Demographic characteristics and lifestyle related factors of depressive symptoms in Chinese children and adolescents

Objective To explore the demographic characteristics and lifestyle factors associated with depressive symptoms among Chinese children and adolescents. Methods A cross-sectional study was conducted on 22 693 children and adolescents who were subjected with stratified random sampling from the fourth grade of primary school to the third grade of junior high school in 10 provinces across 4 major economic regions in China during July to November 2022. All participants were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and a self-developed questionnaire to collect the factors associated with depressive symptoms and analyze statistically. Results ① The overall prevalence of depressive symptoms was 17.9% in Chinese children and adolescents, with mild depressive symptoms accounting for 12.8% and severe symptoms for 5.1%. ②Demographic analysis revealed that the female had significantly higher prevalence of depressive symptoms (19.6% vs 16.2%, χ2=44.445, P < 0.001) and higher depressive symptom score (5.53±5.53 vs 5.10±5.13, t=-6.083, P < 0.001) than the male. Significant differences were observed in the participants at different educational stages, and those with different parental education levels, parental occupations, family economic status, urban and rural areas, and residential areas, respectively (P < 0.001). ③ Lifestyle analysis indicated that the prevalence of depressive symptoms (20.0% vs 13.1%, χ2=169.680, P < 0.001) and the depressive symptom score (5.73±5.46 vs 4.37±4.85, t=18.560, P < 0.001) were obviously higher in the participants without adequate sleep duration than those with. The frequency of sugar-sweetened beverages (SSBs) consumption, exercise frequency, and daily internet usage on school days were significantly correlated with the prevalence and scores of depressive symptoms (P < 0.001). ④ Regression analysis identified that female, junior high school status, maternal military occupation, residence in the Western area, occasional or frequent SSBs consumption, and daily internet usage on school days were negative factors for depressive symptoms (P < 0.001); Whereas maternal education level of junior high school or over, family economic status of moderate or higher, adequate sleep duration, and regular exercise were positive factors (P < 0.001). Conclusion The prevalence of depressive symptoms among Chinese children and adolescents may be influenced by demographic characteristics, such as gender, age, maternal education level, maternal occupation, family economic status, and region of residence. Unhealthy lifestyle behaviors, such as inadequate sleep, frequent SSBs consumption, lack of exercise, and prolonged daily internet usage are closely related to the occurrence of depressive symptoms.