Risk factors associated with depressive symptoms in adolescents in a small municipality
Keywords:Depression; Adolescent; Mental health; Small town.
Introduction: World Health Organization projections indicate that depressive disorders in adolescents increase worldwide, with 10% to 20% experiencing mental health problems. In Brazil, studies show an average of 13.2%, thus considered a public health issue. For that, we sought to elucidate the risk factors associated with depression symptoms in adolescents who live in small cities. Methodology: Cross-sectional, descriptive and analytical study with a quantitative approach. The data was collected from a sample of 324 students from the municipality of Marialva / PR - Brazil, through a sociodemographic questionnaire and a screening tool for depressive episodes, the PHQ - 9 (Patiente Health Questionnaire - 9). The analysis occurred by linear regression, correlation matrix and network analysis. Results: 64.2% had moderate to severe symptoms, with a higher prevalence in female adolescents, with 20.1% showing severe symptoms. The associated risk factors were longer use of cell phones; not going to parks; not playing sports; using legal drugs; and reporting anxiety diagnosis and family depression cases. Adolescents who play on their cell phone alone were 5.1 times more likely to develop depressive symptoms, and those who use drugs in groups, 5.5 times. The strongest negative connections were found between PHQ-9 and being female, not going to parks or areas of sports and leisure, and reporting family depression. Conclusion: The study suggests that small cities with inadequate and unfriendly urban structures may highlight the issue of depressive disorders in adolescents, which indicates the need for public policies to improve the prospects of this demographic.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Arlington, VA: American Psychiatric Association, 2013.
Bai, S., Zeledon, L. R., D'Amico, E. J., Shoptaw, S., Avina, C., LaBorde, A. P., Anderson, M., Fitzpatrick, O. M., & Asarnow, J. R. (2018). Reducing Health Risk Behaviors and Improving Depression in Adolescents: A Randomized Controlled Trial in Primary Care Clinics. Journal of pediatric psychology, 43(9), 1004–1016. https://doi.org/10.1093/jpepsy/jsy048
Bickham, D. S., Hswen, Y., & Rich, M. (2015). Media use and depression: exposure, household rules, and symptoms among young adolescents in the USA. International journal of public health, 60(2), 147–155. https://doi.org/10.1007/s00038-014-0647-6
Brazilian Society of Pediatrics (SBP). Brazil. 2019. https://www.sbp.com.br/imprensa/detalhe/nid/aumento-da-depressao-na-infancia-e-adolescencia-preocupa-pediatras/
Brito, M. F. S. F., Pinho, L., Brito, A. B., Messias, R. B., Pinto, S. Oliveira, A. A., Silva, C. S. O., Volker, V., & Silveira, M. F. (2019). Fatores associados ao estilo de vida de estudantes do ensino médio de escolas públicas. Rev Gaúcha Enferm. 40:e20180168. https://doi. org/10.1590/1983-1447.2019.20180168.
David Hevey (2018) Network analysis: a brief overview and tutorial, Health Psychology and Behavioral Medicine, 6:1, 301-328, 10.1080/21642850.2018.1521283
Dzhambov, A. M. (2018). Residential green and blue space associated with better mental health: a pilot follow-up study in university students. Arhiv za higijenu rada i toksikologiju, 69(4), 340–349. https://doi.org/10.2478/aiht-2018-69-3166
Fatori, D., et al (2018). Prevalência de problemas de saúde mental na infância na atenção primária. Ciência & Saúde Coletiva, 23(9), 3013-3020. https://doi.org/10.1590/1413-81232018239.25332016
Fleitlich-Bilyk, B., & Goodman, R. (2004). Prevalence of child and adolescent psychiatric disorders in southeast Brazil. Journal of the American Academy of Child and Adolescent Psychiatry, 43(6), 727–734. https://doi.org/10.1097/01.chi.0000120021.14101.ca
Fu, Q. (2018). Communal space and depression: A structural-equation analysis of relational and psycho-spatial pathways. Health & Place. Sep; 53: 1-9. DOI: 10.1016/j.healthplace.2018.06.007.
