The Prevalence of Depression in a High School Population
Connelly, Brian, Johnston, David, Brown, Ian D. R., Mackay, steve, Blackstock, Edward G., Adolescence
An increasing number of articles, books, and conferences attest to the growing attention being paid to depression in children and adolescents. While few authors question its existence (Chartier & Ranieri, 1984), there is a general lack of empirical data on affective disorders in nonclinical adolescent populations (Teri, 1982; Puig-Antich, 1985; Faulstich et al., 1986; Sullivan & Engin, 1986). Studies in the area of adolescent depression have involved different populations, methodologies, and instruments, resulting in widely discrepant results (Hodgman, 1985; see Table 1). Consequently, a confusing picture emerges of the mental health of North American youth.
In spite of the difficulties posed by empirical research, prevalence studies are essential for professionals in this field. Clinically we are likely to respond differently if we see depression in adolescence as ubiquitous as opposed to a phenomenon that is rare or does not exist at all during that stage of development. Prevalence studies provide an idea of the proportion of adolescents who experience depressive symptomatology at a given time.
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Another clinical consideration is that, as professionals, we are expected to represent fairly and accurately the people with whom we work. Whether this occurs through the presentation of papers, published articles, or simply in conversation, it is incumbent upon us to reflect the "current state" of adolescent mental health.
Prevalence studies provide important data for further explorations. The accumulation of knowledge in this area facilitates understanding of this group over time, and allows comparison with other groups. In addition, data obtained from these investigations can play a part in determining types and amounts of clinical services. In short, the allocation of (scarce) clinical resources can be affected by the prevalence rates of mental illnesses afflicting adolescents.
The present study was undertaken in the metropolitan Toronto area. Parents and students of three representative secondary schools were informed that, on a specified day, a mental health questionnaire would be distributed for completion by the students. Both parents and students had the opportunity to decline participation. The completed questionnaires were then collected and tabulated by a research team not connected with the schools involved.
Each school offered a combination of general and advanced academic courses, as well as business and technical subjects. Data were obtained from 2,909 students. An additional 430 students were absent from school on the day data were collected, and another 272 chose not to participate.
Of the 2,909 students who completed the form, 141 did not indicate their gender and 70 were aged 20 or older. Data from these students were not included in the overall analysis. Thus, the final number of students in this study was 2,698, of which 49% were male and 51% were female.
Kovacs (1985) points out that it is important to quantify clinical phenomena such as depression in order to understand them from a scientific perspective. However, one reason for the lack of empirical information on adolescent depression may be that there is no widely accepted instrument specifically designed for evaluation of this population, although there is for children (Children's Depression Inventory; Kovacs, 1985) and adults (Beck Depression Inventory; Beck & Beamesderfer, 1974). Nevertheless, Table 1 demonstrates that the Beck Depression Inventory (BDI) has been used successfully with an adolescent population. It has also been used effectively as a screening instrument with both adults and adolescents.
The BDI is a 21-item self-report measure assessing four relevant aspects of depression: cognition, behavior, affect, and somatic concerns. Each item consists of four statements reflecting increasing depressive symptomatology. …