-in-bed-smartphone-use-induced sleep procrastination scale (WSPS) in Chinese undergraduates with/without problematic smartphone use

PURPOSE

Problematic smartphone use (PSU) has become a global public health problem. Excessive while-in-bed smartphone use may result in sleep procrastination and other negative outcomes. The present study aimed to develop and validate a new scale called WSPS to assess while-in-bed-smartphone-use-induced sleep procrastination among undergraduates.

METHODS

In total, 910 Chinese undergraduates completed the collection of WSPS, smartphone addiction scale-short version (SAS-SV), bedtime procrastination scale, Pittsburgh sleep quality index, and Zung self-rating depression scale. The whole sample were randomly splited in the exploratory factor analysis (EFA) sample (n = 455) and confirmatory factor analysis (CFA) sample (n = 455). 40 undergraduates with PSU (SAS-SV > 31) and 40 without PSU were asked to keep sleep diary for 2 weeks and complete the WSPS again.

RESULTS

EFA and CFA supported a six-item unidimensional structure of the WSPS. The WSPS demonstrated acceptable internal consistency among undergraduates. The WSPS showed good concurrent validity with other relevant variables including PSU, BP, sleep quality, and depression. Scalar invariance of the WSPS between undergraduates with/without PSU was supported, as well as scalar invariance across gender. The WSPS showed good convergent validity with self-report everyday while-in-bed smartphone use duration and good discriminant validity with sleep duration and sleep onset latency recorded by sleep diary. The WSPS also presented good test-retest reliability among undergraduates with/without PSU.

CONCLUSION

The WSPS is a reliable and valid measure of while-in-bed-smartphone-use-induced sleep procrastination in undergraduates with/without PSU.

Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese military personnel

Background

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely used assessment of resilience. However, psychometric properties of the Chinese version of CD-RISC-10 have not been well investigated in a Chinese military personnel sample.

Methods

A total of 3,129 Chinese military personnel completed the CD-RISC-10, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Among them, 528 recruits completed the CD-RISC-10, SAS, and SDS again after 3-month basic military training (BMT). Meanwhile, the commanding officers were asked to rate recruits' training performance on the training performance rating scale for recruits (TPRS). Confirmatory factor analysis (CFA) was implemented to examine the single-factor model of the CD-RISC-10, and multigroup CFA was conducted to test measurement invariance across military rank (officers vs. enlisted), gender (male vs. female), and time (before and after 3-month BMT). Internal consistency was evaluated using Cronbach's α and McDonald's ω, and test-retest reliability was tested using the intra-class correlation coefficient (ICC). The criterion-related validity of CD-RISC was evaluated using Pearson's correlation analysis between the CD-RISC-10 total score and SAS scores, SDS scores, and training performance ratings.

Results

The single-factor model of the CD-RISC-10 showed adequate fit (CFI = 0.955-0.970, TLI = 0.943-0.962, RMSEA = 0.059-0.072) in all examined subsamples (male, female, officer, and enlisted), and strict invariance was also supported across military rank, gender, and time (ΔCFI ≤ 0.001, ΔTLI ≤ 0.005, ΔRMSEA ≤ 0.006). The CD-RISC-10 showed good internal consistency in all subsamples (Cronbach's α of > 0.93 and McDonald's ω of > 0.93) and good test-retest reliability (ICC = 0.88). Moreover, concurrent and predictive validity with the SAS and SDS scores were good (r = -0.68 to -0.49, p < 0.001). The resilience level of recruits at the beginning of BMT was significantly associated with training performance rated by supervisors after training (r = 0.29, p < 0.001).

Conclusion

The psychometric evidence reported in this study suggests that the CD-RISC-10 is a reliable and valid assessment of resilience and a potential predictor for mental health and military performance in Chinese military personnel.

Anxiety and depression related abnormalities in socio-affective learning

Affective distress (as observed in anxiety and depression) has been observed to be related to insufficient sensitivity to changing reinforcement during operant learning. Whether such findings are specific to anxiety or depression is unclear given a wider literature relating negative affect to abnormal learning and the possibility that relationships are not consistent across incentive types (i.e., punishment and reward) and outcomes (i.e., positive or negative). In two separate samples (n = 100; n = 88), participants completed an operant learning task with positive or negative, and neutral socio-affective feedback, designed to assess adaptive responses to changing environmental volatility. Individual parameter estimates were generated with hierarchical Bayesian modelling. Effects of manipulations were modelled by decomposing parameters into a linear combination of effects on the logit scale. While effects tended to support prior work, neither general affective distress nor anxiety or depression were consistently related to a decrease in the adaptive adjustment of learning-rates in response to changing environmental volatility (Sample 1: β_{α:volatility} = -0.01, 95 % HDI = -0.14, 0.13; Sample 2: β_{α:volatility} = -0.15, 95 % HDI = -0.37, 0.05). Interaction effects in Sample 1 suggested that while distress was associated with decrements in adaptive learning under punishment-maximisation, it was associated with improvements under reward-maximisation. While our results are broadly consistent with prior work, they suggest that the role of anxiety or depression in volatility learning, if present, is subtle and difficult to detect. Inconsistencies between our samples, along with issues of parameter identifiability complicated interpretation.

Cybervictimization and non-suicidal self-injury among Chinese adolescents: The effect of depression and school connectedness

Cybervictimization has been shown in many studies to be a risk factor for adolescent non-suicidal self-injurious behavior (NSSI). In this study we tested the roles of depression and school connectedness in this association. The Integrative Model of NSSI, Emotion Regulation and Interpersonal Relationship Model of NSSI, and Integrative Model of Social Media and Suicide provided the conceptual framework for the study. A sample of 1106 adolescents (Mage = 13.17; SD = 0.69; 51.78% girls) completed anonymous questionnaires in their classrooms. The results of structural equation modeling showed that the positive association between cybervictimization and adolescent NSSI was mediated by depression. Moreover, this indirect link was stronger for adolescents with low vs. high school connectedness. The results have implications for intervention programs aimed at reducing NSSI among adolescents.