Gomes, G. A. de O., Papini, C. B., Nakamura, P. M., Teixeira, I. P., & Kokubun, Eduardo. (2019). Barreiras para prática de atividade física entre mulheres atendidas na Atenção Básica de Saúde. Revista Brasileira de Ciências do Esporte, 41(3), 263-270. 2019.https://doi.org/10.1016/j.rbce.2018.04.007
Gorostiaga, A., Aliri, J., Balluerka, N., & Lameirinhas, J. (2019). Parenting Styles and Internalizing Symptoms in Adolescence: A Systematic Literature Review. International journal of environmental research and public health, 16(17), 3192. https://doi.org/10.3390/ijerph16173192
He, J. P., Paksarian, D., & Merikangas, K. R. (2018). Physical Activity and Mental Disorder Among Adolescents in the United States. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, 63(5), 628–635. https://doi.org/10.1016/j.jadohealth.2018.05.030
Instituto Brasileiro de Geografia e Estatística (IBGE cidades) page. https://cidades.ibge.gov.br/.
Instituto Brasileiro de Geografia e Estatística (IBGE) page. https://censo2010.ibge.gov.br/sinopse/index.php?uf=41&dados=6
Instruction manual for the Patient Health Questionaire (PHQ-9) and CAD-7. www.phqscreeners.com
Jatobá, J. D’Arc V.N., & Bastos, Othon. (2007). Depressão e ansiedade em adolescentes de escolas públicas e privadas. Jornal Brasileiro de Psiquiatria, 56(3), 171-179. https://dx.doi.org/10.1590/S0047-20852007000300003
Johnson, R. A., & Wichern, D. W. (2007). Applied multivariate statistical analysis, Madison: Prentice Hall International.
King, D. L., Delfabbro, P. H., Perales, J. C., Deleuze, J., Király, O., Krossbakken, E., & Billieux, J. (2019). Maladaptive player-game relationships in problematic gaming and gaming disorder: A systematic review. Clinical psychology review, 73, 101777. https://doi.org/10.1016/j.cpr.2019.101777
La Maison, C., Munhoz, T. N., Santos, I. S., Anselmi, L., Barros, F. C., & Matijasevich, A. (2018). Prevalence and risk factors of psychiatric disorders in early adolescence: 2004 Pelotas (Brazil) birth cohort. Social psychiatry and psychiatric epidemiology, 53(7), 685–697. https://doi.org/10.1007/s00127-018-1516-z
Machado, I.C., Silva, N.S.S., Haikal, D.S., Silveira, M.F., Alves, M.L.T.S., & Silva, R.R.V. (2018). Prevalência De Sintomas Depressivos Entre Adolescentes Da Rede Pública De Ensino. Adolesc. Saúde. 1(4): 27-35.
