| Objectives: The primary aim of this study were to determine the reliability and validity of the Child Depression Inventory (CDI) in Chinese version in Hefei and know the prevalence of depressive symptoms and its related factors among primary and high school students in Hefei, and to develop cognitive- behavioral intervention on depression among primary and high school students , and to assess the feasibility and effectiveness of the intervention.Methods: The Chinese version of the CDI(Kovacs, 1992) provided by Queensland University of Technology in Australia, was implemented in Hefei to know its reliability and validity among 2943 students aged 7 to 18 years. A total of 4820 students were recruited from grade three of primary school to grade three of senior high school by stratified-cluster sampling method in Hefei. They completed Children's Depression Inventory(CDI), the Student Resilience Survey, Dysfunctional Attitudes Scales(DAS) and Family Environment Scale (FES-CV).One primary school, one junior high school and one senior high school were selected as the sample school in two districts of Hefei respectively. Two or three classes were recruited from Grade three of a primary school, Grade one of a junior high school and Grade one of a senior high school in each sample school of two districts as the intervention group, the control group were matched to numbers of students and grade in the commom school. There are 682 students in the intervention group, and 673 students in the control group. The intervention group received two months cognitive-behavioral intervention, the control group received health education as usual. We had compared the rate of depressive symptoms between the intervenetion and control grade in four weeks after the intervention completed.Results: The reliability was estimated by internal consistency and test-retest reliability. The coefficient of Cronbach alpha was 0.823, the coefficient of Split-half was 0.820, and test-retest reliability was 0.894. Sample factor extraction was conducted with the eigenvalue of 1, and five factors described 37.2% of the total variance, factor analysis further show that one factor were illustrated with eigenvalue of 2.595. The range of item total-score correlation coefficients is 0.232~0.549, were all significant at the P<0.01 level for the whole sample. There was a strong correlation of scores between the CDI and Dystunctional Attitudes Scales(r=0.451, P<0.01), and Center for Epidemiological Survey of Depression Scale(r=0.679, P<0.01).The prevalence rate of depressive symptoms was 13.1% among primary and high school students in Hefei. The prevalence rate of depressive symptoms was highest in students of senior high school(15.7%), 12.1% for primary school students, and lowest in junior high school students(11.8%). The mean scores of CDI presented decreasing with grade in primary school students, and increasing with grade in high school students. Logistic regression analysis revealed that depressive symptoms was significantly related to academic record, dysfunctional attitudes, resilience, cohesion, expressiveness, active-religious orientation, organization, conflict and control.Before intervention, there were no statistically difference in prevalence of depressive symptoms and scores of CDI and scores of DAS. After intervenetion, the intervention group had lower prevalence of depressive symptoms (12.0%) than that in the control group(17.5%)(χ2=8.292, P<0.01), as well as male(χ2=4.253,P<0.05), female (χ2=14.083, P<0.01), Grade three of primary school(χ2=14.327, P<0.01) and Grade one of junior high school(χ2=10.93, P<0.01). T test showed the intervention group (10.13±5.92)had lower scores of CDI than those in the control group (12.40±6.52)(t=-6.664, P<0.01), the scores of DAS in the intervention group (120.35±23.52) were also significant lower than those in the control group (126.46±24.29) (t=-4.680, P<0.01).Conclusions: CDI in Chinese version implemented to assess depressive symptoms among students in Hefei showed high validity and reliability. Depressive symptoms was common among primary and high school students, and develop mental health education to improve the mental health of students should be priority of public health. Cognitive-behavioral intervention is helpful in reducing the prevalence of depressive symptoms and the scores of CDI, and improving cognitive style.
|
PDF Full Text Request