Depression and Reasoning Ability in Adolescents: Examining the Moderating Role of Growth Mindset

The present two-year longitudinal study aimed to examine the relationship between depression and reasoning ability in adolescents, and further investigated the modulation effect of growth mindset on this relationship. A total of 1,961 and 1,667 Chinese adolescents participated in the study for the first year (T1) and second year (T2), respectively. The results showed that T1 depression was negatively correlated with T1 growth mindset (r = -0.35, p < 0.001), T1 reasoning (r = -0.30, p < 0.001), and T2 reasoning (r = -0.23, p < 0.001). Regression analysis revealed that T1 depression and the interaction between T1 depression and T1 growth mindset significantly predicted T1 reasoning (β = -0.220/-0.044, all ps < 0.05). After controlling for gender, age, family socioeconomic status, and T1 reasoning ability, both T1 depression and the interaction between T1 depression and T1 growth mindset still significantly predicted T2 reasoning (β = -0.104/β = 0.054, all ps < 0.05). The simple slope analysis found that the negative correlation between depression and reasoning in the high growth mindset group was weaker than that of the low growth mindset group in both T1 and T2, suggesting that growth mindset plays a significant moderating role in the relationship between depression and reasoning. In conclusion, depression was negatively correlated with reasoning ability in adolescents, in addition, growth mindset moderated the relationship between depression and reasoning.

Affective Representation of Early Relationships with Parents and Current Anxiety and Depression

Research on the role of early relationships with parents on youth's anxiety and depression, especially in collectivist societies such as China, is limited. To fill this gap, we investigated the unique role of early relationship with mothers and fathers, respectively, in Chinese youth's anxiety and depression outcomes. The participants were 347 Chinese college students from 20 provinces. They first separately rated the frequency of experiencing 13 emotions (e.g., anger) from recalling early relationships with their mothers and fathers, then completed the Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale. Logistic regression was performed to determine the unique contribution of early relationships with mothers and fathers, respectively, to the participants' clinical-level anxiety and depression. Based on the final model of our logistical regression, we found that an increase in negative affective representation of early relationship with the mother was associated with a higher likelihood of clinical level anxiety (OR = 3.58; 95% CI = 1.32-9.70), while an increase in positive affective representation of early relationship with the mother was associated with a lower likelihood of clinical-level depression (OR = 0.47; 95% CI = 0.25-0.87). Furthermore, an increase in negative affective representation of early relationship with the father was associated with a higher likelihood of clinical-level anxiety (OR = 3.36; 95% CI = 1.37-8.26) and depression (OR = 3.68; 95% CI = 1.59-8.52), above and beyond their affective representation of early relationship with the mother.

Depression and anxiety symptoms to COVID-19 outbreak among the public, medical staff and patients during the initial phase of the pandemic: an online questionnaire survey by a WeChat Mini Program

OBJECTIVES

To survey anxiety and depression symptoms to COVID-19 outbreak in the public, medical staff and patients during the initial phase of the pandemic.

DESIGN

Cross-sectional online survey administered through WeChat Mini Program using Chinese versions of Zung Self-rating Depression Scale and Zung Self-rating Anxiety Scale.

SETTING

Guangzhou, China.

PARTICIPANTS

47 378 public, 1512 medical staff and 125 patients with COVID-19.

RESULTS

Higher rates of depression (47.8%) and anxiety symptoms (48.7%) were shown by patients who were screened positive compared with those of the public (35.6%, 25.7%) or medical staff (15.4%, 13.3%). The professional identity of a nurse, conditions of 'with an infected family member' and 'working at the frontline' were risk factors to depression or anxiety symptoms for the medical staff. Younger age, lower educational level, female and not having adequate masks were the risk factors for the public.

CONCLUSION

The COVID-19 outbreak increased people's depression or anxiety emotion responses, which varied extensively among the patients, public and medical staff.

Behaviors of ADHD and Peer Relationship Difficulties in Chinese and American Youths: Role of Co-Occurring Behaviors of Depression and Anxiety

The co-occurrence of behaviors of attention-deficit/hyperactivity disorder (ADHD) with behaviors of anxiety or behaviors of depression is the norm, but little is known on how the co-occurrence accounted for youths' peer relations. The authors report results on difficult peer relations in relation to behaviors of ADHD, co-occurring behaviors of depression, and behaviors of anxiety from three studies on 862 youths in China and in the United States. Study 1 included 313 ethnically and socioeconomically diverse American youths; Study 2 included 250 youths who were adopted out of Chinese orphanages by American parents; and Study 3 included 299 youths from Beijing, China. Data on difficult peer relations and behaviors of ADHD, depression, and anxiety were collected with the third edition of Behavior Assessment System for Children-Self Report of Personality. In all three studies, each type of problems alone significantly predicted difficult peer relations, but behaviors of ADHD were not significant when co-occurring behaviors of depression or co-occurring behaviors of anxiety were considered. Despite that the youths in our study had different cultural and personal backgrounds, there was no evidence that behaviors of ADHD were detrimental to youths' peer relations when behaviors of depression or anxiety were considered. Implications for intervention were discussed.

Self-reported Rates of Abuse, Neglect, and Bullying Experienced by Transgender and Gender-Nonbinary Adolescents in China

IMPORTANCE

This is the first comprehensive national study reporting the rates of abuse, neglect, and bullying from family and classmates or teachers among Chinese transgender and gender-nonbinary adolescents and identifying risk factors associated with poor mental health in this population.

OBJECTIVE

To assess the rates of abuse, neglect, and bullying and their association with poor mental health among Chinese transgender and gender nonbinary adolescents.

DESIGN, SETTING, AND PARTICIPANTS

This national survey study used an online self-selecting survey conducted between January 1, 2017, and September 29, 2017, in China. Eligibility criteria included reporting being aged 12 to 18 years and being transgender or gender nonbinary. Data analysis was performed from March 25 to 28, 2019.

