Factors associated with childhood depression in Saskatoon students: a multilevel analysis

Abstract

Depression is a multi-factorial mental health problem that deeply impacts individuals’ emotions, behaviours and productivity. This study investigated links between depression and its determinants among children recruited from Saskatoon elementary schools. The overall goal of the study is to (i) determine the extent of mental health disparity and identify multilevel factors that are associated with depression (individual-level), and (ii) examine whether there is a depression discrepancy among Saskatoon elementary schools (school-level). Our study could provide theoretical bases for future interventions which reducing mental health disparities in Saskatoon school children.

This is a cross-sectional study based on the Saskatoon Student Health Survey administered by Saskatoon Health Region in 2008/2009. It included 4200 students from 76 elementary schools. Data on self-reported mental health, physical activity, bullying experiences, and school refusal behaviours was collected. School-level material and social deprivation were also measured. A multilevel logistic model was used to analyze the data.

A total of 3648 (86.9%) students responded to the questions on depression. Among them, 813 (22.3%) reported suffering from symptoms of depression. Most of the responders were between the ages of 11 and 13, 80% had a normal Body Mass Index (BMI), and a majority (78.2%) were Caucasian. Factors associated with depression were: female, student from single parent family, reporting a ‘good relationship’ with parents, over weight/obese, having experienced social or electronic bullying, having few friends, feeling like an outsider, skipped school, and being treated badly at school. In addition, students in schools deemed as representing moderate material deprivation were 2.04 times more likely to be depressed compared to schools deemed to represent low material deprivation (OR=2.04, 95% CI: 1.53-2.72, p<.0001). Our study revealed that disparities in depression exist between schools, and students’ school refusal behaviour was the main factors contributing to the disparity between schools.

The study will increase awareness in Saskatoon Health Region and among stakeholders about mental health disparity and its complex determinants among children in Saskatoon.