Psychosocial risk-factors of depression in adolescents: a cross-sectional study at tertiary hospital of southern Rajasthan

Prerna Vaishnav; Lalit Kumar Seju; Ravi Choudhary; Gargi Bansal; Milli Singh

doi:10.18203/2349-3291.ijcp20252911

Authors

Prerna Vaishnav Department of Paediatrics, GBH General Hospital - American International Institute of Medical Sciences (AIIMS) College, Udaipur, Rajasthan, India
Lalit Kumar Seju Department of Paediatrics, GBH General Hospital - American International Institute of Medical Sciences (AIIMS) College, Udaipur, Rajasthan, India
Ravi Choudhary Department of Paediatrics, GBH General Hospital - American International Institute of Medical Sciences (AIIMS) College, Udaipur, Rajasthan, India
Gargi Bansal Department of Paediatrics, GBH General Hospital - American International Institute of Medical Sciences (AIIMS) College, Udaipur, Rajasthan, India
Milli Singh Department of Paediatrics, GBH General Hospital - American International Institute of Medical Sciences (AIIMS) College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20252911

Keywords:

Depression, Family, Social, Adolescents, Abuse

Abstract

Introduction: Depression in adolescent is a growing global issue in India where world largest adolescent population with 253 million individuals resides. In 2024 global prevalence of depression among adolescent’s ranges from 6% to 21.3% according to World Health Organization. Family unrest contributes to risk of depression among adolescents.

Methods: A Cross-sectional study was conducted on adolescents with non-cardiac chest pain between age 10-19 years. Research-designed questionnaire including demographic and risk factors was completed for each participant. PHQ 9 is patient health questionnaire tool of 9 items used to assess depressive symptoms. The participated adolescents who scored 15 and above were considered Depressed. Univariate analysis was performed to find out psychosocial risk factors. Adjusted odds ratio with 95% confidence intervals were derived. To test association of depression with socio-demographic factors we used PHQ-9 continuous scores as our main outcome.

Results: Total 60 adolescents were assessed for depression using PHQ 9 severity assessment tool. 26.6% were found depressed using PHQ 9 score 15 and above. On Univariate analysis female gender, elder in age, belonging to lower socioeconomic class, dropped out of school, experiencing family conflicts and experiencing domestic abuse were significantly associated with depression. Living with single parents had 3.76 times higher risk of depression. 15.7% males were experiencing academic stress. Living arrangement, chronic illness, use of social media and relationship breakdown were not found significant risk factors.

Conclusions: Depression is common in elderly female of Rajasthan belonging to lower socioeconomic class. Most common risk factors being family conflicts and domestic abuse. Academic stress in male adolescents living with parents was significant risk factor. There is urgent need to educate parents, to reduce parental pressure on academic performance and to stop early child marriage at rural level to save mental health of adolescents.

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References

Hendel N. United Nations International Children’s Emergency Fund (UNICEF). In International conflict and security law: A Research Handbook. 2022: 719-731. DOI: https://doi.org/10.1007/978-94-6265-515-7_34

Andrade EA, Galvão MC. International Statistical Classification of Diseases and Related Health Problems (ICD-11): from its origin to its use in digital systems. Ciência & Saúde Coletiva. 2025;30:1402024. DOI: https://doi.org/10.1590/1413-812320242911.01402024en

Kavya Sri T, Donipudi PC. A study on Prevalence and Risk factors of depression. J Med Sci National Board Exam. 2024;2(7):704-15. DOI: https://doi.org/10.61770/NBEJMS.2024.v02.i07.007

Nelson EE, Leibenluft E, McClure EB, Pine DS. The social re-orientation of adolescence: a neuroscience perspective on the process and its relation to psychopathology. Psychol Med. 2005;35(2):163-74. DOI: https://doi.org/10.1017/S0033291704003915

Mullen S. Major depressive disorder in children and adolescents. Ment Health Clin. 2018;8(6):275-83. DOI: https://doi.org/10.9740/mhc.2018.11.275

Shekhawat R, Sharrma N, Sodha VS. Prevalence of mental health problems by using strength and difficulty questionnaire in school going adolescents (11–17 years) of Jaipur city, Rajasthan. Int J Comm Med Publ Health. 2019;6:2216-22. DOI: https://doi.org/10.18203/2394-6040.ijcmph20191847

Malhotra S. Characteristics of patients visiting the child & adolescent psychiatric clinic: a 26-year study from North India. J. Indian Assoc. Child Adolesc. Ment. Health. 2007;3(3):53-60. DOI: https://doi.org/10.1177/0973134220070302

Khairandish Z, Jamali L, Haghbin S. Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic. Cardiol Young. 2017;27(1):125-30. DOI: https://doi.org/10.1017/S1047951116000238

Eliacik K, Bolat N, Kanik A, Malas N, Demircan T, Hortu H, Özyurt G. Adolescents with unexplained chest pain reported depression and impaired emotional and social functioning. Acta Paediatr. 2020;109(8):1642-8. DOI: https://doi.org/10.1111/apa.15144

Bhan N, Jose R, Silverman JG, Raj A. Family violence as determinant of suicidality and depression among adolescents in India. J Glob Health Rep. 2019;3:71. DOI: https://doi.org/10.29392/joghr.3.e2019072

Osok J, Kigamwa P, Stoep A, Huang KY. Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi. BMC Psych. 2018;18:136. DOI: https://doi.org/10.1186/s12888-018-1706-y

Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. 2012;379(9820):1056-67. DOI: https://doi.org/10.1016/S0140-6736(11)60871-4

Bhardwaj T, Arora N, Rajvanshi A. Psychometric Evaluation of Patient Health Questionnaire 9 Hindi for Use with Patients with Cancer in Community Palliative Care Settings. Indian J Palliat Care. 2025;31:177-85. DOI: https://doi.org/10.25259/IJPC_250_2024

Sagar R, Pattanayak RD, Mehta M. Clinical profile of mood disorders in children. Indian Pediatr. 2012;49(1):21-3.

Handbook S. Rashtriya Kishor Swasthya Karyakram. Adolescent Health Division Ministry of Health and Family Welfare Government of India. 2014.

Siddik MAB, Munmun SM, Hasan N, Syfullah E. Physio-psychosocial risk of depression among college-going adolescents: A cross-sectional study in Bangladesh. J Affect Disord. 2024;16:100768. DOI: https://doi.org/10.1016/j.jadr.2024.100768

Piechaczek CE, Pehl V, Feldmann L, Haberstroh S, Allgaier AK, Freisleder FJ, Schulte-Körne G, Greimel E. Psychosocial stressors and protective factors for major depression in youth: evidence from a case–control study. Child Adoles Psychiat Mental Heal. 2020;14(1):6. DOI: https://doi.org/10.1186/s13034-020-0312-1

Ahir R, Singhal YK, Dhaked MS, Sharma P. A comparative study on protective factors, mental health and violence among male adolescents students of urban and rural school of Udaipur (Rajasthan), India. International J Comm Med Publ Health. 2017;2(4),421–4. DOI: https://doi.org/10.18203/2394-6040.ijcmph20150910

Sagar R, Pattanayak RD, Mehta M. Clinical profile of mood disorders in children. Indian Pediatr. 2012;49(1):21-3. DOI: https://doi.org/10.1007/s13312-012-0009-5

Verma H. Pushing Boundaries by Engaging Adolescent Girls and Communities: Evidence from Evaluation of the PAnKH Program in Rajasthan, India. International Centre for Research on Women (ICRW) New Delhi, India. 2019.