Perinatal and early life factors associated with symptoms of depression in Brazilian children

Abstract

BackgroundFew studies have been conducted on the association between perinatal and early life factors with childhood depression and results are conflicting. Our aim was to estimate the prevalence and perinatal and early life factors associated with symptoms of depression in children aged 7 to 11 years from two Brazilian birth cohorts.MethodsThe study was conducted on 1444 children whose data were collected at birth and at school age, in 1994 and 2004/2005 in Ribeirao Preto, where they were aged 10–11 years and in 1997/98 and 2005/06 in São Luís, where children were aged 7–9 years. Depressive symptoms were investigated with the Child Depression Inventory(CDI), categorized as yes (score ≥ 20) and no (score < 20). Adjusted and non-adjusted prevalence ratios (PR) were estimated by Poisson regression with robust estimation of the standard errors.ResultsThe prevalence of depressive symptoms was 3.9% (95%CI = 2.5-5.4) in Ribeirão Preto and 13.7% (95%CI = 11.0-16.4) in São Luís. In the adjusted analysis, in Ribeirão Preto, low birth weight (PR = 3.98; 95%CI = 1.72-9.23), skilled and semi-skilled manual occupation (PR = 5.30; 95%CI = 1.14-24.76) and unskilled manual occupation and unemployment (PR = 6.65; 95%CI = 1.16-38.03) of the household head were risk factors for depressive symptoms. In São Luís, maternal schooling of 0–4 years (PR = 2.39; 95%CI = 1.31-4.34) and of 5 to 8 years (PR = 1.80; 95%CI = 1.08-3.01), and paternal age <20 years (PR = 1.92; 95%CI = 1.02-3.61), were independent risk factors for depressive symptoms.ConclusionsThe prevalence of depressive symptoms was much higher in the less developed city, São Luís, than in the more developed city, Ribeirão Preto, and than those reported in several international studies. Low socioeconomic level was associated with depressive symptoms in both cohorts. Low paternal age was a risk factor for depressive symptoms in the less developed city, São Luís, whereas low birth weight was a risk factor for depressive symptoms in the more developed city, Ribeirão Preto.

Childhood Depression As Emerging Public Health Problem: A Systematic Review

“…Even though there are no longer any doubts about its occurrence [18,274], many gaps in knowledge still exist regarding childhood depression. There is no agreement about the criteria to be used to identify this condition in population-based studies.…”

“…Prevalence varies depending on the age range studied. Factors associated with this disorder are also very different depending on the criterion used to identify depression, the setting and the age range of the studied population [18,20,275,276].…”

“…al [15] the etiology of depression and anxiety has been extensively investigated in recent years. Given the accumulating evidence about the high prevalence and debilitating related to childhood depression, a better understanding of the etiology of depression in youth is needed [16,17] Several investigations have demonstrated a wide variation in the prevalence of depression in children and differences according to the criteria of diagnostic classification adopted, mainly due to the diverse mode of presentation of depression and the association of this disorder with other psychopathologies [18]. Prevalence estimates among different racial/ethnic groups vary widely too [19]: American Indian youths reported the highest prevalence of depressive symptoms (29%), followed by Hispanic (22%), non-Hispanic White (18%), Asian American (17%), and African American (15%) youths [19,20].…”

“…Prevalence estimates among different racial/ethnic groups vary widely too [19]: American Indian youths reported the highest prevalence of depressive symptoms (29%), followed by Hispanic (22%), non-Hispanic White (18%), Asian American (17%), and African American (15%) youths [19,20]. Thus, knowing the risk factors for depression during childhood is essential for a better understanding of the etiology of this disorder and for planning prevention strategies [18].…”

“…The diagnostic criteria for major depressive disorder in adults can be applied to children, with the exception that children can express irritability rather than sad or depressed mood, and weight loss can be seen in terms of failure to achieve the proper weight for the age group. It is worth mentioning that several investigations have demonstrated a wide variation in the prevalence of depression in children and differences according to the criteria of diagnostic classification adopted, mainly due to the diverse mode of presentation of depression and the association of this disorder with other psychopathologies [18]. This happens because the current diagnostic criteria were developed for the adult population, neglecting many of the developmental differences between children/adolescents and adults [11].…”