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Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Depression in late adolescence: a cross-sectional study in senior high schools in Greece

Authors: Konstantina Magklara, Stefanos Bellos, Dimitrios Niakas, Stelios Stylianidis, Gerasimos Kolaitis, Venetsanos Mavreas, Petros Skapinakis

Published in: BMC Psychiatry | Issue 1/2015

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Abstract

Background

Depression is a common mental health problem in adolescents worldwide. The aim of the present study was to investigate the prevalence, comorbidity and sociodemographic and socioeconomic associations of depression and depressive symptoms, as well as the relevant health services use in a sample of adolescents in Greece.

Methods

Five thousand six hundred fourteen adolescents aged 16–18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R). The use of substances, such as alcohol, nicotine and cannabis, and several sociodemographic and socioeconomic variables have been also assessed.

Results

In our sample the prevalence rates were 5.67 % for the depressive episode according to ICD-10 and 17.43 % for a broader definition of depressive symptoms. 49.38 % of the adolescents with depressive episode had at least one comorbid anxiety disorder [OR: 7.76 (5.52-10.92)]. Only 17.08 % of the adolescents with depression have visited a doctor due to a psychological problem during the previous year. Anxiety disorders, substance use, female gender, older age, having one sibling, and divorce or separation of the parents were all associated with depression. In addition, the presence of financial difficulties in the family was significantly associated with an increased prevalence of both depression and depressive symptoms.

