Prevalence
of Subclinical Depression among College Students: A Review
Anamika Modi Jain and
Dr. M. Jha
Psychometric laboratory, School of Studies in
Psychology, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh.
anamikamodi.28@gmail.com
*Corresponding
author: anamikamodi.28@gmail.com
Abstract
INTRODUCTION
- Early adult stage is the transition from adolescence to young
adulthood, presents significant challenges like the chance to manage one’s life
and affect more independent roles. A number of them adjust with these
challenges and a few couldn’t manage these stressors which can cause the mental
health problems. Among these problems depression is very common, and it is very
difficult to detect in early stage, which often identified as a minor or
subclinical depression.
SD patients were in a
mean position between non-depressive and depressive patients with regard to
social isolation and physical destruction; women were overrepresented in the
depressive and sub-depressive groups” (Schnieder et al. 2000). Study suggests the prevalence rate of
subclinical depression was very high, which need urgent attention for
identification and treatment. If it is ignored or left untreated long term
effect may be appear in the form of major or severe depression.
METHOD - A comprehensive systematic search of
published literature and journal articles from Google Scholar, Pub Med, MEDLINE
and EBSCO was taken. Search strategy specific to each data repository was used.
During initial search 642 titles were retrieved and finally 38 empirical
researches were selected based on the inclusion criteria.
RESULT - Total
38 articles were selected, out of 38 approx 36 studies shows the rate of
prevalence of Subclinical depression among college students and some studies
based on impact and factors associated with subclinical depression.
CONCLUSION - It is very important that health care
providers, counselors, teachers and parents should pay special attention for
early detection and treatment of subclinical depressive symptoms in early
adults.
KEYWORDS -
Subclinical depression (SD), College students, Prevalence, Health care
providers.
Introduction:
"Subclinical
depression refers to an emotionally negative state which significantly
influences level of achievement and quality of life, but which cannot be classified
as an illness. Based on the seriousness of the symptoms, it could be measured
on different scales of depression as mild or moderate” (Margitics, 2006). “When
4-5 symptoms of depression present continue two weeks with the impairment
present in individual functioning, then it is subclinical depression. It is a
common condition person falling below the diagnostic threshold experience”, it
affect our daily life negatively.
“Depressive syndromes
that do not obey with the diagnostic criteria for specific depressive disorders
are nominated as 'subclinical' or 'sub-syndromal' depressive syndromes. SD
patients were in a mean position between non-depressive and depressive patients
with regard to social isolation and physical destruction; women were overrepresented
in the depressive and sub-depressive groups” (Schnieder et al. 2000). Regarding
subclinical depression, also called sub-threshold depression or sub-syndromal
symptomatic depression, between 2 and 5 depressive symptoms were required for
the diagnosis and a minimum duration of 2 weeks. Significant destruction
associated with sub-threshold depressive conditions, as well as co morbidity
with other mental disorders, has been described.
Need
for the study:
The world health organization (WHO) defines “depression
is a common mental disorder that presents with sad mood, loss of interest or
happiness, feeling of guiltiness or low sense of worth, scattered sleep or
appetite low energy and reduced attention”. These problems can become constant,
repeated and change in to significant disability in a person’s capability to
take care of his or her daily responsibilities”. At its bad, depression can
direct to suicide, a disastrous casualty linked with the loss of about 850,000
life’s per year. The WHO highlights the occurrence of depression in younger age
group (20-25). Based on data NCR-R (National Co-morbidity Survey-Replication),
half of all life time cases of mood disorders start at 14 years and
three-fourths by 24 years (Kessler, Berglund, Demler, Jin & Walters, 2005).
Subclinical Depression (minor or sub threshold depression) have been defined in
a wide range of forms, varying on a number of symptoms and duration required.
Subclinical Depression in adolescent is a risk factor for further development
of clinical depression. However there is a lacuna of research that document
subclinical depression among adolescent in India.
Aim:
The aim of the study find out the
prevalence rate of subclinical depression among college students and factors
associated with it.
Objective:
To determine the prevalence of subclinical depression and factors
associated with it.
Methodology:
Search strategy methods:
The subclinical depression was selected as the area of interest
and a search was conducted on online database. Google scholar, Pub Med,
MEDLINE, EBSCO to retrieve quantitative and qualitative research article
published from 2003-2020 and the search was confined to only English language.
The search terms used “subclinical depression”, minor depression, “sub-threshold
depressive symptoms”, sub-threshold depression; “subclinical depressive
conditions” sub-syndromal depression and prevalence of depression among college
students and those terms were searched both in the title and in the abstract. We
included original research, prevalence and associated characteristics of minor
and sub-threshold depression in general in both community and primary care
settings.