MAIN OUTCOMES AND MEASURES

The main outcome was self-reported poor mental health, including depressive symptoms, anxiety symptoms, and suicidal ideation. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 9-item scale. Anxiety symptoms were measured using the 7-item General Anxiety Disorder scale. Suicidal ideation was measured using standardized questions adapted from previous Chinese studies. Abuse, neglect, and bullying were measured using specifically designed questions.

RESULTS

Of 564 responses collected, 385 respondents (mean [SD] age, 16.7 [1.2] years) met inclusion criteria, including 109 (28.3%) transgender adolescent boys, 167 (43.4%) transgender adolescent girls, and 109 (28.3%) gender-nonbinary adolescents. Among 319 respondents who reported that their parents were aware of their gender identity, 296 (92.8%) reported having experienced parental abuse or neglect. Among the full cohort, 295 respondents (76.6%) reported having experienced abuse or bullying owing to being transgender or gender nonbinary in school from classmates or teachers. There were 173 respondents (44.9%) with Center for Epidemiological Studies Depression 9-item scale scores indicating they were at risk of major depressive disorder, and 148 respondents (38.4%) had 7-item General Anxiety Disorder scale scores indicating they were at risk of an anxiety disorder. In univariate analysis, reporting experiences of bullying from a classmate or teacher was significantly associated with suicidal ideation (odds ratio, 1.68 [95% CI, 1.04-2.70]; P = .03), but the association was no longer statistically significant after controlling for level of educational attainment, aversion to assigned sex, and depressed mood at the onset of puberty (odds ratio, 1.63 [95% CI, 0.97-2.73]; P = .06).

CONCLUSIONS AND RELEVANCE

In this survey study, transgender and gender-nonbinary adolescents in China reported high rates of abuse, neglect, and bullying at home and in school and high rates of symptoms associated with poor mental health. This study highlights the importance of reducing home- and school-based abuse, neglect, and bullying of transgender and gender-nonbinary adolescents in China to improve mental health outcomes; however, broader change in the social environment may be required to address the prejudice and stigma aimed at gender minorities.

Frequency of breakfast consumption is inversely associated with the risk of depressive symptoms among Chinese university students: A cross-sectional study

Introduction

Eating breakfast has been proved to positively influence human health. However, evidence for the association between breakfast consumption and depressive symptoms is lacking, especially among young adults. The aim of this study was to determine whether breakfast consumption is associated with depressive symptoms among Chinese university students.

Methods

A cross-sectional study involving 10,174 undergraduate students (6,287 males and 3,887 females) was conducted in 2015. Breakfast consumption was assessed using a self-reported questionnaire. Depressive symptoms were assessed using the Zung self-rating depression scale (SDS) score. Three cut-off values of the SDS score (40, 45, and 50) were used to assess the severity of the depressive symptoms. Logistic regression models were used to analyze the association between the frequency of breakfast consumption and depressive symptoms.

Results

The mean SDS score was 37.1±8.0 in present study. In crude model, a higher frequency of breakfast consumption was primarily associated with a lower prevalence of depressive symptoms in all three SDS groups (p = 0.001, < 0.001, = 0.009 for SDS cut-off value 40, 45, and 50 points, respectively). These associations remained significant after adjustment for confounding factors.

Conclusions

A higher frequency of breakfast consumption was strongly associated with a lower prevalence of depressive symptoms among Chinese university students. These results corroborate the evidence that the habit of eating breakfast may be beneficial to mental health.

Effectiveness of Online Mindfulness-Based Interventions on Psychological Distress and the Mediating Role of Emotion Regulation

Online mindfulness-based intervention as a feasible and acceptable approach has received mounting attention in recent years, yet more evidence is needed to demonstrate its effectiveness. The primary objective of this study was to examine the effects of online mindfulness-based programs on psychological distress (depression and anxiety). The randomized controlled intervention design consisted of four conditions: group mindfulness-based intervention (GMBI), self-direct mindfulness-based intervention (SDMBI), discussion group (DG) and blank control group (BCG). The program lasted 8 weeks and a total of 76 participants completed the pre- and post-test. Results showed that participants in GMBI and SDMBI had significant pre- and post-test differences on mindfulness, emotion regulation difficulties, and psychological distress, with medium to large effect sizes. In addition, ANCOVA results indicated significant effects of group membership on post-test scores of mindfulness, depression and anxiety when controlling the pretest scores, with medium to large effect sizes. The GMBI appeared to exert the greatest effects on outcome variables in comparison with other groups. In addition, changes in emotion regulation difficulties across groups could mediate the relationship between changes in mindfulness dimensions (Observing and Describing) and changes in psychological distress across groups. These results provided encouraging evidence for the effectiveness of online mindfulness-based interventions in reducing psychological distress, and the possible mediating role of emotion regulation, while also underlining the importance of group discussion in online mindfulness-based interventions.

Longitudinal changes of associations between the preproghrelin Leu72Met polymorphism with depression in Chinese Han adolescents after the Wenchuan earthquake

AIM

The present study aimed to investigate longitudinal associations of preproghrelin Leu72Met with depression in Chinese Han adolescents after the Wenchuan earthquake in 2008.

MATERIALS AND METHODS

A total of 709 volunteers were enrolled from a high school near the epicenter of the earthquake and 662, 643, and 510 students were finally included at 6, 12, and 18 months, respectively, after the earthquake. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). The genotypes were identified by PCR-restriction fragment length polymorphism analyses and verified by DNA sequencing.

RESULTS

Females had a higher prevalence of depression than males at 6 months after the earthquake in 72Leu/Leu homozygotes (χ-test, P=0.007), but not in 72Met allele carriers. 72Met allele carriers had lower prevalence (χ-test, P=0.025) and BDI scores (Kruskal-Wallis test, P=0.034) than 72Leu/Leu homozygotes only among males at 18 months, but not at 6 or 12 months. The prevalence was consecutively decreased in male 72Met allele carriers (χ-test, P=0.010), but not in male 72Leu/Leu homozygotes, female 72Met allele carriers, or female 72Leu/Leu homozygotes during follow-up. Potential factors of depression prevalence and predictors of BDI scores were different between 72Leu/Leu homozygotes and 72Met allele carriers at different time points during follow-up.

