Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study

Abstract Background The emergence of the COVID-19 pandemic led to increased levels of depression among adolescents in 2019. However, the situation regarding adolescent depression in the later stages of the pandemic remains unclear. This study investigated depressive symptoms status and changing tren...

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Main Authors: Xingchen Zhu, Na An, Zaixiang Tang, Jianping Huang, Qingxin Ren, Yue Wu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21252-8
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author Xingchen Zhu
Na An
Zaixiang Tang
Jianping Huang
Qingxin Ren
Yue Wu
author_facet Xingchen Zhu
Na An
Zaixiang Tang
Jianping Huang
Qingxin Ren
Yue Wu
author_sort Xingchen Zhu
collection DOAJ
description Abstract Background The emergence of the COVID-19 pandemic led to increased levels of depression among adolescents in 2019. However, the situation regarding adolescent depression in the later stages of the pandemic remains unclear. This study investigated depressive symptoms status and changing trends among middle and junior high school students from 2019 to 2023. Methods Data were collected from 9,920 middle and junior high school students between 2019 and 2023 via multistage stratified cluster sampling. Students were administered an online survey, completed the Chinese version of the Center for Epidemiologic Studies Depression Scale, and answered questions regarding basic information, such as birth date. Univariate and multivariate analyses were performed to examine the factors that influenced depressive symptoms. Furthermore, Trend X 2 Test and Logistic regression was employed to analyze the changing trends of depressive symptoms among the participants. Results Of the students, 14.5% and 5.8% could have and had definitely experienced depressive symptoms, respectively. Junior high school students (AOR = 1.409, 95%CI = 1.164–1.706) had a higher risk of definite depressive symptoms. Males (possible depressive symptoms: AOR = 0.803, 95%CI = 0.716–0.902; definite depressive symptoms: AOR = 0.829, 95%CI = 0.695–0.988) were less likely to experience depressive symptoms. Families with parental absence (single-parent families, reconstituted families, and families where both parents are absent), less than one hour of outdoor activity and less than eight hours of sleep, increased the risk of both possible and definite depressive symptoms. Detection rate of depressive symptoms among middle school students followed an inverted U-shape trend; it rose in 2020 and 2021 and declined in 2022 and 2023. Detection rates of depressive symptoms among junior high school students in 2020, 2022, and 2023 decreased compared with 2019 (p < 0.05). Conclusion Educational stage, sex, family type, and duration of outdoor activities and sleep were factors that influenced depressive symptoms among middle and junior high school students. A proportion of middle school students with depressive symptoms exhibited an increasing and decreasing trend from 2019 to 2023. Students exposed to risk factors require additional attention, with timely early intervention to mitigate the impact of environmental stress and prevent the further development of depressive symptoms into a more severe and less manageable state.
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spelling doaj-art-d95fb4d30f294c849a8b9ecff6e41acf2025-01-12T12:42:51ZengBMCBMC Public Health1471-24582025-01-0125111110.1186/s12889-024-21252-8Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional studyXingchen Zhu0Na An1Zaixiang Tang2Jianping Huang3Qingxin Ren4Yue Wu5Nantong Center for Disease Control and PreventionNantong Center for Disease Control and PreventionDepartment of Biostatistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow UniversityNantong Center for Disease Control and PreventionNantong Center for Disease Control and PreventionNantong Center for Disease Control and PreventionAbstract Background The emergence of the COVID-19 pandemic led to increased levels of depression among adolescents in 2019. However, the situation regarding adolescent depression in the later stages of the pandemic remains unclear. This study investigated depressive symptoms status and changing trends among middle and junior high school students from 2019 to 2023. Methods Data were collected from 9,920 middle and junior high school students between 2019 and 2023 via multistage stratified cluster sampling. Students were administered an online survey, completed the Chinese version of the Center for Epidemiologic Studies Depression Scale, and answered questions regarding basic information, such as birth date. Univariate and multivariate analyses were performed to examine the factors that influenced depressive symptoms. Furthermore, Trend X 2 Test and Logistic regression was employed to analyze the changing trends of depressive symptoms among the participants. Results Of the students, 14.5% and 5.8% could have and had definitely experienced depressive symptoms, respectively. Junior high school students (AOR = 1.409, 95%CI = 1.164–1.706) had a higher risk of definite depressive symptoms. Males (possible depressive symptoms: AOR = 0.803, 95%CI = 0.716–0.902; definite depressive symptoms: AOR = 0.829, 95%CI = 0.695–0.988) were less likely to experience depressive symptoms. Families with parental absence (single-parent families, reconstituted families, and families where both parents are absent), less than one hour of outdoor activity and less than eight hours of sleep, increased the risk of both possible and definite depressive symptoms. Detection rate of depressive symptoms among middle school students followed an inverted U-shape trend; it rose in 2020 and 2021 and declined in 2022 and 2023. Detection rates of depressive symptoms among junior high school students in 2020, 2022, and 2023 decreased compared with 2019 (p < 0.05). Conclusion Educational stage, sex, family type, and duration of outdoor activities and sleep were factors that influenced depressive symptoms among middle and junior high school students. A proportion of middle school students with depressive symptoms exhibited an increasing and decreasing trend from 2019 to 2023. Students exposed to risk factors require additional attention, with timely early intervention to mitigate the impact of environmental stress and prevent the further development of depressive symptoms into a more severe and less manageable state.https://doi.org/10.1186/s12889-024-21252-8Mental healthAdolescentsDepressive symptomsCOVID-19China
spellingShingle Xingchen Zhu
Na An
Zaixiang Tang
Jianping Huang
Qingxin Ren
Yue Wu
Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
BMC Public Health
Mental health
Adolescents
Depressive symptoms
COVID-19
China
title Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
title_full Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
title_fullStr Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
title_full_unstemmed Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
title_short Influencing factors and changing trends of depressive symptoms among middle and junior high school students in Eastern China from 2019 to 2023: a cross-sectional study
title_sort influencing factors and changing trends of depressive symptoms among middle and junior high school students in eastern china from 2019 to 2023 a cross sectional study
topic Mental health
Adolescents
Depressive symptoms
COVID-19
China
url https://doi.org/10.1186/s12889-024-21252-8
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