Conclusions

Prevalence and comorbidity rates of depression among Greek adolescents are substantial. Only a small minority of depressed adolescents seek professional help. Significant associations with financial difficulties are reported.
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Literature
1.
go back to reference Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.PubMedCrossRef Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.PubMedCrossRef
3.
go back to reference Fletcher JM. Adolescent depression and educational attainment: results using sibling fixed effects. Health Econ. 2008;17:1215–35.PubMedCrossRef Fletcher JM. Adolescent depression and educational attainment: results using sibling fixed effects. Health Econ. 2008;17:1215–35.PubMedCrossRef
4.
go back to reference Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent depression. J Adolesc Health. 2007;41:256–62.PubMedCrossRef Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent depression. J Adolesc Health. 2007;41:256–62.PubMedCrossRef
6.
go back to reference Kessler RC, Avenevoli S, Ries Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry. 2001;49(12):1002–14.PubMedCrossRef Kessler RC, Avenevoli S, Ries Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry. 2001;49(12):1002–14.PubMedCrossRef
7.
go back to reference Hankin BL, Abramson LY. Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychol Bull. 2001;127(6):773.PubMedCrossRef Hankin BL, Abramson LY. Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychol Bull. 2001;127(6):773.PubMedCrossRef
8.
go back to reference Ge X, Conger RD, Elder Jr GH. Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Dev Psychol. 2001;37(3):404.PubMedCrossRef Ge X, Conger RD, Elder Jr GH. Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Dev Psychol. 2001;37(3):404.PubMedCrossRef
9.
go back to reference Costello EJ, Egger H, Angold A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Adolesc Psychiatry. 2005;44(10):972–86.PubMedCrossRef Costello EJ, Egger H, Angold A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Adolesc Psychiatry. 2005;44(10):972–86.PubMedCrossRef
10.
go back to reference Costello EJ, Erkanli A, Angold A. Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry. 2006;47(12):1263–71. Costello EJ, Erkanli A, Angold A. Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry. 2006;47(12):1263–71.
11.
go back to reference Lewinsohn PM, Rohde P, Klein DN, Seeley JR. Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. J Am Acad Child Adolesc Psychiatry. 1999;38(1):56–63.PubMedCrossRef Lewinsohn PM, Rohde P, Klein DN, Seeley JR. Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. J Am Acad Child Adolesc Psychiatry. 1999;38(1):56–63.PubMedCrossRef
12.
go back to reference Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE. Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998;107(1):128.PubMedCrossRef Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE. Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998;107(1):128.PubMedCrossRef
13.
go back to reference Fombonne E. Depressive disorders: time trends; and possible explanatory mechanisms. In: Rutter M, Smith DJ, editors. Psychosocial disorders in young people: time trends and their causes. Chichester: Wiley; 1995. Fombonne E. Depressive disorders: time trends; and possible explanatory mechanisms. In: Rutter M, Smith DJ, editors. Psychosocial disorders in young people: time trends and their causes. Chichester: Wiley; 1995.
14.
go back to reference Sixty-Fifth-World health Assembly WHA65.4 Agenda item 13.2. 25 May 2012. The global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Geneva: World Health Organization; 2012. Sixty-Fifth-World health Assembly WHA65.4 Agenda item 13.2. 25 May 2012. The global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Geneva: World Health Organization; 2012.
15.
go back to reference Lazaratou H, Dikeos DG, Anagnostopoulos DC, Soldatos CR. Depressive symptomatology in high school students: the role of age, gender and academic pressure. Community Ment Health J. 2010;46(3):289–95.PubMedCrossRef Lazaratou H, Dikeos DG, Anagnostopoulos DC, Soldatos CR. Depressive symptomatology in high school students: the role of age, gender and academic pressure. Community Ment Health J. 2010;46(3):289–95.PubMedCrossRef
16.
go back to reference Madianos MG, Gefou-Madianou D, Stefanis CN. Depressive symptoms and suicidal behavior among general population adolescents and young adults across Greece. Eur Psychiatry. 1993;8(3):139–46. Madianos MG, Gefou-Madianou D, Stefanis CN. Depressive symptoms and suicidal behavior among general population adolescents and young adults across Greece. Eur Psychiatry. 1993;8(3):139–46.