CONCLUSION

These results suggest that the 72Met allele of the preproghrelin Leu72Met polymorphism may be associated with rehabilitation of depression in male Chinese Han adolescents after the natural disaster.

Sleep disordered breathing symptoms and daytime sleepiness are associated with emotional problems and poor school performance in children

This study examined the prevalence of sleep disordered breathing (SDB) symptoms and their associations with daytime sleepiness, emotional problems, and school performance in Chinese children. Participants included 3979 children (10.99±0.99 years old) from four elementary schools in Jintan City, Jiangsu Province, China. Children completed a self-administered questionnaire on sleep behavior and emotional problems, while parents completed the Child Sleep Habit Questionnaire (CSHQ). SDB symptoms included 3 items: loud snoring, stopped breathing, and snorting/gasping during sleep. Teachers rated the children's school performance. The prevalence rates of parent- and self-reported SDB symptoms were 17.2% and 10.1% for "sometimes" and 8.9% and 5.6% for "usually". SDB symptoms, more prevalent in boys than in girls, increased the risks for depression, loneliness, and poor school performance. Daytime sleepiness mediated the relationship between SDB symptoms and depression, loneliness, and poor school performance. This study suggests the importance of early screening and intervention of SDB and daytime sleepiness in child behavioral and cognitive development.

Developmental changes in genetic and environmental influences on Chinese child and adolescent anxiety and depression

BACKGROUND

Twin and family studies using Western samples have established that child and adolescent anxiety and depression are under substantial genetic, modest shared environmental, and substantial non-shared environmental influences. Generalizability of these findings to non-Western societies remains largely unknown, particularly regarding the changes of genetic and environmental influences with age. The current study examined changes in genetic and environmental influences on self-reported anxiety and depression from late childhood to mid-adolescence among a Chinese twin sample. Sex differences were also examined.

METHOD

Self-reported anxiety and depression were collected from 712 10- to 12-year-old Chinese twins (mean = 10.88 years, 49% males) and again 3 years later. Quantitative genetic modeling was used to examine developmental changes in genetic and environmental influences on anxiety and depression, and sex differences.

RESULTS

Heritability of anxiety and depression in late childhood (23 and 20%) decreased to negligible in mid-adolescence, while shared environmental influences increased (20 and 27% to 57 and 60%). Shared environmental factors explained most of the continuity of anxiety and depression (75 and 77%). Non-shared environmental factors were largely time-specific. No sex differences were observed.

CONCLUSIONS

Shared environmental influences might be more pronounced during the transition period of adolescence in non-Western societies such as China. Future research should examine similarities and differences in the genetic and environmental etiologies of child and adolescent internalizing and other psychopathology in development between Western and non-Western societies.

Incidence and Teachers' Perceived Causation of Depression in Primary School Children in Greece

Emotional difficulties, and especially depressive symptomatology, constitute a serious and relatively frequent childhood problem which are often overlooked. Teachers' responses to pupils' depression seem to be related to their understanding concerning the causes of this problem. Thus, the aims of the present research are: (a) to estimate the proportion of pupils displaying depressive symptomatology; (b) to examine teachers' readiness and ability to identify those pupils; (c) to search for teachers' perceptions concerning the causation of pupils' behavioural-emotional problems including depression and (d) to explore the differences between younger and older teachers' causal attributions. The sample consisted of 323 pupils from the fifth to sixth grades and their teachers, in the area of Volos, Greece. Pupils completed the Children's Depression Inventory, while their teachers completed a questionnaire concerning their perceptions of the incidence and causes of their students' emotional-behavioural problems and depressive symptoms. The results indicate that approximately 30 percent of the students indicated a high level of depressive symptoms, while their teachers seemed to lack readiness and skills for identifying this; they reported more often behaviour problems and tended to attribute students' difficulties to factors lying outside the school context. Implications are discussed in terms of developments in teachers' training and policies leading to greater support for pupils experiencing depressive symptoms.

Evaluation of the Psychometric Properties of the Asian Adolescent Depression Scale and Construction of a Short Form: An Item Response Theory Analysis

The present study applied item response theory to examine the psychometric properties of the Asian Adolescent Depression Scale and to construct a short form among 1,084 teenagers recruited from secondary schools in Hong Kong. Findings suggested that some items of the full form reflected higher levels of severity and were more discriminating than others, and the Asian Adolescent Depression Scale was useful in measuring a broad range of depressive severity in community youths. Differential item functioning emerged in several items where females reported higher depressive severity than males. In the short form construction, preliminary validation suggested that, relative to the 20-item full form, our derived short form offered significantly greater diagnostic performance and stronger discriminatory ability in differentiating depressed and nondepressed groups, and simultaneously maintained adequate measurement precision with a reduced response burden in assessing depression in the Asian adolescents. Cultural variance in depressive symptomatology and clinical implications are discussed.

Genetic and environmental contributions to anxiety among Chinese children and adolescents--a multi-informant twin study

BACKGROUND

Child and adolescent anxiety has become a major public health concern in China, but little was known about the etiology of anxiety in Chinese children and adolescents. The present study aimed to investigate genetic and environmental influences on trait anxiety among Chinese children and adolescents. Rater, sex, and age differences on these estimates were also examined.

METHODS

Self-reported and parent-reported child's trait anxiety was collected from 1,104 pairs of same-sex twins aged 9-18 years. Genetic models were fitted to data from each informant to determine the genetic (A), shared (C), and non-shared environmental (E) influences on trait anxiety.

RESULTS

The parameter estimates and 95% confidence intervals (CI) of A, C, E on self-reported trait anxiety were 50% [30%, 60%], 5% [0%, 24%], 45% [40%, 49%]. For parent-reported data, the corresponding parameter estimates were 63% [47%, 78%], 13% [1%, 28%], and 24% [22%, 27%], respectively. The heritability of anxiety was higher in girls for self-reported data, but higher in boys for parent-reported data. There was no significant age difference in genetic and environmental contributions for self-reported data, but a significant increase of heritability with age for parent-reported data.

