Clinically significant depressive disorder in adolescence; cross-sectional study of two Croatian counties

The aim of the study was to determine whether there is a difference in the intensity of depression, suicidality, and expression of clinical features among adolescents in two different regions of Krapina-Zagorje (KZ) and Split-Dalmatia (SD).

The study was designed as a descriptive cross-sectional, the sample consisted of 200 adolescents, 100 from each region, aging 16-18 years, from various high schools. The research was conducted by psychiatrists in Split and Krapina, where school population of Split-Dalmatia County and Krapina-Zagorje County gravitates. For the assessment of depression, the Hamilton rating scale for depression with 21 items was used, which has proven in clinical practice. For the inclusion in the study, among other parameters, participants needed to satisfy the criterion that depression is clinically significant (19 or more points on the HAMD-21).

The data obtained points out to statistically significant difference in the intensity of depression between the two regions (p<0.001). There was no difference in suicidal impulses. For the most part, the expression of clinical features between adolescents in these regions showed no significant difference, except that guilt (p=0.001), failing in the work plan and activities (p=0.000) and paranoid ideas (p=0.013) were significantly more expressed in adolescents of Krapina-Zagorje County and sleep disorders (p<0.001) in adolescents of Split-Dalmatia County.

It can be concluded that depression, suicidality and much of the clinical features depend on the developmental age, i.e. the turbulent adolescent development, rather than on regional differences, although, to a lesser extent, the expression of clinical features can be influenced by milieu, lifestyle, family dynamics and educational procedures, which can partially affect the expression of clinical features.