Effects of gender differences and lifestyle factors on depression among Chinese children and adolescents

PURPOSE: This study aims to investigate the variations in the prevalence of depressive symptoms among Chinese children and adolescents with different lifestyles, including Internet use, breakfast, exercise, sleep and homework, and to further explore the impact of gender on the relationship between lifestyles and depressive symptoms. METHODS: The cross-sectional study recruited school-based students (8–18 years) throughout Chongqing, China. The Center for Epidemiological Studies Depression Scale for Children (CES-DC) was utilized to assess depressive symptoms. Lifestyle factors were assessed based on self-reported responses to specific questions about time or frequency. Binary logistic regression was employed to identify the factors significantly contributing to the prevalence of depressive symptoms. The analysis was stratified by gender. RESULTS: A total of 22,373 children and adolescents were recruited from February 2019 to December 2019, comprising 11,141 boys (49.80%) and 11,232 girls (50.20%). Among them, 2922 (13.06%) participants reported experiencing depressive symptoms, with a prevalence rate of 10.56% for boys and 15.54% for girls. The binary logistic regression analysis revealed that spending more than 2 h on the Internet, skipping breakfast, and spending more than 1.5 h on homework were risk factors for depressive symptoms. Conversely, exercising for 3 to 5 h and sleeping for 6 to 10 h were protective factors of depressive symptoms. Notably, gender-stratified analysis revealed that the associations between depressive symptoms and both Internet use and exercise were statistically significant only among girls. CONCLUSIONS: The insights gained from this study may assist in raising awareness among families and schools about the need to focus on the lifestyles of children and adolescents, with special attention to gender interactions, when implementing preventive measures for depressive symptoms.