Depression among Adolescents in Northern Ireland

Article excerpt

The present research attempts to describe the nature, frequency, and pattern of self-reported depression among a sample of secondary school students living in Northern Ireland. The study focuses on adolescents in the community rather than on those who have been referred for professional help since community surveys provide important data on the distribution of psychiatric problems in the population. Many psychiatrically disturbed youngsters are never referred to professional services and, therefore, studies of unreferred populations are required in order to achieve a complete understanding of the nature and frequency of depression in adolescence (Angold, 1988).

Compared with research into adult psychiatric and psychological conditions there have been few community studies of the prevalence of adolescent psychiatric disorder and, more specifically, fewer again of depression. In a series of studies, Rutter, Tizard and Whitmore (1970/1981) made multiple assessments of children and adolescents at two ages, 10 and 14, using instruments administered to teachers, parents, psychiatrists, and the young people who participated in the research. With respect to 10-11-year old children Rutter (1986) wrote:

". . . 13% showed a depressed mood at interview, 9% appeared preoccupied with depressive topics, 17% failed to smile, and 15% showed poor emotional responsiveness . . . at age 14-15 years depressive feelings were considerably more prevalent. Over 40% of the adolescents reported substantial feelings of misery and depression during a psychiatric interview, 20% expressed feelings of self-depreciation, 7-8% reported that they had suicidal feelings, and 25% described ideas of reference."

It would seem that feelings of misery and depression including quite severe depression (even suicidal) feelings causing personal suffering are not often detected by parents, teachers, and other adults. A self-report measure such as the Child Depression Inventory (CDI; Kovacs, 1983) affords a ready opportunity for a young person to express his or her personal feelings. In addition, a number of studies have shown that youngsters' reports of their own affective states are reliable (e.g., Angold et al., 1987).

Several studies have investigated the psychological well-being of Northern Irish children (Cairns, 1987). For example, Fee (1980; 1983), using the Rutter Teacher Rating Questionnaire, reported a 15% incidence of psychiatric disturbance in 10-year-old Belfast children. This proportion was higher than the rate for children living in rural Isle of Wight (11%) but lower for children living in inner London (19%). Fee concluded that the incidence of psychiatric disturbance "is probably no worse than might have been expected in similar urban areas in other parts of the United Kingdom." There have been fewer studies of the psychological well-being of adolescents living in Northern Ireland. In one study, McWhirter (1989) found that a sample of 18-year-old adolescents participating in a longitudinal study on the transition from school to work had a similar mean score on the General Health Questionnaire as did two English cohorts of school leavers. In other words, the psychological well-being of older Northern Irish adolescents was comparable to their English counterparts.

A review of the relatively few studies of adolescent psychiatric disorder in the general population illustrate: (1) an increase in both depressive feelings and depressive disorder during adolescence (which is mirrored by a dramatic increase in both attempted and completed suicide (Shaffer, 1986)); and (2) A greater increase in the rate of depression for females than males. The adult female preponderance in depressive disorders is a well-established finding both in community and clinical studies. Although the data from hospital statistics and clinical research with young people is limited, it tends to demonstrate a similar pattern to those found in community surveys. …