Depression among a sample of Egyptian adolescent females; Psychosocial correlates

Background: Female gender is one of the risk factors that may influence the development of depression among adolescents. Recognizing other factors that may contribute to the development of early onset depression is therefore important and would help in treatment. Objective: To identify psychosocial correlates of depression in a representative sample of Egyptian secondary school female students. Methods: This study was designed as a school-based case-control study; 602 female adolescent students were recruited from public and private schools in Eastern Cairo and interviewed by a team of researchers from the Institute of Psychiatry Ain Shams University between 2007 and 2008. All subjects were administered: the General Health Questionnaire (GHQ) [Arabic version] and the Arabic version of the Children’s Depression Inventory (CDI). In addition, all were administered a psychosocial questionnaire based on an Institute of Psychiatry-Ain Shams University form. To identify cases with clinical depression, subjects scoring 24 or higher on the CDI were administered the Structured Clinical Interview for DSM-IV (Axis I) Diagnoses (SCID-I) and the Hamilton Rating Scale for Depression (Ham-D). A total of 80 female adolescents with depression were identified and subsequently compared to 160 controls matched on school grade and socioeconomic status. Results: There were no significant differences between cases and controls in age, age of menarche or history of substance use. Female adolescents with depression, however, had significantly lower school performance and lower engagement in outdoor activities than controls. They also had a significantly higher frequency of a family history of psychiatric disorders and troubled home atmosphere. They were more likely to have experienced negative life events and a break-up of romantic relationship. Cases did not differ significantly from controls in their history of substance use. Conclusion: We concluded that different psychosocial correlates may influence the development of depression among female adolescents. These correlates include poor scholastic performance, lack of outdoors activities, disturbed home atmosphere, positive family history of psychiatric disorders, history of negative life events and break up of romantic relationship. Addressing these correlates may be important to improving outcome and quality of life in depressed adolescent females.