17.
go back to reference Economou M, Madianos M, Peppou LE, Patelakis A, Stefanis CN. Major depression in the era of economic crisis: a replication of a cross-sectional study across Greece. J Affect Disord. 2013;145(3):308–14.PubMedCrossRef Economou M, Madianos M, Peppou LE, Patelakis A, Stefanis CN. Major depression in the era of economic crisis: a replication of a cross-sectional study across Greece. J Affect Disord. 2013;145(3):308–14.PubMedCrossRef
18.
go back to reference Skapinakis P, Bellos S, Koupidis S, Grammatikopoulos I, Theodorakis PN, Mavreas V. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry. 2013;13(1):163.PubMedPubMedCentralCrossRef Skapinakis P, Bellos S, Koupidis S, Grammatikopoulos I, Theodorakis PN, Mavreas V. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry. 2013;13(1):163.PubMedPubMedCentralCrossRef
19.
go back to reference Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837–44.PubMedCrossRef Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837–44.PubMedCrossRef
20.
go back to reference Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, et al. Service utilization for lifetime mental disorders in US adolescents: results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011;50(1):32–45.PubMedCrossRef Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, et al. Service utilization for lifetime mental disorders in US adolescents: results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011;50(1):32–45.PubMedCrossRef
21.
go back to reference Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psychiatr. 1994;151:979–86.PubMedCrossRef Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psychiatr. 1994;151:979–86.PubMedCrossRef
22.
go back to reference Roberts RE, Roberts CR, Chen YR. Ethnocultural differences in prevalence of adolescent depression. Am J Community Psychol. 1997;25(1):95–110.PubMedCrossRef Roberts RE, Roberts CR, Chen YR. Ethnocultural differences in prevalence of adolescent depression. Am J Community Psychol. 1997;25(1):95–110.PubMedCrossRef
23.
go back to reference Skapinakis P, Magklara K, Mpellos S, Gkatsa T, Mihalis G, Mavreas V. The association between socio-economic status and mental disorders in late adolescence: Cross-sectional survey in the Northwestern part of Greece. Arch of Hellenic Med. 2007;24 Suppl 1:19–29. Skapinakis P, Magklara K, Mpellos S, Gkatsa T, Mihalis G, Mavreas V. The association between socio-economic status and mental disorders in late adolescence: Cross-sectional survey in the Northwestern part of Greece. Arch of Hellenic Med. 2007;24 Suppl 1:19–29.
24.
go back to reference Dunn GRAHAM, Pickles A, Tansella M. Two-phase epidemiological surveys in psychiatric research. Br J Psychiatry. 1999;174(2):95–100.PubMedCrossRef Dunn GRAHAM, Pickles A, Tansella M. Two-phase epidemiological surveys in psychiatric research. Br J Psychiatry. 1999;174(2):95–100.PubMedCrossRef
25.
go back to reference Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992;22(02):465–86.PubMedCrossRef Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992;22(02):465–86.PubMedCrossRef
26.
go back to reference Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H. Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry. 2003;15(1–2):65–73.PubMedCrossRef Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H. Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry. 2003;15(1–2):65–73.PubMedCrossRef
27.
go back to reference Lewis G, Pelosi AJ, Glover E, Wilkinson G, Stansfeld SA, Williams P, et al. The development of a computerized assessment for minor psychiatric disorder. Psychol Med. 1988;18(03):737–45.PubMedCrossRef Lewis G, Pelosi AJ, Glover E, Wilkinson G, Stansfeld SA, Williams P, et al. The development of a computerized assessment for minor psychiatric disorder. Psychol Med. 1988;18(03):737–45.PubMedCrossRef
28.
go back to reference Patton GC, Coffey C, Posterino M, Carlin JB, Wolfe R, Bowes G. A computerised screening instrument for adolescent depression: population-based validation and application to a two-phase case–control study. Soc Psychiatry Psychiatr Epidemiol. 1999;34(3):166–72.PubMedCrossRef Patton GC, Coffey C, Posterino M, Carlin JB, Wolfe R, Bowes G. A computerised screening instrument for adolescent depression: population-based validation and application to a two-phase case–control study. Soc Psychiatry Psychiatr Epidemiol. 1999;34(3):166–72.PubMedCrossRef
29.
