Prevalence of possible depression and associated biosocial risk factors among adolescents in a private school in Chennai, South India


  • Aravind Sunderavel Kumaravel Kanagavelu Department of School Health, Velammal Matriculation Higher Secondary School, Mogappair East, Chennai, Tamil Nadu, India
  • Vishnu Chidambaram Department of General Medicine, Government Villupuram Medical College, Villupuram, Tamil Nadu, India
  • Subalakshmi Jayachandar Department of Biology, University of York, York, United Kingdom



Adolescent, Depression, Kutcher’s scale, Physical activity, Mother’s literacy status, School health


Background: Depression among adolescents is often undetected because of lack of awareness in mental health. Schools are the best place to study, analyze and report adolescent depression. The objective of this survey is to find out the prevalence of possible depression and associated bio-social risk factors among high school going adolescents aged 15 and 16 years. This can help reform school curriculum based on the prevalence of depression.

Methods: A school based cross-sectional study done by randomly selecting 10 classrooms from the 11th standard high school compartment in a private school. Data was collected using a pre-designed and structured questionnaire based on Kutcher’s Adolescent Depression Scale. The results were analyzed using R Studio software with Pearson Chi-square test and a p-value of <0.05 was considered statistically significant.

Results: Out of 486 students included in the study, 164(33.7%) have ‘possible depression’ and adolescents aged 16 years(39.5%) has higher proportion of possible depression than adolescents aged 15 years(29.2%), which is statistically significant(p=0.016). About 46.2% of adolescents having illiterate mothers had a possibility of depression. With regards to physical activity 28.1% who played for 3 hours and more had depressive signs and adolescents who played less had 37.2%. This difference is statistically significant (p=0.039).

Conclusions: Being a dormant and hidden disease, depression is one such disease that must be probed by regular health screening. Mother’s literacy status and a modifiable factor ‘physical activity’ have shown promising statistical significance. Adequate physical activity must be included in school curriculum to reduce the risk of depression.


World Health Organization, Adolescent health and development, 13 Jul 2017. Available at: Accessed 28 August 2019.

Fazel MS, Stein K. Depression in young people often goes undetected. Practitioner. 2015 May 21;259(1782).

Collishaw S, Maughan B, Goodman R, Pickles A. Time trends in adolescent mental health. J Child Psychol Psychiat. 2004:45(8):1350-62.

Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatr. 2016 Dec 1;138(6):e20161878.

Naicker K, Galambos NL, Zeng Y, Senthilselvan A, Colman I. Social, demographic, and health outcomes in the 10 years following adolescent depression. Journal of Adolescent Health. 2013 May 1;52(5):533-8.

Untreated Depression, 2008. Available at: Accessed 29 August 2019.

Williams SB, O'Connor EA, Eder M, Whitlock EP. Screening for child and adolescent depression in primary care settings: a systematic evidence review for the US Preventive Services Task Force. Pediatr. 2009 Apr 1;123(4):e716-35.

Garber J, Robinson NS, Valentiner D. The relation between parenting and adolescent depression: Self-worth as a mediator. J adol research. 1997 Jan;12(1):12-33.

Motl RW, Birnbaum AS, Kubik MY, Dishman RK. Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosomatic medicine. 2004 May 1;66(3):336-42.

Brown HE, Pearson N, Braithwaite RE, Brown WJ, Biddle SJ. Physical activity interventions and depression in children and adolescents. Sports medicine. 2013 Mar 1;43(3):195-206.

Rothon C, Edwards P, Bhui K, Viner RM, Taylor S, Stansfeld SA. Physical activity and depressive symptoms in adolescents: a prospective study. BMC medicine. 2010 Dec;8(1):32.

Jerstad SJ, Boutelle KN, Ness KK, Stice E. Prospective reciprocal relations between physical activity and depression in female adolescents. J Consulting Clin Psychol. 2010 Apr;78(2):268.

Brooks S. The Kutcher Adolescent Depression Scale (KADS). Child and Adolescent Psychopharmacol News. 2004 Aug 1;9(5):4-6.

Shukla NK, Shukla M, Ahmad S, Shukla R, Khan Z. A cross-sectional study on depression among school going adolescent girls in Barabanki district, Uttar Pradesh, India. Intern J Contemporary Pediatr. 2016:4(1):178-181.

Twenge JM, Nolen-Hoeksema S. Age, gender, race, socioeconomic status, and birth cohort difference on the children's depression inventory: A meta-analysis. J Abnormal Psychol. 2002 Nov;111(4):578.

Mohanraj R., Subbaiah K. Prevalence of Depressive Symptoms among Urban Adolescents of South India. Indian Association for Child and Adolescent 2010.

Saluja G, Iachan R, Scheidt PC, Overpeck MD, Sun W, Giedd JN. Prevalence of and risk factors for depressive symptoms among young adolescents. Archives of pediatr and adol Med. 2004 Aug 1;158(8):760-5.

Piccinelli M, Wilkinson G. Gender differences in depression: Critical review. The British J Psychiatr. 2000 Dec;177(6):486-92.

Wade TJ, Cairney J, Pevalin DJ. Emergence of gender differences in depression during adolescence: National panel results from three countries. J Am Academy of Child and Adol Psychiatry. 2002 Feb 1;41(2):190-8.

Lewinsohn PM, Gotlib IH, Lewinsohn M, Seeley JR, Allen NB. Gender differences in anxiety disorders and anxiety symptoms in adolescents. J Abnormal psychol. 1998 Feb;107(1):109.

Arroyo-Borrell E, Renart G, Saurina C, Saez M. Influence maternal background has on children’s mental health. Int J equity in Health. 2017 Dec;16(1):63.

Etherington N, McDougall J, DeWit D, Wright V. Maternal factors and the emotional and behavioural functioning of adolescents with chronic health conditions. Disability and rehabilitation. 2016 Jul 2;38(14):1359-69.

Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Preventive Med. 2013 Nov 1;45(5):649-57.

Dunn AL, Trivedi MH, O'Neal HA. Physical activity dose-response effects on outcomes of depression and anxiety. InDatabase of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews 2001. Centre for Reviews and Dissemination (UK).

Ströhle A. Physical activity, exercise, depression and anxiety disorders. J neural transmission. 2009 Jun 1;116(6):777.

Dishman RK, Hales DP, Pfeiffer KA, Felton GA, Saunders R, Ward DS, et al. Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls. Health Psychol. 2006 May;25(3):396.

Martinsen EW. Physical activity and depression: clinical experience. Acta Psychiatrica Scandinavica. 1994 Feb;89:23-7.






Original Research Articles