Malas, N., Plioplys, S., & Pao, M. (2019). Depression in Medically Ill Children and Adolescents. Child and adolescent psychiatric clinics of North America, 28(3), 421–445. https://doi.org/10.1016/j.chc.2019.02.005
Marin, A. H., Peuker, A. C., & Kessler, F. H. P. (2019). Sociodemographic Characteristics, School Performance, Pattern of Consumption and Emotional Health as Risk Factors for Alcohol use among Adolescents. Trends in Psychology, 27(1), 279-292. https://doi.org/10.9788/tp2019.1-20
Min, K.b., Kim, H.J., Kim, H.J., & Min, J.Y. (2017). Parks and green areas and the risk for depression and suicidal indicators. Int J Public Health 62, 647–656. https://doi.org/10.1007/s00038-017-0958-5
Mullins, N., & Lewis, C. M. (2017). Genetics of Depression: Progress at Last. Current psychiatry reports, 19(8), 43. https://doi.org/10.1007/s11920-017-0803-9
Na, E., Choi, I., Lee, T. H., Lee, H., Rho, M. J., Cho, H., Jung, D. J., & Kim, D. J. (2017). The influence of game genre on Internet gaming disorder. Journal of behavioral addictions, 6(2), 1–8. Advance online publication. https://doi.org/10.1556/2006.6.2017.033
Ning, K., Gondek, D., Patalay, P., &Ploubidis, G.B. (2020). The association between early life mental health and alcohol use behaviours in adulthood: A systematic review. PLoS ONE. 15(2): e0228667. https://doi.org/10.1371/journal.pone.0228667
Orellana, J. D. Y., Ribeiro, M. R. C., Barbieri, M. A., Saraiva, M. da C., Cardoso, V. C., Bettiol, H. Silva, A. A. M. da, Barros, F. C., Gonçalves, H., Wehrmeister, F. C., Menezes, A. M. B., Del-Ben, C. M., & Horta, B. L. (2020). Transtornos mentais em adolescentes, jovens e adultos do Consórcio de Coortes de Nascimento brasileiras RPS (Ribeirão Preto, Pelotas e São Luís). Cadernos de Saúde Pública, 36(2), e00154319. 31, 2020.https://doi.org/10.1590/0102-311x00154319
Park, S. Y., Yang, S., Shin, C. S., Jang, H., & Park, S. Y. (2019). Long-Term Symptoms of Mobile Phone Use on Mobile Phone Addiction and Depression Among Korean Adolescents. International journal of environmental research and public health, 16(19), 3584. https://doi.org/10.3390/ijerph16193584
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.
Pérez, C. A., Valdés, M. E. F., Ramos, K. F., González, L. I. F., & Figueredo, I. C. G. (2020) Indicadores de la realidad de un grupo de púberes en el entorno escolar. Multimed, 24(6), 1258-1270. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-48182020000601258&lng=es&tlng=es.
Pullmer, R., Chung, J., Samson, L., Balanji, S., & Zaitsoff S. (2019) A systematic review of the relation between self-compassion and depressive symptoms in adolescents. Journal of Adolescence74:210-220. 10.1016/j.adolescence.2019.06.006.
Raphaelli, C. de O., et al (2020). Cross-sectional study on work and health risk behaviors among school students in a rural area of Rio Grande do Sul State, Brazil, 2010. Epidemiologia e Serviços de Saúde, 29(3), e2019285. https://doi.org/10.5123/s1679-49742020000300006
Stein, G., Curry, J., Hersh, J., Breland-Noble, A., March, J., Silva, S., Reinecke, M., & Jacobs, R. (2010). Ethnic Differences Among Adolescents Beginning Treatment for Depression. Cultural diversity & ethnic minority psychology. 16. 152-8. 10.1037/a0018666.
Twenge J.M., & Campbell, K. (2018) Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive Medicine Reports. 12: 271–283
Vanaken, G. J., & Danckaerts, M. (2018). Impact of Green Space Exposure on Children's and Adolescents' Mental Health: A Systematic Review. International journal of environmental research and public health, 15(12), 2668. https://doi.org/10.3390/ijerph15122668
World Health Organization (WHO), 2018. https://nacoesunidas.org/oms-1-em-cada-5-adolescentes-enfrenta-problemas-de-saude-mental/
World Health Organization (WHO), 2020. Depression. https://www.who.int/health-topics/depression#tab=tab_1.
Yun, J. Y., Chung, H., Sim, J. A., & Yun, Y. H. (2019) Prevalence and associated factors of depression among Korean adolescents. PLoS ONE 14(10): e0223176. https://doi.org/10.1371/journal.pone.0223176
How to Cite
Copyright (c) 2021 Ademilson José Bernardineli; Lincoln Luis Silva; Claudia Regina Marchiori Antunes Araújo; Raissa Bocchi Pedroso
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.