| Objective: To determine the prevalence of depressive symptoms in primary school students and examine associations between symptoms and psychological resilience and social support. To compare the prevalence and the risk factors of depressive symptoms among primary school students in Hefei and Shenzhen. To develop effective mental healthy promoting methods for primary school students.Method: Four schools were selected from four district in Hefei, a total of 2,078 primary school students were recruited from three classmates in 3 grade to 5 grade.Participants were asked to fill out the questionnaires of Children's Depression Inventory(CDI), a self-designed questionnaire of Social Support Questionnaire and the Student Resilience Survey revised from the California Healthy Kids Survey. At first,the questionnaires were issued by our trained investigator. then investigators explained how to fill in it and the students finished the questionnaires. At the end, investigators taked the questionnaires back after checking it. using T test examine the relation between the scores of CDI and resilience and social support. And Chi square test determine the relation between depressive symptoms and lifestyles. Unconditional multinomial logistic regression model were used to examine the correlated factors of depressive symptoms in primary school students. There are four districts in Hefei,one school were selected from each district,a total of 2,071 primary school students were recruited in three classmates from 3 grade to 5 grade.In Shenzhen,there are six districts,three of them are new and others are old .two primary schools were selected from new districts and other two from old districts. a total of 1,153 primary school students were recruited in three class from 3 grade to 5 grade.Participants from Hefei and Shenzhen were asked to fill out the questionnaires of Children's Depression Inventory(CDI), a self-designed questionnaire of Social Support Questionnaire and the Student Resilience Survey revised from the California Healthy Kids Survey.According to the number of student,two primary schools were selected as site intervention study.of the two school,one is intervention school and the other is control school. The intervention school received one year mental healthy promotion based on health promoting school theory.there is no intervention in control school. We compared depressive symptoms of students from 3 to 5 grades pre- and post- intervention in intervenetion and control schools,and compared the scores of CDI and social support as well.Result: The prevalence of depression symptom was 11.9% in primary school students. Boys(13.9%) get higher prevalence than girls(9. 6%) (x~2=7.01, P<0.01), going to sleeping after 10:00 PM,and having diet behaviour can increase the risk of depression. During a week,having less breakfast, playing computer game everyday,watching TV and not having physical exercise everyday were associated with depressive symptoms. The scores of CDI had negative association with psychological resilience(r=-0.43, P<0.01). Significant negative relationship was found between social support and depression symptom. The scores of social support in the students with depressive symptoms group of were significantly lower than those without depressive symptoms the normal group,i.e.parent support(t=12.87, P<0.01),school support(t=7.84, P< 0.01),peer support(t=11.89, P<0.01). By use of unconditional multivariate logistic regression model,results showed that on the one hand, protective factors for depressive symptoms in form of Odds Ratios and its 95% Confidence Interval (95%CI) were ranked as the following:parent support (OR=0.609,95%CI 0.534～0.694)) peer support(OR=0.677, 95%CI 0.596～0.769), school support(OR=0.735, 95%CI 0.615～0.877),resilience (OR=0.955, 95%CI 0.936～0.974).on the other hand risk factors for depressive symptoms were ranked as the following: feeling bad when going to bed(OR=2.333, 95%CI 1.585～3.434), feeling bad when getting up (OR=1.989, 95%CI 1.404～2.816), having less breakfast and supper (OR=1.628, 95%CI 1.066～2.484), playing computer games everyday (OR=1.523, 95%CI 1.004～2.310), having fasting behaviour(OR=1.463, 95%CI 1.046～2.045), going to bed after 10:00 PM(OR=1.269, 95%CI 1.114～1.444).The prevalence of depressive symptoms was significantly higher in participants from Hefei(11.9%) than that in Shenzhen (8.2%). Depressive symptoms showed higher prevalence in boys and girls from Hefei than from Shenzhen,and got likewise higher in grade 3 and 4 from Hefei than that from Shenzhen.In all items of social support, participants from Hefei got lower score than those from Shenzhen except that of parent support. In the Hefei and Shenzhen participant group,Social support,parent support and school support were significantly and negatively related to the scores of CDI. In unconditional multivariate logistic regression model (Backward:LR),results showed that in Hefei protective factors for depressive symptoms were ranked as follows:parent support (OR=0.53,95%CI 0.47～0.59), peer support(0.59, 95%CI 0.53～0.67), school support (OU=0.70, 95%CI 0.59～0.83), in Shenzhen, protecting factors for depressive symptoms were ranked as follows: parent support(OR=0.42, 95%CI 0.34～0.51),school support(OR=0.52, 95%CI 0.41～0.67), peer support (OR=0.61, 95%CI 0.51～0.74). Before intervention,there were no statistically difference in prevalence of depressive symptoms and three subtests of social support between intervention group and control group.After intervenetion, intervention group had lower depressive symptoms prevalence(11.6%) than control group(14.2%) (x~2 =2.12, p<0.05),T test showed the scores of social support in intervention group are also significant higher than those in control group, as well as school support and peer support scores 0=2.33,3.24,2.01, P<0.05). Parent support had no difference between intervention group and control group.After intervention,the prevalence of depressive symptoms decreased significantly (15.8%/11.6%, x~2=4.10,p<0.05;),the scores of social support,school support and peer support increased significantly in study group (t= 3.24,4.14,2.23,P<0.05), while there were no change in control group. Furthermore, Primary school students who were boys,grade 5 and born in Hefei had significantly lower depressive symptoms prevalence after intervention than those before intervention (x~2=4.31,4.54, 4.31,p<0.05).Conclusion: The prevalence of depressive symptoms was 11. 9% in primary school students in Hefei. Improving social supportive environment and strengthing resilient skills of student may help prevent depressive symptoms among primary students. It is important to consider the regional specific risk factors when developing depression intervention programs to target different regional population. Health promoting school methods is helpful in reducing the prevalence of depressive symptoms, and improving social support of primary school students. |
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