CONCLUSIONS

The trait anxiety in Chinese children and adolescents was highly heritable. Non-shared environmental factors also played an important role. The estimates of genetic and environmental effects differed by rater, sex and age. Our findings largely suggest the cross-cultural generalizability of the etiological model of child and adolescent anxiety.

Trajectory and predictors of depressive symptoms among adolescent survivors following the Wenchuan earthquake in China: a cohort study

OBJECTIVE

To investigate the trajectory of depressive symptoms among adolescents exposed to the Wenchuan earthquake as well as predictors after the earthquake.

METHODS

A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan city was followed-up periodically for 2 years. Participants were assessed at 6, 12, 18, and 24 months after the earthquake. Adolescents completed the Depression Self-rating Scale for Children, Adolescent Self-Rating Life Event Checklist, Resilience Scale, and earthquake exposure questionnaire.

RESULTS

The prevalence rates of depressive symptoms at 6, 12, 18 and 24 months were 27.4, 41, 31.9, and 38.3 %, respectively. The number of adolescents who kept no depressive symptoms and persistent depressive symptoms at each stage was stable, accounted for almost 50 and 20 % of the total, respectively. Adolescents turning no depressive symptoms to depressive symptoms were mostly in 6-12 months, followed by 18-24 months. Additionally, girls (OR 1.24-1.37), post-disaster negative life events (OR for high vs. low = 5.54-15.06), resilience (OR for low vs. high = 9.40-13.69), and depressive symptoms at previous stage (OR 4.96-6.03) had a long-term effect on depressive symptoms, while the impact of earthquake exposure diminished with the passage of time and could not predict depressive symptoms after one and a half years after the earthquake.

CONCLUSIONS

Among adolescent survivors, the resistance and persistence of depressive symptoms were common. Moreover, depressive symptoms tended to outbreak close to the anniversary date, showing the anniversary reaction. Adolescent girls, adolescents who encountered high levels of life events, had low levels of resilience and a history of depressive symptoms should be provided with psychological intervention.

Agreement between parents and adolescents on emotional and behavioral problems and its associated factors among Chinese school adolescents: a cross-sectional study

BACKGROUND

Most studies about informant agreements on adolescents' emotional and behavioral problems have been conducted in Western countries, but this subject has not been well researched in China. The aim of this study was to evaluate the pattern of parent-adolescent agreement on adolescents' problems and its associated factors among school-age adolescents in China.

METHODS

This cross-sectional study was conducted in November and December of 2010. A questionnaire including the Child Behavior Checklist (CBCL), the Youth Self-Report (YSR), the Family Environment Scale (FES) and the characteristics of the child (age and gender), parents (parent-adolescent relationship and parental expectations) and family (family structure, negative life events) was distributed to our study population. A total of 2,199 Chinese adolescents (aged 11-18) from 15 public schools in Liaoning Province, who completed the questionnaire, became our final participants. Pearson's correlation coefficient was used to assess parent-adolescent agreement, and linear regression analysis was used to explore the associated factors of parent-adolescent discrepancies on emotional and behavioral problems.

RESULTS

The parent-adolescent agreement on emotional and behavioral problems was high (mean r = 0.6). The scores of YSR were higher than those of CBCL. Factors that increased informant discrepancies on emotional and behavioral problems were boys, older age, the experience of negative life events, low levels of cohesion and organization, and high levels of conflict in the family.

CONCLUSIONS

A high level of parent-adolescent agreement on emotional and behavioral problems was found. Adolescents reported more problems than their parents did. Family environment is an important factor to be considered when interpreting informant discrepancies on the mental health of Chinese adolescents.

Genetic and environmental influences on depressive symptoms in Chinese adolescents

Adolescent depression is common and has become a major public health concern in China, yet little research has examined the etiology of depression in Chinese adolescents. In the present study, genetic and environmental influences on Chinese adolescent depressive symptoms were investigated in 1,181 twin pairs residing in Beijing, China (ages 11-19 years). Child- and parent-versions of the children's depression inventory were used to measure adolescents' depressive symptoms. For self-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 50, 5, and 45 % of the variation in depressive symptoms, respectively; for parent-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 51, 18, and 31 % of the variation, respectively. These estimates are generally consistent with previous findings in Western adolescents, supporting the cross-cultural generalizability of etiological model of adolescent depression. Neither qualitative nor quantitative sex differences were found in the etiological model. Future studies are needed to investigate how genes and environments work together (gene-environment interaction, gene-environment correlation) to influence depression in Chinese adolescents.

Interaction between a serotonin transporter gene promoter region polymorphism and stress predicts depressive symptoms in Chinese adolescents: a multi-wave longitudinal study

BACKGROUND

The serotonin transporter (5-HTT) gene may play an important role in the onset and development of mental disorders. Past studies have tested whether a functional polymorphism in the 5-HTT gene linked promoter region (5-HTTLPR) moderated the association between stress and depressive symptoms, but the results of these studies were inconsistent. Thus, the aim of the current study was to examine the interaction between 5-HTTLPR and stress that predict depressive symptoms in Chinese adolescents.

METHODS

A total of 252 healthy adolescents (131 females and 121 males, aged from 14 to 18, mean = 16.00, standard deviation = 0.60) participated in this study. During the initial assessment, all participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Adolescent Life Events Questionnaire (ALEQ) and were genotyped for the 5-HTTLPR polymorphism. Participants subsequently completed CES-D and ALEQ once every three months during the subsequent 24 months. A multilevel model was used to investigate the 5-HTTLPR × stress interaction in predicting depressive symptoms.

RESULTS

The results indicated no main effect of 5-HTTLPR and a significant 5-HTTLPR × stress interaction in females only. Females with at least one 5-HTTLPR S allele exhibited more depressive symptoms under stressful situations. No significant 5-HTTLPR × stress interaction was found in males.

