Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender

Authors: Mark Asbridge, Sunday Azagba, Donald B Langille, Daniel Rasic

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered.

Methods

Data were drawn in 2010–11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012.

Results

Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed.

Conclusion

Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk.
Literature
1.
Josse JM, MacKay M, Osmond MH, MacPherson AK: School injury among Ottawa-area children: a population-based study. J Sch Health. 2009, 79 (2): 45-50. 10.1111/j.1746-1561.2008.00375.x.PubMed
2.
Birken CS, Parkin PC, To T, MacArthur C: Trends in rates of death from unintentional injury among Canadian children in urban areas: influence of socioeconomic status. CMAJ. 2006, 175 (8): 867-10.1503/cmaj.051207.PubMedPubMedCentral
3.
SMARTRISK: The Economic Burden of Injury in Canada. 2009, Toronto, ON: SMARTRISK
4.
5.
Commission on Social Determinants of Health: Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. 2008, Geneva: World Health Organization
6.
Social determinants of health: Canadian perspectives. Edited by: Raphael D. 2008, Toronto, ON: Canadian Scholars’ Press, 2
7.
Soubhi H, Raina P, Kohen D: Neighborhood, family, and child predictors of childhood injury in Canada. Am J Health Behav. 2004, 28 (5): 397-409. doi: 10.5993/AJHB.28.5.2PubMed
8.
Oliver LN, Kohen DE: Neighbourhood variation in hospitalization for unintentional injury among children and teenagers. Health Rep. 2010, 21 (4): 9-17.PubMed
9.
Lea S, Black K, Asbridge M: An overview of injuries to adolescents and young adults related to substance use: data from Canadian emergency departments. CJEM. 2009, 11 (4): 330-336.PubMed
10.
Pickett W, Molcho M, Simpson K, Janssen I, Kuntsche E, Mazur J, Harel Y, Boyce WF: Cross national study of injury and social determinants in adolescents. Inj Prev. 2005, 11 (4): 213-218. 10.1136/ip.2004.007021. doi: 10.1136/ip.2004.007021PubMedPubMedCentral
11.
Simpson K, Janssen I, Craig WM, Pickett W: Multilevel analysis of associations between socioeconomic status and injury among Canadian adolescents. J Epidemiol Commun Health. 2005, 59 (12): 1072-1077. 10.1136/jech.2005.036723. doi: 10.1136/jech.2005.036723
12.
Jiang X, Li D, Boyce W, Pickett W: Variations in injury among Canadian adolescents by urban–rural geographic status. Chronic Dis Can. 2007, 28 (1–2): 56-62.PubMed
13.
Spady DW, Saunders DL, Schopflocher DP, Svenson LW: Patterns of injury in children: a population-based approach. Pediatrics. 2004, 113 (3 Pt 1): 522-529. doi: 10.1542/peds.113.3.522PubMed
14.
Harrop AR, Brant RF, Ghali WA, MacArthur C: Injury mortality rates in Native and non-Native children: a population-based study. Public Health Rep. 2007, 122 (3): 339-346.PubMedPubMedCentral
15.
Emery CA: Risk factors for injury in child and adolescent sport: a systematic review of the literature. Clin J Sport Med. 2003, 13 (4): 256-268. 10.1097/00042752-200307000-00011. doi: 10.1097/00042752-200307000-00011PubMed
16.
Pickett W, Garner MJ, Boyce WF, King MA: Gradients in risk for youth injury associated with multiple-risk behaviours: a study of 11,329 Canadian adolescents. Soc Sci Med. 2002, 55 (6): 1055-1068. 10.1016/S0277-9536(01)00224-6. doi: 10.1016/S0277-9536(01)00224-6PubMed
17.
Jiang X, Li D, Boyce W, Pickett W: Alcohol consumption and injury among Canadian adolescents: variations by urban–rural geographic status. J Rural Health. 2008, 24 (2): 143-147. 10.1111/j.1748-0361.2008.00150.x. doi: 10.1111/j.1748-0361.2008.00150.xPubMed
18.
19.
Cherpitel CJ: Alcohol and injuries: a review of international emergency room studies. Addiction. 1993, 88: 923-937. 10.1111/j.1360-0443.1993.tb02110.x. doi: 10.1111/j.1360-0443.1993.tb02110.xPubMed
20.
Elder RW, Shults RA, Swahn MH, Strife BJ, Ryan GW: Alcohol-related emergency department visits among people ages 13 to 25 years. J Stud Alcohol. 2004, 65: 297-300.PubMed
21.
22.
Poulin C, Elliot D: Student Drug Use Survey in the Atlantic Provinces 2007: Atlantic Technical Report. 2007, Halifax, NS: Dalhousie University
23.
Beghi M, Rosenbaum JF: Risk factors for fatal and nonfatal repetition of suicide attempt: a critical appraisal. Curr Opin Psychiatry. 2010, 23 (4): 349-355. 10.1097/YCO.0b013e32833ad783. doi: 10.1097/YCO.0b013e32833ad783PubMed
24.
