Prevalence, severity, and risk factors for depressive and anxiety symptoms among adolescents: A cross-sectional study.

BACKGROUND

Depressive and anxiety symptoms among adolescents have become significant public health concerns, yet comprehensive studies examining their prevalence and associated factors are limited. Functional constipation (FC), as a common gastrointestinal disorder potentially linked to brain-gut axis dysfunction, along with other modifiable factors such as physical activity and electronic device use, may influence adolescent mental health, though these relationships remain understudied.

AIM: To examine depressive/anxiety symptoms prevalence and their associations with FC and other potential risk factors among adolescents in Lianyungang, Jiangsu Province, China.

METHODS

We conducted a cross-sectional survey of 22925 adolescents using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 for depressive and anxiety symptoms, respectively. FC was evaluated using the Rome IV criteria, and social support using the Perceived Social Support Scale.

RESULTS

Depressive symptoms were reported by 16.0%, anxiety symptoms by 24.1%, with 13.1% experiencing both. Among the total group, 27.5% reported mild, 10.0% moderate, 4.0% moderately severe, and 2.0% severe depressive symptoms, while 23.0% reported mild, 7.2% moderate, and 3.8% severe anxiety symptoms. Female sex, smoking, FC, parental conflict, lower household income, lower levels of physical activity, and longer weekly electronic device use time were identified as significant risk factors for depressive and anxiety symptoms (all P < 0.05), while age and body mass index were identified as additional significant risk factors for anxiety symptoms (all P < 0.05). In contrast, received support was identified as a significant protective factor against depressive and anxiety symptoms.

CONCLUSION

Targeting modifiable risk factors (physical activity, smoking, excessive device use) and improving mental health support access are priorities to address the high prevalence of depression and anxiety symptoms.