go back to reference Skapinakis P, Anagnostopoulos F, Bellos S, Magklara K, Lewis G, Mavreas V. An empirical investigation of the structure of anxiety and depressive symptoms in late adolescence: cross-sectional study using the Greek version of the revised Clinical Interview Schedule. Psychiatry Res. 2011;186(2):419–26.PubMedCrossRef Skapinakis P, Anagnostopoulos F, Bellos S, Magklara K, Lewis G, Mavreas V. An empirical investigation of the structure of anxiety and depressive symptoms in late adolescence: cross-sectional study using the Greek version of the revised Clinical Interview Schedule. Psychiatry Res. 2011;186(2):419–26.PubMedCrossRef
30.
go back to reference Magklara K, Skapinakis P, Niakas D, Bellos S, Zissi A, Stylianidis S, et al. Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece. Int J Equity in Health. 2010;9:3.CrossRef Magklara K, Skapinakis P, Niakas D, Bellos S, Zissi A, Stylianidis S, et al. Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece. Int J Equity in Health. 2010;9:3.CrossRef
31.
go back to reference Currie CE, Elton RA, Todd J, Platt S. Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey. Health Educ Res. 1997;12(3):385–97.PubMedCrossRef Currie CE, Elton RA, Todd J, Platt S. Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey. Health Educ Res. 1997;12(3):385–97.PubMedCrossRef
32.
go back to reference Koivusilta LK, Rimpelä AH, Kautiainen SM. Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position? BMC Public Health. 2006;6(1):110.PubMedCrossRef Koivusilta LK, Rimpelä AH, Kautiainen SM. Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position? BMC Public Health. 2006;6(1):110.PubMedCrossRef
33.
go back to reference Rabe-Hesketh S, Skrondal A. Multilevel and longitudinal modeling using Stata. College Station, TX: STATA press; 2008. Rabe-Hesketh S, Skrondal A. Multilevel and longitudinal modeling using Stata. College Station, TX: STATA press; 2008.
34.
go back to reference Angelopoulos N, Economou M. Prevalence of anxiety and depressive symptoms in a high-school student population. Eur Psychiatry. 1994;19:26. Angelopoulos N, Economou M. Prevalence of anxiety and depressive symptoms in a high-school student population. Eur Psychiatry. 1994;19:26.
35.
go back to reference Pez O, Gilbert F, Bitfoi A, Carta MG, Jordanova V, Garcia-Mahia C, et al. Validity across translations of short survey psychiatric diagnostic instruments: CIDI-SF and CIS-R versus SCID-I/NP in four European countries. Soc Psychiatry Psychiatr Epidemiol. 2010;45(12):1149–59.PubMedCrossRef Pez O, Gilbert F, Bitfoi A, Carta MG, Jordanova V, Garcia-Mahia C, et al. Validity across translations of short survey psychiatric diagnostic instruments: CIDI-SF and CIS-R versus SCID-I/NP in four European countries. Soc Psychiatry Psychiatr Epidemiol. 2010;45(12):1149–59.PubMedCrossRef
36.
go back to reference Araya R, Montero-Marin J, Barroilhet S, Fritsch R, Montgomery A. Detecting depression among adolescents in Santiago, Chile: sex differences. BMC Psychiatry. 2013;13(1):122.PubMedPubMedCentralCrossRef Araya R, Montero-Marin J, Barroilhet S, Fritsch R, Montgomery A. Detecting depression among adolescents in Santiago, Chile: sex differences. BMC Psychiatry. 2013;13(1):122.PubMedPubMedCentralCrossRef
37.
go back to reference Salokangas RKR et al. Gender differences in depressive symptoms: An artefact caused by measurement instruments? J Affect Disord. 2002;68(2):215–20.PubMedCrossRef Salokangas RKR et al. Gender differences in depressive symptoms: An artefact caused by measurement instruments? J Affect Disord. 2002;68(2):215–20.PubMedCrossRef
38.
go back to reference Sørensen MJ, Nissen JB, Mors O, Thomsen PH. Age and gender differences in depressive symptomatology and comorbidity: an incident sample of psychiatrically admitted children. J Affect Disord. 2005;84(1):85–91.PubMedCrossRef Sørensen MJ, Nissen JB, Mors O, Thomsen PH. Age and gender differences in depressive symptomatology and comorbidity: an incident sample of psychiatrically admitted children. J Affect Disord. 2005;84(1):85–91.PubMedCrossRef
39.
go back to reference Garber J, Weersing VR. Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clin Psychol Sci Pract. 2010;17(4):293–306.CrossRef Garber J, Weersing VR. Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clin Psychol Sci Pract. 2010;17(4):293–306.CrossRef
40.
41.
go back to reference Brady EU, Kendall PC. Comorbidity of anxiety and depression in children and adolescents. Psychol Bull. 1992;111(2):244.PubMedCrossRef Brady EU, Kendall PC. Comorbidity of anxiety and depression in children and adolescents. Psychol Bull. 1992;111(2):244.PubMedCrossRef
42.
