DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20210248

Prevalence of depression among school going adolescents in India: a systematic review and meta-analysis of cross-sectional studies

Prashanthi Kamath, Sushma Marita Dsouza, Subhransu Mahapatra, Sruthi Jayakumar

Abstract


The objective of this systematic review was to estimate the pooled prevalence of depression among schoolgoing adolescents in India by using Beck’s Depression Inventory (BDI 1 or BDI 2). A systematic literature search was conducted in PubMed, Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, PsycINFO and Google Scholar to identify cross-sectional school-based studies published during 1990-2020. Studies with pre-identified mental illness were excluded. Heterogeneity between studies were examined and estimates were pooled using a random-effects model. Subgroup and sensitivity analysis were performed. Publication bias was evaluated using funnel plot and Egger’s test. We included 13 studies in the meta-analysis. The random effect meta-analysis revealed that the pooled prevalence of depression among school going adolescents was 53% (95% CI: 41% - 65%). By gender, the prevalence was 50% (95 % CI: 38%–62%) in males and 57% (95% CI: 46% - 69%) in females. The subgroup analysis revealed that the pooled prevalence increased with the education levels (High school: 42%; High school and pre-university: 55%; and Pre-university: 67%). In this review we found that more than half of the school going adolescents in India suffered from depression that ranged from mild to severe. These results draw attention to re-look at the mental health policy and newer public health approaches to address depression. Further, strengthening school-based mental health services, along with the community and center-based care is crucial to prevent and effective management of depression among adolescents.


Keywords


Adolescent, Cross sectional, Depression, India, Meta-analysis, Systematic review

Full Text:

PDF

References


Patel V. Mental health in low- and middle-income countries. British Medical Bulletin. 2007;(4):81-96.

WHO. The burden of mental disorders across the states of India: the global burden of disease study 1990-2017. Lancet Psychiatry. 2019;1-14.

Herrman H, Kieling C, McGorry P, Horton R, Sargent J, Patel V. Reducing the global burden of depression: a Lancet-World Psychiatric Association Commission. The Lancet. 2019;393(10189):42-3.

Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJL, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. Hay PJ, Editor. PLoS Med. 2013;10(11):e1001547.

WHO. Caring for children and adolescents with mental disorders: setting WHO directions. Available at http://www.myilibrary.com?id=9727. Accessed on 17 September 2020.

Asarnow JR, Jaycox LH, Duan N, LaBorde AP, Rea MM, Murray P, et al. Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: A randomized controlled Trial. JAMA. 2005;293(3):311.

WHO. Adolescent Mental Health. Available at https://www.who.int/news-room/fact-sheets/detail/ adolescent-mental-health. Accessed on 17 September 2020.

World Health Organization, Regional Office for South-East Asia. mental health status of adolescents in South-East Asia: evidence for action. 2017.

Bansal V, Goyal S, Srivastava K. Study of prevalence of depression in adolescent students of a public school. Ind Psychiatry J. 2009;18(1):43.

Jha K, Singh S, Nirala S, Kumar C, Kumar P, Aggrawal N. Prevalence of depression among school-going adolescents in an Urban area of Bihar, India. Indian J Psychol Med. 2017;39(3):287.

Dhanasekara PR, Sreeranjini T, Aiman A, John S, Prabhu S, Shrinivasa BU, et al. A Study on the prevalence of depression among young adults in South India. Indian J Ment Heal. 2016;4(1):24.

Basker M, Moses PD, Russell S, Russell P. The psychometric properties of beck depression inventory for adolescent depression in a primary-care paediatric setting in India. Child Adolesc Psychiatry Ment Health. 2007;1(1):8.

Breslau N, Peterson EL, Schultz LR, Chilcoat HD, Andreski P. Major depression and stages of smoking: a longitudinal investigation. Arch Gen Psychiatry. 1998;55(2):161.

Joseph DN. prevalence of depression among pre-university college students in an urban area of south India. Int J Curr Res. 2011;3:4.

Khurana S, Sharma S. National mental health program of India: a review of the history and the current scenario. Int J Community Med Public Health. 2016;2:697-704.