Hawton K, Rodham K, Evans E, Weatherall R: Deliberate self harm in adolescents: self report survey in schools in England. BMJ. 2002, 325 (7374): 1207-1211. 10.1136/bmj.325.7374.1207. doi: 10.1136/bmj.325.7374.1207PubMedPubMedCentral
25.
Nixon MK, Cloutier P, Jansson SM: Non-suicidal self-harm in youth: a population-based survey. CMAJ. 2008, 178 (3): 306-312.PubMedPubMedCentral
26.
Whooley MA, Kip KE, Cauley JA, Ensrud KE, Nevitt MC, Browner WS: Depression, falls, and risk of fracture in older women. Arch Intern Med. 1999, 159 (5): 484-490. 10.1001/archinte.159.5.484. doi: 10.1001/archinte.159.5.484PubMed
27.
Iaboni A, Flint AJ: The complex interplay of depression and falls in older adults: a clinical review. Am J Geriatr Psychiatry. 2012, [epub ahead of print]. doi:10.1097/JGP.0b013e318252e773
28.
Glantz MD, Anthony JC, Berglund PA, Degenhardt L, Dierker L, Kalaydijan A, Merikangas KR, Ruscio AM, Swendsen J, Kessler RC: Mental disorders as risk factors for later substance dependence: estimates of optimal prevention and treatment benefits. Psychol Med. 2009, 39: 1365-1377. 10.1017/S0033291708004510. doi: 10.1017/S0033291708004510PubMed
29.
Angold A, Costello EJ: Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues. Am J Psychiatry. 1993, 150 (12): 1779-1791.PubMed
30.
Glania T, Lialiaris T, Tripsianis G, Papadakis N, Constandinidis TC: Is psychopathology related to children’s unintentional injury?. Int J Adolesc Med Health. 2010, 22 (4): 567-573. doi: 10.1515/IJAMH.2010.22.4.567PubMed
31.
Bruce B, Kirkland S, Waschbusch D: The relationship between childhood behaviour disorders and unintentional injury events. Paediatr Child Health. 2007, 12 (9): 749-754.PubMedPubMedCentral
32.
Martiniuk ALC, Ivers RQ, Glozier N, Patton GC, Senserrick T, Boufous S, Lam LT, Williamson A, Stevenson M, Woodward M, Norton R: Does psychological distress increase the risk for motor vehicle crashes in young people? Findings from the DRIVE Study. J Adolesc Health. 2010, 47 (5): 488-495. 10.1016/j.jadohealth.2010.03.010. doi: 10.1016/j.jadohealth.2010.03.010PubMed
33.
Mann RE, Asbridge M, Stoduto G, Smart RG, Goldbloom DS, Vingilis ER, Wickens CM: Psychological distress and collision involvement among adult drivers. Stress Health. 2010, 26 (2): 127-134. 10.1002/smi.1274. doi: 10.1002/smi.1274
34.
Fitzpatrick KM: Exposure to violence and presence of depression among low-income, African-American youth. J Consult Clin Psychol. 1993, 61 (3): 528-doi: 10.1037/0022-006X.61.3.528PubMed
35.
Ferguson CJ, San Miguel C, Hartley RD: A multivariate analysis of youth violence and aggression: the influence of family, peers, depression, and media violence. J Pediatr. 2009, 155 (6): 904-908. 10.1016/j.jpeds.2009.06.021. doi: 10.1016/j.jpeds.2009.06.021PubMed
36.
Jelalian E, Spirito A, Rasile D, Vinnick L, Rohrbeck C, Arrigan M: Risk taking, reported injury, and perception of future injury among adolesecents. J Pediatr Psychol. 1997, 22 (4): 513-531. 10.1093/jpepsy/22.4.513. doi: 10.1093/jpepsy/22.4.513PubMed
37.
38.
39.
Chapman RL, Buckley L, Sheehan MC, Shochet IM, Romaniuk M: The impact of school connectedness on violent behavior, transport risk-taking behavior, and associated injuries in adolescence. J Sch Psychol. 2011, 49 (4): 399-410. 10.1016/j.jsp.2011.04.004. doi: 10.1016/j.jsp.2011.04.004PubMed
40.
Melchior LA, Huba GJ, Brown VB, Reback CJ: A short depression index for women. Educ Psychol Meas. 1993, 53: 1117-1125. 10.1177/0013164493053004024. doi: 10.1177/0013164493053004024
41.
DiClemente RJ, Wingood GM, Crosby RA, Sionean C, Brown LK, Rothbaum B, Zimand E, Cobb BK, Harrington K, Davies S: A prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics. 2001, 108 (5): e85-10.1542/peds.108.5.e85. doi: 10.1542/peds.108.5.e85PubMed
42.
Wight RG, SepÚlveda JE, Aneshensel CS: Depressive symptoms: how do adolescents compare with adults?. J Adolesc Health. 2004, 34 (4): 314-323. 10.1016/j.jadohealth.2003.05.003. doi: 10.1016/j.jadohealth.2003.05.003PubMed
43.
Szumilas M, Kutcher S, LeBlanc JC, Langille DB: Use of school-based health centres for mental health support in Cape Breton, Nova Scotia. Can J Psychiatry. 2010, 55: 319-328.PubMed
44.
Langille D, Rasic D, Kisely S, Flowerdew G, Cobbett S: Protective associations of school connectedness with risk of depression in Nova Scotia adolescents. Can J Psychiatry. 2012, 57: 759-764.PubMed
