Effects of negative life events on depression in middle school students: The chain-mediating roles of rumination and perceived social support.

Background: Negative life events in middle school students have a significant impact on depression. However, the mechanism of this association is not fully understood. This study used rumination and perceived social support as mediating variables to explore the influence of negative life events on depression. Materials and methods: Due to the COVID-19 pandemic and social distancing, a convenient sampling method was adopted to collect information about middle school students in Shandong Province by means of online questionnaire. Adolescent Self-Rating Life Events Check List, Ruminative Responses Scale, Perceived Social Support Scale and Children's Depression Inventory were used. Descriptive statistics and correlation analysis were conducted for four variables of middle school students, including life events, depression, rumination thinking and perceived social support, and the chain mediated effect was tested by using process plug-in. All statistically analysis was conducted by SPSS 23.0. Results: 493 middle school students (16.7000 ± 0.9500 years) including 343 female students (69.6000%) from Shandong Province recruited. Results showed that the total effect between life events and depression was significant (effect = 0.2535, 95%CI: 0.2146, 0.2924). The total indirect effect was significant (effect = 0.1700, 95%CI: 0.1349, 0.2072). The indirect effect was significant (effect = 0.0988, 95%CI: 0.0741, 0.1252) with rumination as the mediating variable. The indirect effect of pathway with perceived social support as the mediating variable was significant (effect = 0.0476, 95%CI: 0.0295, 0.0674). The indirect effect of pathway with rumination and perceived social support as mediating variables was also significant (effect = 0.0236, 95%CI: 0.0147, 0.0339). Conclusion: This study indicated that ruminant thinking and perceived social support had a significant chain mediating effect on adolescents' life events and depression. Life events can not only directly affect depressive emotions, but also indirectly affect depressive emotions by affecting ruminant thinking and perceived social support. The results of this study not only provide new directions for the relationship between life events and depression, but also provide possible approaches for future prevention and intervention of depression in middle school students.

The prevalence and incidence of major depressive disorder in 8079 Chinese university freshmen before and during COVID-19.

BACKGROUND: COVID-19 pandemic may impact the prevalence and incidence of depression in college students. However, there is no longitudinal study focusing on major depressive disorder (MDD) before and during COVID-19 pandemic. METHODS: A cohort study was carried out among 8079 Chinese college freshmen. The baseline survey was conducted in 2018 (T0) and annual follow-ups were in 2019 (T1, before COVID-19) and in 2020 (T2, during COVID-19). CIDI-3.0 was used to diagnose MDD. Random effects logistic models of panel data analysis were used for the risk of MDD incidence. STATA 15.1 was used for all analysis. RESULTS: The weighted 12-month prevalence of MDD at T2 (2.10%) was significantly lower than that at T1 (2.67%) (p < 0.001). However, among students who reported exposure to the COVID-19 events, the annual prevalence of MDD at T2 was higher than that at T1 (4.21% vs. 2.79%, p < 0.001). The incidence from T0 to T1, incidence from T1 to T2, and the 2-year incidence was 2.23%, 1.34% and 3.75%, respectively. Only 8.93% of MDD students had chosen to seek professional help during the COVID-19 pandemic period. LIMITATIONS: The computer assisted CIDI may not be as sensitive and specific as the diagnosis made by a psychiatrist and may have caused report bias. CONCLUSIONS: Although the MDD incidence of college students was decreasing over time, the impact of the pandemic on student mental health may depend on exposure to COVID-19 events. Not seeking professional help in the Chinese college students is still an important issue.

Gender-Specific Related Factors for Suicidal Ideation During COVID-19 Pandemic Lockdown Among 5,175 Chinese Adolescents