go back to reference Clark DB, Pollock N, Bukstein OG, Mezzich AC, Bromberger JT, Donovan JE. Gender and comorbid psychopathology in adolescents with alcohol dependence. J Am Acad Child Adolesc Psychiatry. 1997;36(9):1195–203.PubMedCrossRef Clark DB, Pollock N, Bukstein OG, Mezzich AC, Bromberger JT, Donovan JE. Gender and comorbid psychopathology in adolescents with alcohol dependence. J Am Acad Child Adolesc Psychiatry. 1997;36(9):1195–203.PubMedCrossRef
43.
go back to reference Kandel DB, Huang FY, Davies M. Comorbidity between patterns of substance use dependence and psychiatric syndromes. Drug Alcohol Depend. 2001;64(2):233–41.PubMedCrossRef Kandel DB, Huang FY, Davies M. Comorbidity between patterns of substance use dependence and psychiatric syndromes. Drug Alcohol Depend. 2001;64(2):233–41.PubMedCrossRef
44.
go back to reference Sher KJ, Grekin ER, Williams NA. The development of alcohol use disorders. Annu Rev Clin Psychol. 2005;1:493–523.PubMedCrossRef Sher KJ, Grekin ER, Williams NA. The development of alcohol use disorders. Annu Rev Clin Psychol. 2005;1:493–523.PubMedCrossRef
45.
go back to reference Zucker RA, Fitzgerald HE, Moses HD. Emergence of alcohol problems and the several alcoholisms: A developmental perspective on etiologic theory and life course trajectory. In: Cicchetti D, Cohen DJ, editors. Developmental psychopathology, Vol. 2: Risk, disorder, and adaptation. New York: Wiley; 1995. p. 677–711. Zucker RA, Fitzgerald HE, Moses HD. Emergence of alcohol problems and the several alcoholisms: A developmental perspective on etiologic theory and life course trajectory. In: Cicchetti D, Cohen DJ, editors. Developmental psychopathology, Vol. 2: Risk, disorder, and adaptation. New York: Wiley; 1995. p. 677–711.
46.
go back to reference Schuckit MA, Tipp JE, Bergman M, Reich W, Hesselbrock VM, Smith TL. Comparison of induced and independent major depressive disorders in 2,945 alcoholics. Am J Psychiatr. 1997;154(7):948–57.PubMedCrossRef Schuckit MA, Tipp JE, Bergman M, Reich W, Hesselbrock VM, Smith TL. Comparison of induced and independent major depressive disorders in 2,945 alcoholics. Am J Psychiatr. 1997;154(7):948–57.PubMedCrossRef
47.
go back to reference Rowe MG, Fleming MF, Barry KL, Manwell LB, Kropp S. Correlates of depression in primary care. J Fam Pract. 1995;41(6):551–8.PubMed Rowe MG, Fleming MF, Barry KL, Manwell LB, Kropp S. Correlates of depression in primary care. J Fam Pract. 1995;41(6):551–8.PubMed
48.
go back to reference McDowell I, Lindsay J, Sykes E, Verreault R, Laurin D, Hendrie HC, et al. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatr. 2004;49:124–38. McDowell I, Lindsay J, Sykes E, Verreault R, Laurin D, Hendrie HC, et al. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatr. 2004;49:124–38.
49.
go back to reference Frances RJ. The wrath of grapes versus the self-medication hypothesis. Harv Rev Psychiatry. 1997;4(5):287–9.PubMedCrossRef Frances RJ. The wrath of grapes versus the self-medication hypothesis. Harv Rev Psychiatry. 1997;4(5):287–9.PubMedCrossRef
50.
go back to reference Lagoni L, Crawford E, Huss MT. An examination of the self-medication hypothesis via treatment completion. Addict Res Theory. 2011;19(5):416–26.CrossRef Lagoni L, Crawford E, Huss MT. An examination of the self-medication hypothesis via treatment completion. Addict Res Theory. 2011;19(5):416–26.CrossRef
51.
go back to reference Bovasso GB. Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatr. 2001;158(12):2033–7.PubMedCrossRef Bovasso GB. Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatr. 2001;158(12):2033–7.PubMedCrossRef
52.
go back to reference Audrain-McGovern J, Rodriguez D, Tercyak KP, Cuevas J, Rodgers K, Patterson F. Identifying and characterizing adolescent smoking trajectories. Cancer Epidemiol Biomark Prev. 2004;13(12):2023–34. Audrain-McGovern J, Rodriguez D, Tercyak KP, Cuevas J, Rodgers K, Patterson F. Identifying and characterizing adolescent smoking trajectories. Cancer Epidemiol Biomark Prev. 2004;13(12):2023–34.
53.
go back to reference Crone MR, Reijneveld SA. The association of behavioural and emotional problems with tobacco use in adolescence. Addict Behav. 2007;32(8):1692–8.PubMedCrossRef Crone MR, Reijneveld SA. The association of behavioural and emotional problems with tobacco use in adolescence. Addict Behav. 2007;32(8):1692–8.PubMedCrossRef
54.
go back to reference Elkins IJ, McGue M, Iacono WG. Prospective effects of attention-deficit/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Arch Gen Psychiatry. 2007;64(10):1145–52.PubMedCrossRef Elkins IJ, McGue M, Iacono WG. Prospective effects of attention-deficit/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Arch Gen Psychiatry. 2007;64(10):1145–52.PubMedCrossRef
