Self-reported depressive symptoms among Chinese adolescents

Previous reports on the prevalence and features of depression among adolescents have been inconsistent. The purpose of the current study was to estimate the prevalence of depression among Chinese adolescents with a standardized instrument. A total of 2462 students, aged 13-22, were sampled from the Shandong province of China. The Zung Self-Rating Depression Scale (SDS) was administered to the subjects in their classrooms. It was shown that the mean SDS score was 44.8 (SD 9.9) and it decreased significantly from the age of 18 upward (F = 31.73, df = 9, P < 0.01). No significant difference was found between males and females (t = 0.70, P > 0.05). Taking 55 as a cut-off score, the prevalence rate of depression was 16.9% (95% CI = 15.4-18.4%). Logistic regression showed that increasing age appeared to decrease the risk for depression. Most of the individual items differed between ages, except for weight loss and constipation. Principal components factor analysis revealed that the characteristics of adolescent depression were depressive/anxious mood, psychomotor retardation, loss of self-esteem, somatic symptoms and decreased appetite and libido. Although the study was based on a large sample using an established instrument, the sample was not from a general adolescent population and case ascertainment was not by clinical diagnosis.