Mangal A, Thakur A, Nimavat K, Dabar D, Yadav S. Screening for common mental health problems and their determinants among school-going adolescent girls in Gujarat, India. J Fam Med Prim Care. 2020;9(1):264.

Beck’s Depression Inventory. Available at https://www.ismanet.org/doctoryourspirit/pdfs/ Beck-Depression-Inventory-BDI.pdf. Accessed on 17 September 2020.

Mina F, Kimberly H, Sharon S, Tamsin F. Mental health interventions in schools. Lancet Psych. 2009;1(5):377-87.

Russell PS, Basker M, Russell S, Moses PD, Nair MKC, Minju KA. Comparison of a self-rated and a clinician-rated measure for identifying depression among adolescents in a primary-care setting. Indian J Pediatr. 2012;79(S1):45-51.

Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934-9.

Sharma V. Prevalence of depression among adolescents: a comparative analysis. Paripex. Indian J Res. 2012;3(6):53-5.

Malik M, Khanna P, Rohilla R, Mehta B, Goyal A. Prevalence of depression among school going adolescents in an urban area of Haryana, India. Int J Community Med Public Health. 2015;624-6.

Jayashree K, Mithra P, Nair M, Unnikrishnan B, Pai K. Depression and anxiety disorders among schoolgoing adolescents in an urban area of South India. Indian J Community Med. 2018;43(5):28.

K N, D S, C G, Nk K. prevalence and association of depression and suicidal tendency among adolescent students. Int J Biomed Adv Res. 2012;3(9):714-9.

Sinha S, Patil MS, Viveki RG, Halki S. Prevalence of depression among school going adolescents in an urban area of Karnataka, India: a cross sectional study. Int J Community Med Public Health. 2020;7(5):1790.

Nair MKC, Paul MK, John R. Prevalence of depression among adolescents. Indian J Pediatr. 2004;71(6):523-4.

Rama SL, Patel S, Maata S, Negi P, Sahu N, DKP, et al. Prevalence of depression amongst higher secondary school adolescents in Bhopal Madhya Pradesh. Ntl J Community Med. 2016;7(11):856-8.

P J, M T. Prevalence of Depression among School Going Adolescents in South India. IJPCR. 2015;7(1):61-3.

Mohanraj R, Subbaiah K. Prevalence of depressive symptoms among rural adolescents in South India. J Indian Assoc Child Adolesc Ment Health. 2010;6(2):33-43.

Basu G, Biswas S. Mental health and depression among school going adolescents: excerpts from a school based study of Nadia district, West Bengal. Asian J Med Sci. 2017;8(5):64-9.

Grover S, Raju VV, Sharma A, Shah R. Depression in children and adolescents: a review of indian studies. Indian Psych Soc. 2019;41(3):216-27.

Vankar J, Prabhakaran A, Sharma H. Depression and stigma in medical students at a private medical college. Indian J Psychol Med. 2014;36(3):246.

Jiang CX, Li ZZ, Chen P, Chen LZ. Prevalence of depression among college-goers in Mainland China: a methodical evaluation and meta-analysis. Medicine (Baltimore). 2015;94(50):e2071.

Tang X, Tang S, Ren Z, Wong DFK. Prevalence of depressive symptoms among adolescents in secondary school in mainland China: a systematic review and meta-analysis. J Affect Disord. 2019;245:498-507.

Rao WW, Xu DD, Cao XL, Wen SY, Che WI, Ng CH, et al. Prevalence of depressive symptoms in children and adolescents in China: a meta-analysis of observational studies. Psychiatry Res. 2019;272:790-6.

Xu DD, Rao WW, Cao XL, Wen SY, An FR, Che WI, et al. Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis. J Affect Disord. 2020;268:20-7.

Sajjadi H, Kamal SHM, Rafiey H, Vameghi M, Forouzan AS, Rezaei M. A systematic review of the prevalence and risk factors of depression among iranian adolescents. Global J Health Sci. 2013;5(3):16-27.

Conley CS, Rudolph KD. The emerging sex difference in adolescent depression: Interacting contributions of puberty and peer stress. Development and Psychopathology. 2009;21:593-620.