CONCLUSIONS

In Chinese adolescents, there are gender differences on the interaction between 5-HTTLPR and stress that predict depressive symptoms. The association between stress and depressive symptoms is moderated by 5-HTTLPR in Chinese female adolescents.

Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models

The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha and 592 adolescents (287 female, 305 male) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular 1-month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents.

Depression in China: integrating developmental psychopathology and cultural-clinical psychology

With a starting point in John Abela's groundbreaking developmental psychopathology research on adolescent depression in China, we aimed to review the state of the literature on Chinese depression across the lifespan. We began with Dr. Abela's published studies relevant to depression in China and our own research with adults before turning to the reference lists of these articles to find additional sources. Then we conducted literature searches using PsycINFO and PubMed to find other relevant studies published between April 2001 and April 2011 . There are two distinct literatures on depression in China. Developmental psychopathology research has emphasized adolescent samples and cognitive models of causation; cultural-clinical psychology and cultural psychiatry research have emphasized adult samples and the meanings associated with emotions, symptoms, and syndromes. Both approaches to the study of depression in China have yielded important findings but have also highlighted issues that could be better addressed by incorporating the other approach. Beyond depression in China, the psychological study of culture and mental health more generally would benefit from greater exchange between developmental psychopathology and cultural-clinical psychology.

Behaviour problems in Chinese primary school children

PURPOSE

This study aimed to determine levels of behaviour problem in primary school children, and to explore key determinants relevant to the Chinese context: being an only child, urban living, school stressors, being bullied and physical punishment.

METHODS

We administered a child self-completion questionnaire to children aged 7-13 and Rutter Parent Scales to their parents in nine primary schools, in urban and rural Zhejiang Province, eastern China.

RESULTS

Full data were available for 2,203 child-parent pairs. Rutter Scores showed that 13.2% of the children (16.4% of boys, 9.4% of girls) had a behaviour problem. Girls manifest more emotional problems (5.3 vs. 2.3%) and boys more conduct problems. Questions about school stress showed that 78% worry "a lot" about exams, 80% felt pressure to perform at school "all the time", and 44% were bullied at least sometimes. Seventy-one percent were sometimes or often physically punished by their parents. Conduct problems were strongly significantly associated with male gender (OR 3.8 95% CI 3.0-4.6), rural residence OR 2.3, 1.3-3.4, having been bullied (1.8, 1.5-2.2) and frequent physical punishment (4.5, 3.2-5.8). Emotional problems were most strongly associated with being bullied (OR 4.9, 2.3-7.7). Being an only child was not associated with behaviour problems.

CONCLUSIONS

High levels of behaviour problems in these Chinese children could relate to high expectations in a very competitive educational environment. Our results raise concerns for the future mental well-being of those children with behaviour problems.

Condition of depressive symptoms among Japanese dental students

The Zung Self-Rating Depression Scale (SDS) is generally used to screen for the presence of depression. The purpose of this study was to investigate scores on the SDS, Japanese version, in undergraduates at Tsurumi University School of Dental Medicine in Yokohama, Japan. A total of 2,197 dental students completed the SDS from 2006 through 2008. The investigation took place each year over a 3-week period from June to July. When investigating, the Institutional Review Board at Tsurumi University approved the study. Students could voluntarily agree or decline to participate in the study, and all responses were provided anonymously. SDS scores by sex, class year, and change over time were analyzed. The mean SDS score ranged from 43.7 ± 8.5 to 44.8 ± 9.0 between 2006 and 2008. Women were significantly more depressed than men in 2007 and 2008. The SDS scores of the same students were high continuously for 2 years. "Diurnal variation," "personal devaluation," and "confusion" had the highest scores of the 20 individual items of the SDS. Of the participating students, 31.4-37.2% were classified as being moderately to severely depressed. Logistic regression analysis was used to compute the odds ratio for SDS scores of ≤47 versus ≥48. The item "suicidal rumination" had the highest chance of being associated with depressive symptoms in all 3 years. Although this research was limited to a single department of dentistry, it appears that dental students experience various levels of depression. Providing mental healthcare options to these students may be helpful.

Rumination as a vulnerability factor to depression in adolescents in mainland China: lifetime history of clinically significant depressive episodes

The current study tested the vulnerability and sex differences hypotheses of the response styles theory of depression (Nolen-Hoeksema, 1991). Participants included 494 tenth-grade students (M = 15.25 years, SD = 0.47) recruited from two secondary schools in Beijing, China. Participants completed self-report measures assessing rumination and neuroticism as well as a semistructured clinical interview assessing current and past clinically significant depressive episodes. Higher levels of rumination were associated with a greater likelihood of exhibiting both a current depressive episode and a past history of depressive episodes even after controlling for neuroticism. Higher levels of rumination were also associated with greater severity and duration of current depressive episodes and greater severity of past depressive episodes even after controlling for neuroticism. Contrary to the sex differences hypothesis of the response styles theory, girls and boys did not differ in levels of rumination.

Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China

This study examined the symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among 2,250 adolescents 6 months after the 2008 Wenchuan earthquake in China. Results showed that 15.8%, 40.5%, and 24.5% of participants reported clinical symptoms of PTSD, anxiety, and depression, respectively. Posttraumatic stress disorder, anxiety, and depression were highly comorbid. Risk factors for symptoms of the 3 disorders were female gender, older age, and earthquake disaster exposure. In addition, the interaction effects of residence (urban/rural) and number of siblings of study subjects on symptoms of the 3 disorders were examined. Implications of findings on intervention and prevention of mental health problems among adolescents after experiencing earthquake disasters are discussed.

The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: a multi-wave longitudinal study

BACKGROUND

Most studies have shown that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in adolescents with subthreshold depression. Thus, the current study examined whether high levels of social support from peers buffer adolescents exhibiting subthreshold depressive symptoms against experiencing further increases in such symptoms following the occurrence of negative events.

METHODS

Participants included 143 adolescents (aged 14 to 18; M=16.07, SD=.66) in Hunan Province China who were selected because they were exhibiting subthreshold depressive symptoms at the time of initial assessment. During an initial assessment, participants completed measures assessing social support from peers and depressive symptoms. Participants subsequently completed measures assessing depressive symptoms and the occurrence of negative events once every three months for the subsequent fifteen months.

