The existence of depression in children and adolescents is well established, but debate remains about the phenomenology of the depressive syndrome in the young. In order to discover possible age differences in rates and etiology, the definition and measurement of depression must be comparable across the ages to be studied. A widely used self-report depression symptom scale, the Center for Epidemiologic Studies Depression (CES-D) Scale, was administered to convenient (and not necessarily representative) samples of high school and college students. The scores and patterns of responses to the 20 symptom items of the scale were compared with already existing data from junior high school students, from depressed patients, and from a representative community sample of adults and young adults. The results of the analyses suggest that the CES-D Scale is acceptable and reliable in all the groups studied. The scores of the junior high school group may be inflated by an excess of transient symptoms and should be interpreted with caution, but the scale seems to be very suitable for the high school and older groups.

The Use of the Center for Epidemiologic Studies Depression Scale in Adolescents and Young Adults

Background: The aim of the study was to examine the relationships between various psychosocial factors and depressive symptoms in early adolescence.



Methods:  A representative sample of 2,465 12–14-year-old adolescents comprising 50.8% girls and 49.2% boys, with a mean age of 13.7 years, was recruited in two counties in Norway. The participation rate was 88.3%. Depressive symptoms were measured by the Mood and Feelings Questionnaire (MFQ).



Results:  Correlations between the total sum of stressful events/daily hassles and the total sum of MFQ were moderately high, rs=.49 and rs=.53, respectively. Depressive symptoms were more strongly correlated with school-related stress among boys than girls, whereas the correlation between daily hassles and depressive symptoms was higher for girls than boys. The results of univariate analyses showed significantly higher mean total MFQ scores among adolescents not living with both natural parents, those who had moved more than twice and those with more than 3 siblings or having fewer than 2 close friends. Further, adolescents from Third World societies and adopted adolescents, those from lower SES groups, having unemployed parents or living in coastal areas had higher mean depressive symptom scores. The results of multiple regression analyses yielded the following six significant predictors of total MFQ scores in order of importance: Sum of daily hassles and sum of stressful life events, gender, number of friends, ethnicity and mother's employment status. Altogether, these variables accounted for 43% of the total variance in MFQ scores.



Conclusions:  It is concluded that these psychosocial predictors should be addressed when assessing depressive symptoms in early adolescence. The findings of the study are discussed in view of previous research in the field and their clinical significance.

Psychosocial correlates of depressive symptoms among 12–14‐year‐old Norwegian adolescents

Hygiene and other early childhood influences on the subsequent function of the immune system

The current ‘Darwinian’ synthesis of the hygiene (or ‘Old Friends’) hypothesis suggests that the increase in chronic inflammatory disorders that started in Europe in the mid-19th century and progressed until the late 20th century is at least partly attributable to immunodysregulation resulting from lack of exposure to microorganisms that were tasked by co-evolutionary processes with establishing the ‘normal’ background levels of immunoregulation, a role that they perform in concert with the normal microbiota. This is an example of ‘evolved dependence’. The relevant organisms co-evolved with mammals, already accompanied early hominids in the Paleolithic era and are associated with animals, mud and faeces. These organisms often establish stable carrier states, or are encountered continuously in primitive environments as ‘pseudocommensals’ from mud and water. These organisms were not lost during the first epidemiological transition, which might even have resulted in increased exposure to them. However, the crucial organisms are lost progressively as populations undergo the second epidemiological transition (modern urban environment). Recently evolved sporadic ‘childhood infections’ are not likely to have evolved immunoregulatory roles, and epidemiology supports this contention. The consequences of the loss of the Old Friends and distortion of the microbiota are aggravated by other modern environmental changes that also lead to enhanced inflammatory responses (obesity, vitamin D deficiency, pollution (dioxins), etc.). The range of chronic inflammatory disorders affected may be larger than had been assumed (allergies, autoimmunity, inflammatory bowel disease, but also coeliac disease, food allergy, vascular disease, some cancers, and depression/anxiety when accompanied by raised inflammatory cytokines).

/pdf/hygiene-and-other-early-childhood-influences-on-the-3ydp6rbp4o.pdf

Hygiene and Other Early Childhood Influences on the Subsequent Function of the Immune System

Older adolescents' help-seeking behavior, in terms of talking to friends, family, or professionals about a personal problem, was assessed at five time points over a 12-month period. A longitudinal causal model, controlling for previous help-seeking behavior, prior level of psychological symptoms, and current life events, was used to assess the effects of seeking help for problems on symptoms of psychological distress 12 weeks later. When these variables were controlled, neither seeking professional nor informal help from friends or family resulted in a significant improvement in subsequent psychological health. The help-seeking behavior of these adolescents did not, therefore, appear to effectively alleviate their psychological distress. It is suggested that focusing on problems by talking about them may intensity rather than decrease the arousal of psychological symptoms. Consequently, seeking help by talking about one's problems may not be an adaptive form of coping for adolescents.

The effectiveness of seeking help for coping with personal problems in late adolescence

Public health concern regarding depression has recently increased as a result of the rise in the rate of adolescent suicide, with a probable concomitant rise in the rate of depression in this age group. The rise appears to be both a period effect, in that increased rates are now observed across age categories, and a cohort effect, in that being born after 1960 also contributes to the increase. The clinical phenomena and epidemiology of depression in adolescence are reviewed. Diagnostic criteria for depressive mood and depressive syndrome are similar to those in adults. However, the predictive value of a depressive episode in adolescence, and whether the occurrence of depression in adolescence is a transient developmental experience or whether it predicts a particular subtype of future depression, are at present unknown. The familial, social and personal risk factors for adolescent depression are reviewed, The major factors are: parental history of affective illness, childhood experience of parental loss, and female gender. Other factors, such as birth order and sibling factors, socio-economic status, race, religion, geography, concomitant medical illness, intelligence, career aspirations, substance abuse and life events, are reviewed, although their relative contributions as risk factors are less clear-cut. It is proposed that cross-sectional, retrospective and longitudinal studies are required to clarify important areas of uncertainty.

Risk factors for depression in adolescence.

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Risk factors for depression in adolescence.