Search strategy:
Factors
affecting subclinical depression among college students [All Fields]
"Subclinical depression [Mesh] AND "College students" [Mesh])
AND "minor depression" [Mesh]) AND “early Adulthood" [Mesh]) AND
"prevalence of depression” [Mesh].
Types of studies:
Qualitative
study and Quantitative study, Cross sectional study and longitudinal study.
Type of participants:
College students / early adult / late
adolescents, above residing in rural and urban area.
Settings:
Rural
area, urban area and studying in college and university.
Outcome:
The
narrative review shows that the prevalence of subclinical depression was very
common among the college students and late adolescence or early adult stage,
which may cause the major depression in next stage of life. And several factors
impact on depression among college students which provoke depressive symptoms.
Delivery of Intervention:
This
narrative review was predetermined with the exploration of reviews related to
the topic “Prevalence of subclinical depression among college students” the
search begins with the keywords. Online databases which were used for the
exploration of review were Google scholar, Pub Med from the year 2003-2020. The
search was confined to only English language other was excluded. Those phrases
were searched both within the name and inside the abstract. We protected
authentic researches (Observational and epidemiological studies) occurrence and
related characteristics of youngster and subclinical depression in younger
population in both community and primary health care settings. Bibliography of
retrieved papers changed into examined. 642 papers have been considered. 38
studies have been selected as they had been population based research analyzing
subclinical depressive (mild and moderate depressive) situations in well known
population. The remaining 602 papers
were disqualified because of numerous reasons: the kind of paper; research of
the psychometric properties of instruments, records excluded due to exceed
limitation of the year, restrict to
particular age ranges, evaluation of interventions (effectiveness of
various therapies); studies of the biology of subclinical depressive disorders.
Results:
(Table too large to preview. Please view the Table in PDF version of this article.)
Outcome:
The
narrative review outcome shows the prevalence of subclinical depression among students
studying in different colleges or universities. It reveals that subclinical or
minor depression was very common among early adult or college students and
there
are a variety of variables that influence the severity of depression, including
biological, social, psychological, demographical, behavioral and cognitive
aspects.
Summary of
findings:
The
available literature was refined to get 38 quantitative studies:
· Out
of 38 studies maximum empirical research shows the prevalence rate of subclinical
depression along with different level of occurrence of depression.
· Some longitudinal studies concluded
that significant association between minor depression in adolescences and
adverse mental health result in adulthood or major/severe depression resulted
in adulthood.
· A few studies concluded that
females was vulnerable for depression these studies show the gender effect.
· Among these several studies based
on the socio-demographic variables like locale, stream of education, year of
the studies, type of educational institute, parents education.
· A few number of studies based on
the personal relations with their partners (break up in romance).
· A
number of studies determined that subclinical depression impacts on their
quality of life negatively, social impairments and suicidal ideation also found
with subclinical depression.
Discussions:
Depression may be a one among the foremost common
causes of disability and common global ill health, altogether periods of life,
among these periods college may be a period of change as adolescents develop
new skills, experiences, expand social networks and gain knowledge It are often
a stressful life event for several students getting to college or university as
they agree to change in lifestyle, community and relationship changes. The
transition from adolescence to young adulthood presents significant challenges
like the chance to manage one’s life and affect more independent roles. A
number of them adjust with these challenges and a few couldn’t manage these
stressors which can cause the depression, so it's necessary to try and do
further intervention programs to prevent the subclinical depression in college
students.
Importance in education:
Depression is a taboo subject in our culture. Having
a basic understanding of subclinical depression will assist students who
frequently suffer from various levels of depression, as well as parents,
teachers and healthcare providers, in expanding their knowledge. It will also
help in the early detection of symptoms and will improve the mental health
status of those who are suffering from it.
Future significance:
To minimize
the number of occurrences of subclinical depression, also known as the primary
stage of major depression, it is critical to recognize in youths so that it may
be prevented at this time. It's also crucial to educate and teach family
members about the significance of the symptoms so that they can be identified
and treated earlier.
Limitations:
•
Study based on only early adult or college
student’s even subclinical depression is very common among elderly.
Reference:
1.
Al-Windi
(2005). A Depression in general practice. Nord
Journal of Psychiatry, 59 (4), 272-277.
2.
Asante, K.
O. & Andoh-Arthur, J. (2015). Prevalence and
determinants of depressive symptoms among university students in Ghana. Journal of Affective Disorders, 171, 161–166.
3.
Backenstrass,
M., Frank, A., Joest, K., Hingmann, S., Mundt, C. & Kronmüller, K. (2006).