Background Suicide was an urgent issue during the pandemic period in adolescents. However, few studies were focused on suicide during the coronavirus disease 2019 (COVID-19) pandemic lockdown. Methods An online survey was conducted among 5,175 Chinese adolescents from June 9th to 29th in 2020 to investigate the prevalence of suicidal ideation (SI) during COVID-19 pandemic lockdown. A gender-specific stepwise logistic regression model was used. All analyses were performed with STATA 15.0. Results About 3% of the participants had reported having SI during the COVID-19 pandemic lockdown period. The prevalence of female SI (3.64%, 95% CI: 2.97–4.45%) was higher than that of males (2.39%, 95% CI: 1.88–3.05%) (χ2 = 6.87, p = 0.009). Quarreling with parents [odds ratio (OR) = 9.73, 95% CI: 5.38–17.59], insomnia (OR = 5.28, 95% CI: 2.81–9.93), previous suicide attempt history (OR = 3.68, 95% CI: 1.69–8.03), previous SI history (OR = 2.81, 95% CI: 1.30–6.06), and feeling depressed during pandemic lockdown (OR = 2.26, 95% CI: 1.22–4.18) were positively associated with the males' SI. However, having emptiness inside (OR = 4.39, 95% CI: 2.19–8.79), quarreling with parents (OR = 3.72, 95% CI: 2.16–6.41), insomnia (OR = 3.28, 95% CI: 1.85–5.80), feeling anxious (OR = 2.62, 95% CI: 1.46–4.70), and longing for father's emotional warmth (OR = 0.38, 0.20–0.72) were associated mostly with females' SI. Conclusions Female adolescents, who felt emptiness from their families and their fathers' emotional warmth, were at much higher risk of having SI during COVID-19 lockdown. We must specify a suicide prevention policy and interventions for adolescents in the pandemic crisis based on gender gaps.

The impact of physical conditions on the incidence of major depressive disorder in Chinese university students: Results from a longitudinal study.

BACKGROUND: Major depressive disorder (MDD) is prevalent, and highly comorbid with physical illnesses. Few longitudinal studies have investigated the relationship between physical health conditions and MDD. The objectives of this study were to investigate the comorbid relationship between physical conditions and MDD, and the association between physical conditions and the 2-year risk of MDD. METHODS: A study was conducted in first-year Chinese university students (n = 8,079) over two and half years, using a longitudinal design. An adapted version of the Composite International Diagnostic Interview (CIDI - 3.0) was used to assess for MDD. The presence of physician diagnosed physical conditions was assessed using ten self-report questions. Cross-sectional and longitudinal associations between self-reported physical conditions and MDD were estimated, adjusting for possible confounders. RESULTS: The most frequently reported physical conditions were migraines, chronic rhinitis, and gastritis. We found that migraines, gastritis, and stomach ulcers were associated with a significantly higher lifetime prevalence of MDD than those without any physical health conditions. In those without a lifetime MDD, migraines, gastritis and stomach ulcers were also found to be significant predictors for 2-year risk of new onset MDD. LIMITATIONS: Recall and selection biases are possible when using self-reporting measures. Additionally, the COVID-19 outbreak impacted the response rate at the second follow-up assessment. Lastly, the severity of the physical conditions was not measured. CONCLUSIONS: Physical conditions and MDD are highly prevalent and comorbid in university students. Migraines, gastritis and stomach ulcers are associated with the risk of developing MDD. Future studies should further investigate how this information can be used to prevent MDD.

The impact of self-efficacy on first onset and prognosis of major depressive disorder: findings from a longitudinal study in a sample of Chinese first-year university students.

BACKGROUND: Self-efficacy is a pivotal factor in the etiology and prognosis of major depression. However, longitudinal studies on the relationship between self-efficacy and major depressive disorder (MDD) are scarce. The objectives were to investigate: (1) the associations between self-efficacy and the 1-year and 2-year risks of first onset of MDD and (2) the associations between self-efficacy and the 1-year and 2-year risks of the persistence/recurrence of MDD, in a sample of first-year university students. METHODS: We followed 8079 first-year university students for 2 years from April 2018 to October 2020. MDD was ascertained by the Chinese version of the Composite International Diagnostic Interview (CIDI-3.0) based on self-report. Self-efficacy was measured by the 10-item General Self-efficacy (GSE) scale. Random effect logistic regression modeling was used to estimate the associations. RESULTS: Among participants without a lifetime MDD, the data showed that participants with high baseline GSE scores were associated with a higher risk of first onset of MDD over 2 years [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01-1.08]. Among those with a lifetime MDD, participants with high baseline GSE scores were less likely to have had a MDD over 2 years (OR 0.93, 95% CI 0.88-0.99) compared to others. CONCLUSIONS: A high level of GSE may be protective of the risk of persistent or recurrent MDD. More longitudinal studies in university students are needed to further investigate the impact of GSE on the first onset of MDD.