Anxiety, Depression, And Their Associations With Resilience Among Chinese Adolescents: A Cross-Sectional Study

Abstract

The mental health problems of adolescents appear to have increased worldwide in recent years. The aim of this study was to assess anxiety, depression, and their associations with resilience among Chinese adolescents. 2452 students were recruited from 3 middle schools through cluster randomization in Chengdu, Sichuan province, China. Resilience, family function, depression and anxiety were measured by resilience subscale of Chinese Positive Youth Development Scale (CPYDS), Chinese Family Assessment Instrument (C-FAI), the Center for Epidemiological Studies Depression Scale for Children (CES-DC), and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. Ordinal logistic regression and binary logistic regression were used to explore the independent effect of different variables on anxiety and depression. The prevalence of anxiety and depressive symptoms among adolescents was 30.3% and 40.5% respectively in our study. Senior and male students experienced lower levels of anxiety (OR=0.900, p<0.001; OR=0.479, p<0.001). Resilience was negatively associated with both anxiety and depression (OR=0.700, p<0.001; OR=0.796, p<0.001). Poor interaction with caregivers was a risk factor for both anxiety (OR=0.943, p=0.037) and depression (OR=0.899, p<0.001). Family dysfunction and internet use were protective factors for both anxiety (OR=1.418, p<0.001; OR = 1.001, p<0.001) and depression (OR=1.418, p<0.001; OR = 1.001, p<0.001). The existence of anxiety was found to be positively correlated with depressive symptoms in our sample. More attention should be paid to the mental health of adolescents. Measures that improve resilience and family function might be considered by stakeholders. A healthy lifestyle should also be stressed among adolescents.