A comparative study of nonspecific depressive symptoms and minor depression
regarding functional impairment and associated characteristics in primary care.
Journal of Comparative Psychiatry, 47, 35-41.
4.
Baumeister,
H. & Morar, V. (2008). The impact of clinical significance criteria on
subthreshold depression prevalence rates.
Acta Psychiatrica Scandinavica,
118, 443-450.
5.
Bayram,
N. & Bilgel, N. (2008). The prevalence and socio-demographic correlations
of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric
Epidemiology, 43,667–672.
6. Chen, L., Wang, L., Hui Qiu, X., Yang, X., Xue Qiao,
Z., Yang Y., J. & Liang, Y. (2013). Depression
among Chinese University Students, Prevalence and Socio-Demographic Correlates.
PLOS One. 8(3), e58379.
7.
Cuijpers,
P., de Graaf, R. & Van Dorsselaer, S. (2004). Minor depression, risk
profiles, functional disability, health care use and risk of developing major
depression. Journal of Affective
Disorder, 79, 71-79.
8.
Cuijpers,
P. & Smit, F. (2004). Subthreshold depression as a risk indicator for major
depressive disorder, a systematic review of prospective studies. Acta Psychiatrica Scandinavica, 109, 325-331.
9.
Cukrowicz,
K. C., Schlegel, E. F., Smith, P. N., Jacobs, M. O., Orden, K. A. V., Paukert,
A. L., Pettit, J. W. & Joiner, T. E. (2011). Suicide ideation among college
students evidencing subclinical depression. Journal
of American college Health, 59, (7).575-581.
10. Da Graaf, L. E.,
Huibers, M. J., Cuijpers, P. & Arntz, A. (2010). Minor and major depression
in the general population, does dysfunctional thinking play a role. Comparative Psychiatry, 51 (3), 266-274.
11. Deb, S., Parveen,
R., B., Thomasa, S., Vishnu Vardhan, V., Rao, T., P. & Khawaja, N. (2016). Depression
among. Indian university students and its association with perceived university
academic environment, living arrangements and personal issues. Asian Journal of Psychiatry, 23, 108–117.
12. Dubini, A.,
Mannheimer, R. & Pancheri, P. (2009). Depression in the community, results
of the first Italian survey. International
journal of Clinical Psychopharmacology, 16 (1), 49-53.
13. Fergusson, D., M.,
Horwood, L., J., Ridder, E., M. & Beautrais, A., L. (2005). Subthreshold
depression in adolescence and mental health outcomes in adulthood. Archive of General Psychiatry, 62, 66-72.
14. Fils, J. M., Penick, E. C., Nickel, E. J., Othmer,
E., DeSouza, C., Gabrielli, W. F. &
Hunter, E. E. (2010). Minor versus major depression, a comparative clinical
study. Primary Care Companion Journal of
Clinical Psychiatry, 12 (1).PCC. 08m00752.doi: 10.4088/PCC.08
m0075 2blu
15. Gómez-Restrepo,
C., Bohórquez, A., Pinto Masis, D., Gil Laverde, J. F., Rondon Sepulveda, M.
& Paz Granados, N. (2004). The prevalence of and factors associated with
depression in Colombia. Review of Panama
Salud Publication, 16 (6), 378-386.
16. Iqbal, S., Gupta,
S. & Venkatarao, E. (2015). Stress, anxiety and depression among medical
undergraduate students & their socio-demographic correlates. Indian Journal of Medical Research, 141, 354-357.
17. Jha, K. K., Singh,
S. K., Nirala, S. K., Kumar, C., Kumar, P. & Agrawal, N. (2017). Prevalence of Depression
among School-going Adolescents in an Urban Area of Bihar India. Indian Journal of Psychological medicine,
39(3), 287–292.
18. Johnson, J. G.,
Cohen, P. & Kasen, S. (2009). Minor depression during adolescence and
mental health outcomes during adulthood. British
Journal of Psychiatry, 195, 264-265.
19. Karmakar, T. &
Behera, S. K. (2017). Depression among the College Students, an Empirical
Study. International Journal of Education
and Applied Social Science, 8, 163-170.
20. Kaur, S., Deepti,
S. S. & Lal, M. (2014). Prevalence and Correlates of Depression among
College going Students of District Amritsar, India. International Research Journal of Medical Science, 2, 5-9.
21. Kessler, C. R.,
Berglund, Demler, O. P., Jin, R., Merikangas, R. K. & Walters, E. E. (2005).
Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the
National Co-morbidity Survey application. Archive
of General Psychiatry, 62, 593- 603.