45.
Devins GM, Orme CM, Costello CG, Binik YM, Frizzell B, Stam HJ, Pullin WM: Measuring depressive symptoms in illness populations: psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale. Psychol Health. 1988, 2 (2): 139-156. 10.1080/08870448808400349.
46.
Radloff LS: The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas. 1977, 1 (3): 385-401. 10.1177/014662167700100306.
47.
Corporation Stata: Stata Statistical Software, Release 12. 2011, College Station, TX: Stata Corporation
48.
49.
Pickett W, Schmid H, Boyce WF, Simpson K, Scheidt PC, Mazur J, Molcho M, King MA, Godeau E, Overpeck M, Aszmann A, Szabo M, Harel Y: Multiple risk behavior and injury: an international analysis of young people. Arch Pediatr Adolesc Med. 2002, 156 (8): 786-793. 10.1001/archpedi.156.8.786.PubMed
50.
King M, Pickett W, King A: Injury in Canadian youth: a secondary analysis of the 1993–94 health behaviour in school-aged children survey. Can J Public Health. 1998, 89 (6): 397-401.PubMed
51.
Pless IB, Millar W: Unintentional injuries in childhood: results from Canadian health surveys. 2000, Ottawa, ON: Health Canada
52.
DSM-IV working group: Diagnostic and Statistical Manual of Mental Disorders. 2000, Arlington: American Psychiatric Association, 4
53.
Castaneda AE, Tuulio-Henriksson A, Marttunen M, Suvisaari J, Lönnqvist J: A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults. J Affect Disord. 2008, 106 (1–2): 1-27.PubMed
54.
55.
Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE: Prevalence, severity, and comorbidity of 12-month DSM–IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005, 62: 617-627. 10.1001/archpsyc.62.6.617. doi: 10.1001/archpsyc.62.6.617PubMedPubMedCentral
56.
Cole DA, Carpentieri S: Social status and the comorbidity of child depression and conduct disorder. J Consult Clin Psychol. 1990, 58: 748-757. doi: 10.1037//0022-006X.58.6.748PubMed
57.
Barkley RA, Guevremont DC, Anastopoulos AD, DuPaul GC, Shelton TL: Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey. Pediatrics. 1993, 92: 212-218.PubMed
58.
Fergusson DM, Wanner B, Vitaro F, Horwood LJ, Swain-Campbell N: Deviant peer affiliations and depression: confounding or causation?. J Abnorm Child Psychol. 2003, 31 (6): 605-618. doi: 10.1023/A:1026258106540PubMed
59.
Fergusson DM, Woodward LJ: Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry. 2002, 59 (3): 225-231. 10.1001/archpsyc.59.3.225. doi:10.1001/archpsyc.59.3.225PubMed
60.
Lonczak HS, Neighbors C, Donovan DM: Predicting risky and angry driving as a function of gender. Accid Anal Prev. 2007, 39 (3): 536-545. 10.1016/j.aap.2006.09.010. doi: 10.1016/j.aap.2006.09.010PubMed
61.
Zador PL, Krawchuk SA, Voas RB: Alcohol-related relative risk of driver fatalities and driver involvement in fatal crashes in relation to driver age and gender: an update using 1996 data. J Stud Alcohol. 2000, 61 (3): 387-395.PubMed
62.
Laye-Gindhu A, Schonert-Reichl KA: Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. J Youth Adolesc. 2005, 34 (5): 447-457. 10.1007/s10964-005-7262-z. doi: 10.1007/s10964-005-7262-z
63.
Piccinelli M, Wilkinson G: Gender differences in depression: critical review. British J Psychiatry. 2000, 177 (6): 486-492. 10.1192/bjp.177.6.486. doi: 10.1192/bjp.177.6.486
Metadata
Title
Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender
Authors
Mark Asbridge
Sunday Azagba
Donald B Langille
Daniel Rasic
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-190

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue

Research article

Perceived family support regarding condom use and condom use among secondary school female students in Limbe urban city of Cameroon

Research article

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Research article

Health effects of single motherhood on children in sub-Saharan Africa: a cross-sectional study

Research article

Mothers impose physical activity restrictions on their asthmatic children and adolescents: an analytical cross-sectional study

Research article

Low risk of attrition among adults on antiretroviral therapy in the Rwandan national program: a retrospective cohort analysis of 6, 12, and 18 month outcomes

Research article

Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: cross-sectional analysis from the International Mobility in Aging Study