55.
go back to reference Patton GC, Carlin JB, Coffey C, Wolfe R, Hibbert M, Bowes G. Depression, anxiety, and smoking initiation: a prospective study over 3 years. Am J Public Health. 1998;88(10):1518–22.PubMedPubMedCentralCrossRef Patton GC, Carlin JB, Coffey C, Wolfe R, Hibbert M, Bowes G. Depression, anxiety, and smoking initiation: a prospective study over 3 years. Am J Public Health. 1998;88(10):1518–22.PubMedPubMedCentralCrossRef
56.
go back to reference Liu X. Cigarette smoking, life stress, and behavioral problems in Chinese adolescents. J Adolesc Health. 2003;33(3):189–92.PubMedCrossRef Liu X. Cigarette smoking, life stress, and behavioral problems in Chinese adolescents. J Adolesc Health. 2003;33(3):189–92.PubMedCrossRef
57.
go back to reference Dierker LC, Avenevoli S, Stolar M, Merikangas KR. Smoking and depression: an examination of mechanisms of comorbidity. Am J Psychiatr. 2002;159(6):947–53.PubMedCrossRef Dierker LC, Avenevoli S, Stolar M, Merikangas KR. Smoking and depression: an examination of mechanisms of comorbidity. Am J Psychiatr. 2002;159(6):947–53.PubMedCrossRef
58.
go back to reference Clark DB, Cornelius J. Childhood psychopathology and adolescent cigarette smoking: A prospective survival analysis in children at high risk for substance use disorders. Addict Behav. 2004;29(4):837–41.PubMedCrossRef Clark DB, Cornelius J. Childhood psychopathology and adolescent cigarette smoking: A prospective survival analysis in children at high risk for substance use disorders. Addict Behav. 2004;29(4):837–41.PubMedCrossRef
59.
go back to reference Giannakopoulos G, Tzavara C, Dimitrakaki C, Kolaitis G, Rotsika V, Tountas Y. Emotional, behavioural problems and cigarette smoking in adolescence: findings of a Greek cross-sectional study. BMC Public Health. 2010;10(1):57.PubMedPubMedCentralCrossRef Giannakopoulos G, Tzavara C, Dimitrakaki C, Kolaitis G, Rotsika V, Tountas Y. Emotional, behavioural problems and cigarette smoking in adolescence: findings of a Greek cross-sectional study. BMC Public Health. 2010;10(1):57.PubMedPubMedCentralCrossRef
60.
go back to reference Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98–112.PubMedCrossRef Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98–112.PubMedCrossRef
61.
go back to reference Goodman E, Huang B. Socioeconomic status, depressive symptoms, and adolescent substance use. Arch Pediatr Adolesc Med. 2002;156(5):448–53.PubMedCrossRef Goodman E, Huang B. Socioeconomic status, depressive symptoms, and adolescent substance use. Arch Pediatr Adolesc Med. 2002;156(5):448–53.PubMedCrossRef
62.
go back to reference Thoits, PA. Sociological approaches to mental illness. In: Horwitz AV, Scheid TL, eds. A handbook for the study of mental health: social contexts, theories, and systems. Cambridge, United Kingdom: Cambridge University Press, 1999:121–38. Thoits, PA. Sociological approaches to mental illness. In: Horwitz AV, Scheid TL, eds. A handbook for the study of mental health: social contexts, theories, and systems. Cambridge, United Kingdom: Cambridge University Press, 1999:121–38.
63.
go back to reference Wilkinson R, Pickett K. The spirit level: why equality is better for everyone. UK: Penguin; 2010. Wilkinson R, Pickett K. The spirit level: why equality is better for everyone. UK: Penguin; 2010.
64.
go back to reference Zachrisson HD, Rödje K, Mykletun A. Utilization of health services in relation to mental health problems in adolescents: a population based survey. BMC Public Health. 2006;6(1):34.PubMedPubMedCentralCrossRef Zachrisson HD, Rödje K, Mykletun A. Utilization of health services in relation to mental health problems in adolescents: a population based survey. BMC Public Health. 2006;6(1):34.PubMedPubMedCentralCrossRef
65.
go back to reference Piko BF, Fitzpatrick KM. Socioeconomic status, psychosocial health and health behaviours among Hungarian adolescents. Eur J Public Health. 2007;17(4):353–60.PubMedCrossRef Piko BF, Fitzpatrick KM. Socioeconomic status, psychosocial health and health behaviours among Hungarian adolescents. Eur J Public Health. 2007;17(4):353–60.PubMedCrossRef
Metadata
Title
Depression in late adolescence: a cross-sectional study in senior high schools in Greece
Authors
Konstantina Magklara
Stefanos Bellos
Dimitrios Niakas
Stelios Stylianidis
Gerasimos Kolaitis
Venetsanos Mavreas
Petros Skapinakis
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0584-9

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