22. Kumar, S. G.,
Kattimani, S., Sarkar, S. & Kar, S. S. (2018). Prevalence of depression and
its relation to stress level among medical students in Puducherry, India. Industrial Psychiatry journal, 26, 86-90.
23. Kumar, S. G.,
Jain, A. & Hegde, S. (2012). Prevalence of depression and its associated
factors using Beck depression Inventory among students of medical college
Karnataka. Indian Journal of Psychiatry,
54, 22-36.
24. Margitics, F.
(2006). Interrelation between predisposition factors and sub clinical
depression syndrome at college students. Psychiatria
Hungarica. 20, 211-223.
25. Nahas, A. M.,
Elkalmi, R. M., Al-Shami, A. M. & Elsayed, T. M. (2019). Prevalence of depression
among health sciences students, Findings from a public university in Malaysia. Journal of Pharmacy and Bioallied Science,
11, 170-5.
26. Naushad, S.,
Farooqui, W., Sharma, S., Rani, M., Singh, R. & Verma, S. (2014). Study of
proportion and determinants of depression among college students in Mangalore
city. Nigerian Medical Journal, 55(2), 156–160.
27. Nieremberg, A. A.,
Rapaport, M. H., Schettler, P. J., Howland, R. H., Smith, J. A., Edwards, D.,
Schneider, T. & Mischoulon, D. (2010). Deficits in Psychological Well-Being
and Quality-of-Life in Minor Depression, Implications
for DSM-V. CNS Neuroscience Therapeutics, 16, 208-216.
28. Othieno, C.
J., Okoth, R. O., Peltzer, K., Pengpid, S.
& Malla, L. O. (2014). Depression among university
students in Kenya: Prevalence and socio-demographic correlates. Journal of Affective Disorders, 165, 120-125.
29. Padampriya, b.
& Vijayalaxmi, D. (2014). Level of depression in college students. International Journal of Psychology and Psychiatry,
2, 184-192.
30. Patil, A. S.
(2015). Depression among adolescents, A cross sectional study. International Journal of Current Research
Academy Review. 3,183–6.
31. Raghunathan, D.,
Ramakrishnan, D., Iris Valsan, K. V. & Ambika, S. (2019). Prevalence of
Depression among Students of a Dental Tertiary Care Center in Kerala. Indian Journal of Community Medicine, 44, S14-8.
32. Regeer, E. J.,
Krabbendam, L., de Graaf, R., Have, M., Nolen, W. A. & Van Os, J. (2006). A
prospective study of the transition rates of subthreshold (hypo) mania and
depression in the general population. Psychological
Medicine journal, 36, 619-627.
33. Rucci, P.,
Gherardi, S., Tansella, M., Piccinelli, M., Berardi, D., Bisoffi, G., Corsino,
M. A. & Pini, S. (2003). Subthreshold psychiatric disorders in primary
care, prevalence and associated characteristics. Journal of Affective Disorder, 76, 171-181.
34. Sabbarwal, B.,
Puranik, M. P. & Sowmya, K. R. (2019). Prevalence of depressive symptoms
and associated factors among dental students, a cross-sectional study. Journal of Global Oral Health, 2(1), 16-22.
35. Samson, S. L.
& Hema Nalini, M. (2020). A study on depression among college students. Studies in Indian Place Names, 40 (12), 247-269.
36. Sandal, R. K.,
Goel, N. K., Sharma, M. K., Kaur
Bakshi R., Singh, N. & Kumar, D. (2017). Prevalence
of Depression, Anxiety and Stress among school going adolescent in Chandigarh. Journal of family medicine Prime Care, 6(2),
405-410.
37. Schneider, G., Kruse, A., Nehen, H. G., Senf, W. & Heuft, G. (2000). The Prevalence and differential Diagnosis of
Subclinical Depressive Syndromes in Inpatients 60 Years and Older. Journal of Psychotherapy and Psychosomatics, 69(5), 251-60.
38. Singh, A., Lal, A.
& shekhar. (2011). Prevalence of Depression among Medical Students of a
Private Medical College in India. Journal
of Health and Allied Sciences, 9, (4), 1-3.
39. Singhal, M.,
Manjula, M. & John Vijay Sagar, K. (2016). Subclinical depression in urban
Indian adolescents, Prevalence, felt needs, and correlates. Indian Journal of Psychiatry, 58, 394-402.
40. Wilson, Bohnert,
E. A., Ambrose, A., Davis, Y. D., Jones, M. D. & Magee, J. M. (2014).
Social, behavioral, and sleep characteristics associated with depression
symptoms among undergraduate students at a women’s college, across-sectional
depression survey, 2012. BMC Women's
Health, 14, (8), 2-9.