Depression and anxiety in adolescents in Malta.

Abstract

This cross-sectional study explores the prevalence of depression and anxiety in adolescents attending Form 3 class in Malta, these are usually 13 or 14 years of age. The study population was selected via weighted sampling based on gender and school type and was of 625 students. There were 569 respondents, giving a response rate of 91 %. The study was conducted in June 2006 in 23 state and non state schools. The students answered a self-assessment questionnaire at school in the presence of the teacher. Anonymity and confidentiality were maintained at all times. The questionnaire contained some demographic data and two validated tools namely the Depression Self-Rating Scale for Children by Dr Peter Birleson to assess depressive symptoms and the Revised Child Anxiety and Depression Scale-25 (RCADS-25) devised by Dr Peter Muris which has four sub scales assessing different forms of anxiety and a subscale for depression. Two other questions were included, one concerning bullying and the other pressure to study. The study had the approval of the University Research Ethics Committee and the Education Division and parental consent was obtained. Results revealed that the overall prevalence of depression in our study population was of 21.3%, although females had more than twice the prevalence of males. Students most at risk of developing depression are: • Children not living with both parents • Offspring whose father is unemployed (weakly) • Children whose mothers are in employment • Victims of bullying • Students who are either not pressured to study or those who are very pressured to study. Adolescents in Malta tended to be more anxious and depressed when compared to their Dutch counterparts. There is plenty of comorbidity between anxiety and depression, with panic disorder and depression being the most common closely followed by social phobia and depression, generalized anxiety disorder and depression and separation anxiety disorder and depression. These findings indicate that the problem is significant and interventions including health prevention and health promotion must be introduced in various sectors such as schools and primary care clinics. Targeted intervention is the most cost-effective as it yields the highest benefit. Approach to the problem should be multisectoral and commitment by all the stakeholders, namely, health, education, family and social affairs ministries, agencies, health care professionals, educators, students and parents, is necessary. Resources, although scarce, are present but need to be better allocated. This intersectoral approach is indispensable for the intervention to be both effective and efficient. Increasing awareness and promoting mental health are pivotal to decrease the burden of disease and improve the quality of life and psychological well-being of youths most at risk.