RESULTS

The prevalence of lifetime subthreshold depression in Hunan was 22.9% (n=143). The results of hierarchical linear modeling analyses indicated that lower levels of social support from peers was associated with greater increases in depressive symptoms following the occurrence of negative events.

CONCLUSIONS

The results suggested that the association between the occurrence of negative events and increased depressive symptoms is moderated by social support from peers in adolescents with subthreshold depression in mainland China, in line with the buffering hypothesis.

LIMITATIONS

The adolescent sample used in the current study was from Hunan, China, which could limit the generalizability of our results to other populations. In addition, given that it is possible that cultural context shapes symptom manifestation, future research should assess a broader array of symptom outcomes.

Understanding the effect of social capital on the depression of urban Chinese adolescents: an integrative framework

Using data from an ongoing longitudinal study of 5,164 adolescents and their parents from seven cities in mainland China, this study investigated how social capital embedded in the family and the community, together with family human capital and financial capital, influenced the depressive symptoms of urban Chinese adolescents within an integrative framework. The structural equation modeling results suggested that higher community social capital was associated with lower level of adolescent depressive symptoms and was the strongest predictor among all these contextual factors. Family social capital played a significant role in mediating the effects of all other contextual factors on adolescent depressive symptoms. Unexpectedly, higher family financial capital predicted increased depressive symptoms both directly and indirectly through its negative effect on family social capital. As for gender, female adolescents reported more depressive symptoms as a result of less available family social capital. Implications of these findings for theory, practice, policy, and future research are discussed.

Psychological distress and its correlates in Chinese adolescents

OBJECTIVES

The aim of the present study was to estimate the prevalence of severe psychological distress in Chinese adolescents, and to identify the demographic and psychosocial factors associated with psychological distress in this population.

METHOD

A multi-stage stratified sampling procedure was used to select a sample of adolescents (n = 3109) in Heilongjiang Province (Northeast of China), who were aged 13-18 years old. Psychological distress was measured by the Kessler Psychological Distress Scale (K10). A K10 score between 22 and 30 was defined as moderate psychological distress; a score of >or= 31 was defined as severe psychological distress in this study.

RESULTS

The rates of moderate and severe psychological distress were 27.9% and 12.2%, respectively in the participants. There were no statistical differences in severe psychological distress by gender. Multivariate analysis showed that family environmental variables, schooling variables, self-perception with life and appearance, perceived health and negative life events were significantly associated with psychological distress.

CONCLUSION

Severe psychological distress is prevalent in the Chinese adolescent population. Family dysfunction, higher academic pressure, poor relationship with others and negative self-perception are important risk factors associated with psychological distress in adolescents. More studies using the K10 scale are needed so that national and international comparisons can be made.

The relationship between theory of mind and executive function in a sample of children from mainland China

To explore the relationship between theory of mind (ToM) and executive function (EF) in a sample of individuals from mainland China, 20 children with autism spectrum disorders (ASD), 26 children with Attention Deficit Hyperactivity Disorder (ADHD), and 30 normal control subjects were compared on two batteries of ToM tasks and EF tasks. Children with ASD had a significant theory of mind impairment relative to the other controls, while non-verbal IQ removed group differences in executive function. ToM was significantly correlated with inhibitory control. Performance on inhibitory control tasks, however, did not affect performance on ToM tasks.

Depressive symptoms in Chinese children and adolescents: parent, teacher, and self reports

BACKGROUND

Most studies of depressive symptoms in children and adolescents have been conducted in Western countries. This study was designed to examine depressive symptoms and age and gender differences in children and adolescents in China.

METHODS

Participants consisted of two community samples of children and adolescents (n1=4858, n2=1362) in Shandong, China. Child Behavior Checklist (CBCL), Teacher Report Form (TRF) and Youth Self Report (YSR) were used to assess depressive symptoms.

RESULTS

Using American norms, the prevalence rates of depression in Chinese children and adolescents were 5.9% with self report, 0.9% with parent report, and 0.8% with teacher report. Self and teacher-reported depressive symptoms were significantly increased with age for both boys and girls. Compared with American norms, self-reported depressive scores were significantly higher in Chinese adolescents, while parent and teacher-reported scores were significantly lower in Chinese children.

LIMITATIONS

Our study lacks clinical assessment of depressive symptoms and the study is comprised of two separate samples where parent and teacher reports and youth reports could not be compared directly.

CONCLUSIONS

The prevalence of self-reported depressive symptoms in Chinese children and adolescents are much higher than those reported by either parents or teachers. Depressive symptoms are increased with age but do not differ between boys and girls.

Characteristics of adolescent depression

Depression is a common psychiatric disorder that is acknowledged to be increasing in disease burden. The rates of adolescent depression is particularly concerning as they continue to increase. The seriousness and pervasive effects of depression on young people's lives supports the view that research that extends the knowledge in this area is vital. This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.

Mental health, life stress and social support among young Norwegian adolescents with immigrant and host national background

The first aim of the study was to investigate differences in level of mental health, life stress and social support among adolescents with immigrant and domestic background. A second aim was to identify culture group and gender specific sources of risk and protective factors and their relation to mental health. Questionnaire data were collected from 633 students, aged 13, in Oslo, Norway. Immigrant adolescents reported higher level of psychological distress and lower social support than host students. Of the four gender-culture groups, immigrant boys reported the highest level of problems, with a 28% prevalence of anxiety/depression. There were no significant differences in prevalence among the girls. Specific patterns of relationships between life stress, support, and mental health were found across gender and culture. The results were discussed within a framework of culture differences in values and gender role expectancies, underscoring the importance of studying each gender/culture group separately.

