Association between depressive symptoms and subsequent injuries in early adolescents: a population-based study

Abstract

Objectives

Depressive symptoms (DSs) may be frequent and highly increase the risk of injuries in early adolescents (10–16 years). This study assessed the association between DSs and subsequent school and out-of-school injuries in early adolescents.

Methods

The study population included 1219 middle-school adolescents from north-eastern France (mean age =12.7 ± 1.3) who completed at the end of school-year a questionnaire gathering socioeconomic features (nationality, family structure, parents’ occupation, parents’ education, and family income), obesity, alcohol use, tobacco use, health status, DSs (Kandel scale higher than the median value, hence including moderate levels), and school and out-of-school injuries during the present school-year. Were only considered the DSs and confounders that had started before the school-year. Data was analyzed using multinomial logistic regression models.

Results

DSs were strongly associated with one or more school-physical/sports-training injuries (sex-age-adjusted odds ratio ORsa 2.08, p < 0.001), other-school-training injuries (ORsa 2.13, p < 0.01), school-free-time injuries (ORsa 2.84, p < 0.001), out-of-school-sports injuries (ORsa 1.95, p < 0.001), and traffic injuries (ORsa 3.78, p < 0.001). The risk was higher for having two or more injury categories (ORsa 4.03, p < 0.001) than for only one injury category (ORsa 1.80, p < 0.001). These results were robust and remained after further adjustment for socioeconomic features, obesity, alcohol use, tobacco use, and health status.

Conclusions

DSs strongly increase the injury risk in early adolescents. Injury prevention should include DSs screening and monitoring and help adolescents and their neighborhood be aware of the risk.

Highlights

• Injuries and depressive symptoms (DSs) are frequent in early adolescents.

• DSs highly predict subsequent school and out-of-school injuries and cumulating several injury types.

• These results are robust after adjustment for socioeconomic features, being obese, alcohol use, tobacco use and poor health status.

• Injury prevention should include early DSs screening and monitoring and help adolescents and their neighborhood be aware of the risk.

Keywords:

• Injuries
• depressive symptoms
• early adolescents
• population-based study

Acknowledgements

The authors would like to thank the schools’ staff for their valuable help. This research was made in French national institute which received public funds. The funder has no role in study design, data collection and analysis, decision to publish, or preparing the manuscript.

Ethical approvals

This study was approved by the Commission Nationale de l’Informatique et des Libertés (national review board) and the regional education authority.

Author contributions

K. Chau conceived and conducted the survey, performed the statistical analysis and wrote the article. E. Vilain participated in the statistical analysis and the writing of the paper.

Disclosure statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Additional information

Funding

This research involved French national institute with public funds.

Notes on contributors

Kénora Chau

Chau Kénora is an Assistant Professor of General Medicine at the Lorraine University and INSERM-Unit-1433, France. She received her Doctorate in General Medicine and Ph.D. from Lorraine University. Her research interests include health determinants, needs and barriers to primary-care access; 27 articles; 33 congress presentations; reviewer for 9 journals.

Etienne Vilain

Vilain Etienne is a Doctor of Medicine General. His research interest includes the role of depressive symptoms in injuries among early adolescents. His research has been conducted at the Department of General Medicine of the Lorraine University, France.