Measures of child and adolescent psychopathology in Asia

This article reviews measures of child and adolescent psychopathology used in Asian cultures. Sixteen imported measures from the West are identified and their psychometric equivalence across cultures is reviewed; 2 new measures are briefly introduced. Although initial evidence is generally promising, more studies are needed to support their use in Asia. One recently developed Singapore measure cannot be considered genuinely indigenous. Culture-specific items proposed for imported measures could be grouped into existing diagnostic constructs. There is, as yet, no strong theoretical support for culture-bound diagnostic constructs in Asian cultures.

Health effects of family size: cross sectional survey in Chinese adolescents

AIMS

To determine whether only children differ in terms of morbidity, nutritional status, risk behaviours, and utilisation of health services from children with siblings, in China.

METHODS

A cross sectional survey was carried out using self completion questionnaires, anthropometry, and haemoglobin measurement in middle schools (predominant age 12-16 years) in three distinct socioeconomic areas of Zhejiang province, eastern China.

RESULTS

Data were obtained for 4197 participants. No significant differences were found between only children and those with siblings for some key indicators: underweight 19% v 18%, suicide ideation 14% v 14%, and ever smoking 17% v 15%. Only children were more likely to be overweight (4.8% v 1.5%), and to have attended a doctor (71% v 63%) or dentist (17% v 10%) in the past year. Sibling children are significantly more likely to be anaemic (42% v 32%) and to admit to depression (41% v 21%) or anxiety (45% v 37%). However, after adjusting for area, sex, and parental education levels only two differences remained: sibling children are more likely to be bullied (OR 1.5, 1.1-2.0; p = 0.006) and are less likely to confide in parents (OR 0.6, 0.3-0.8, p = 0.009). There were no significant differences in the key parameters between first and second born children.

CONCLUSIONS

We found no detrimental effects of being an only child using the indicators measured. Being an only child may confer some benefits, particularly in terms of socialisation.

Self-image and depressive symptoms among adolescents in a non-clinical sample

The connection between self-image and depressive symptoms in non-clinical adolescent populations has not been well documented in large samples of teenagers. Our purpose was to investigate the correlation between self-image and depressive symptoms. To assess the adolescent's self-concept, we used the Offer Self-Image Questionnaire (OSIQ), and to study their depressive symptoms, we chose the Children's Depression Inventory (CDI). The sample consisted of 1054 eighth-grade students (465 boys, 589 girls) from normal comprehensive schools in one town with 200 000 inhabitants. The mean age of both gender groups was 14.5 years and they came from all social classes. The results showed a highly significant correlation between OSIQ scale scores and CDI scores. The more problems the adolescents had with their self-image, the greater the number of depressive symptoms. The correlation between the CDI total score and OSIQ scales scores was higher for girls than for boys except for the Superior Adjustment scale. The difference between sexes in the strengths of the correlations was highly significant (P<0.0001) except in the Sexuality scale. Since both the tests have shown to have predictive value for later psychiatric symptoms, further investigation of high-scoring CDI adolescents', and especially girls', self-image problems is important.

Sexual functioning and self-reported depressive symptoms among college women

We conducted an exploratory study comparing 47 college-aged women reporting depressive symptoms but not receiving antidepressant medication to 47 age-matched controls. We examined various dimensions of sexual functioning, including sexual desire, arousal, orgasm, pain, pleasure, and satisfaction. The women with depressive symptoms reported more inhibited sexual arousal, more inhibited orgasm, more sexual pain problems, and less sexual satisfaction and pleasure than control participants. Novel to this study, the women with depressive symptoms reported greater desire for sexual activity alone (masturbation) than the nondepressed women. The findings are discussed in terms of primary reinforcers and depressive symptomology.

Serotonin dysregulation in adolescents with major depression: hormone response to meta-chlorophenylpiperazine (mCPP) infusion

This study examined central serotonin disturbance, as reflected by neuroendocrine hormones, among adolescents with major depression. Prolactin, cortisol, and growth hormone were measured following the infusion of a serotonin agonist, meta-chlorophenylpiperazine (mCPP). Twelve (M=6, F=6) medication-free adolescents with major depression (MDD) were compared with 12 (M=6, F=6) matched normal control subjects, ranging in age from 13 to 17 years. Baseline evaluations and a battery of laboratory tests were completed. mCPP, 0.1 mg/kg i. v., was administered in a placebo-controlled design. Analyses of the neuroendocrine hormones revealed that the depressed group had a higher baseline prolactin level and an augmented prolactin response to mCPP challenge than did the control group. The depressed group experienced a sharper baseline-cortisol decline between 08.00 and 11.00 h, and compared to control subjects they displayed an augmented response to the challenge. The depressed group reported more side effects than the control group during saline infusion, but not during mCPP infusion. Findings suggest that depressed adolescents have an elevated baseline prolactin level, and also experience enhanced prolactin and cortisol responses to the serotonergic challenge. These preliminary findings will be confirmed during our ongoing study.

Depression and body fat deposition in Mexican pregnant adolescents

BACKGROUND

The objective of this study was to assess the effect of maternal depressive symptomatology on fat deposition in a group of pregnant adolescents.

METHODS

A case-control study was performed with 85 pregnant women (45 adolescents and 40 adults) who attended a prenatal care course at a teaching hospital in Mexico City. During the second and third trimesters of gestation, a test proposed by Zung was applied to measure depressive symptoms. Weight and skinfolds (i.e., triceps, biceps, suprailiac, subscapular, and thigh) were measured in all women beginning at week 20 of gestation through 4 weeks postpartum. Monthly evaluations were performed.

RESULTS

At the 28th week of gestation, nearly 40% of pregnant adolescents showed scores above the cut-off points in the depression test, while among the adults this proportion corresponded to 15%. In the adolescents, depression status was related to self-esteem. Percentage of body fat in adult women tended to be relatively constant, while in adolescents a tendency toward increased body fat was found. In adolescents, depressive symptomatology and especially lack of self-esteem and weight gain during pregnancy were the variables that better predicted the fat-increment pattern during gestation, while in adults no variable was found that predicted fat deposition.

CONCLUSIONS

Depression status is a risk factor for excessive fat deposition during pregnancy in Mexican adolescents.