Winston Churchill is one of the examples that prove this theory. So conducting a case study depression patient on the basis of his personality makes sense. When we talk about Churchill, we think of a great man with extraordinary abilities, who had a sharp mind and a great sense of honor. But few people know that the Prime Minister of Great Britain suffered from serious clinical depression. In the Churchill family, five of the seven last Dukes of Marlborough suffered from severe melancholy.
Pathologically burdened heredity not only determined the ups and downs of the mood of the greatest English politician but also influenced his political activity. Affective disorders in a noble family had a different cause. Churchill’s father, a member of the House of Commons and Chancellor of the Treasury, contracted syphilis long before his startling career. When the disease reached its climax, he began hallucinations, which often caused confusion and horror among others. Progressive paralysis led him to death at the age of 45 years.
His mother, the daughter of a wealthy American businessperson, grew up a very nervous child and was considered one of the most beautiful women of her time. The genetic predisposition to pathologies also affected the fate of Churchill’s daughters. The eldest, Diana (1909), in 1953, fell into a long depression and, without a noticeable improvement in her condition, moved from one psychiatric clinic to another. And not recovered, began to seek consolation in alcohol. In the end, in 1963 she committed suicide.
Younger daughter Sarah also suffered from alcohol dependence.Read also HR Management Case Study AssignmentChurchill himself could work day and night during the ascent. He was unusually versatile, even universal, and tireless in his work, continuously writing letters, books and making speeches, impatient, impulsive and irritable, brave to imprudence, boundlessly authoritarian. In conformity with his own confessions, he had a two or three year period of depression in his youth with thoughts of suicide. The second period of depression was observed at the age of 31-32 years, and the third – at 45 years, when he even refrained from reading and talking with others.
Another group of theories of understanding the disease refers to the so-called psychological or socio-psychological approaches. Here the explanation of the onset and course of the disease is based on studying the problems of patient communication, the characteristics of his personality, the psychological problems of his growing up, living in the present, the level of stress.Therefore, a case study for depression is a difficult task. Researchers are faced with a large number of theories and hypothesis, and each of them has a right to exist. Depression is a very ambiguous condition, and a very large number of people are susceptible to this disease due to various factors.;
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This article is part of the research topic.
Women in Psychiatry 2023: Perinatal Psychiatry
The final, formatted version of the article will be published soon.
Objective: Evidence suggests that high-quality health education and effective communication within the framework of social support hold significant potential in preventing postpartum depression. Yet, developing trustworthy and engaging health education and communication materials requires extensive expertise and substantial resources. In light of this, we propose an innovative approach that involves leveraging natural language processing (NLP) to classify publicly accessible lay articles based on their relevance and subject matter to pregnancy and mental health.We manually reviewed online lay articles from credible and medically validated sources to create a gold standard corpus. This manual review process categorized the articles based on their pertinence to pregnancy and related subtopics. To streamline and expand the classification procedure for relevance and topics, we employed advanced NLP models such as Random Forest, Bidirectional Encoder Representations from Transformers (BERT), and Generative Pre-trained Transformer model (gpt-3.5-turbo).The gold standard corpus included 392 pregnancy-related articles. Our manual review process categorized the reading materials according to lifestyle factors associated with postpartum depression: diet, exercise, mental health, and health literacy. A BERT-based model performed best (F1=0.974) in an end-to-end classification of relevance and topics. In a two-step 1 Patra et al.approach, given articles already classified as pregnancy-related, gpt-3.5-turbo performed best (F1=0.972) in classifying the above topics.Discussion: Utilizing NLP, we can guide patients to high-quality lay reading materials as costeffective, readily available health education and communication sources. This approach allows us to scale the information delivery specifically to individuals, enhancing the relevance and impact of the materials provided.
Keywords: Online health information, Health Communication, Natural Language Processing, Pregnancy, postpartum depression
Received: 14 Jul 2023; Accepted: 25 Oct 2023.
Copyright: © 2023 Patra, Sun, Cheng, Kumar, Altammami, Liu, Joly, Jedlicka, Delgado, Pathak, Peng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mx. Yiye Zhang, Weill Cornell Medical Center, NewYork-Presbyterian, New York City, United States
Oct 24 (Reuters) - Dozens of U.S. states are suing Meta Platforms (META.O) and its Instagram unit, accusing them of fueling a youth mental health crisis by making their social media platforms addictive.
In a complaint filed on Tuesday, the attorneys general of 33 states including California and New York said Meta, which also operates Facebook, repeatedly misled the public about the dangers of its platforms, and knowingly induced young children and teenagers into addictive and compulsive social media use.
"Meta has harnessed powerful and unprecedented technologies to entice, engage, and ultimately ensnare youth and teens," according to the complaint filed in the Oakland, California federal court. "Its motive is profit."
Children have long been an appealing demographic for businesses, which hope to attract them as consumers at ages when they may be more impressionable, and solidify brand loyalty.
For Meta, younger consumers may help secure more advertisers who hope children will keep buying their products as they grow up.
But the states said research has associated children's use of Meta's social media platforms with "depression, anxiety, insomnia, interference with education and daily life, and many other negative outcomes."
Meta said it was "disappointed" in the lawsuit.
"Instead of working productively with companies across the industry to create clear, age-appropriate standards for the many apps teens use, the attorneys general have chosen this path," the company said.
Eight other U.S. states and Washington, D.C. are filing similar lawsuits against Meta on Tuesday, bringing the total number of authorities taking action against the Menlo Park, California-based company to 42.
Meta shares fell 0.6% on the Nasdaq.
The cases are the latest in a string of legal actions against social media companies on behalf of children and teens.
Meta, ByteDance's TikTok and Google's (GOOGL.O) YouTube already face hundreds of lawsuits filed on behalf of children and school districts about the addictiveness of social media.
Mark Zuckerberg, Meta's chief executive, has defended in the past his company's handling of content that some critics find harmful.
[1/3] Children playground miniatures are seen in front of displayed Instagram logo in this illustration taken April 4, 2023. REUTERS/Dado Ruvic/Illustration/File Photo Acquire Licensing Rights
"At the heart of these accusations is this idea that we prioritize profit over safety and well-being. That's just not true," he posted in October 2021 on his Facebook page.
In Tuesday's cases, Meta could face civil penalties of $1,000 to $50,000 for each violation of various state laws -- an amount that could add up quickly given the millions of young children and teenagers who use Instagram.
Much of the focus on Meta stemmed from a whistleblower's release of documents in 2021 that showed the company knew Instagram, which began as a photo-sharing app, was addictive and worsened body image issues for some teen girls.
The lawsuit by the 33 states alleged that Meta has strived to ensure that young people spend as much time as possible on social media despite knowing that they are susceptible to the need for approval in the form of "likes" from other users about their content.
"Meta has been harming our children and teens, cultivating addiction to boost corporate profits," said California Attorney General Rob Bonta, whose state includes Meta's headquarters.
States also accused Meta of violating a law banning the collection of data of children under age 13, and deceptively denying that its social media was harmful.
"Meta did not disclose that its algorithms were designed to capitalize on young users' dopamine responses and create an addictive cycle of engagement," the complaint said.
Dopamine is a type of neurotransmitter that plays a role in feelings of pleasure.
According to the complaint, Meta's refusal to accept responsibility extended last year to its distancing itself from a 14-year-old girl's suicide in the UK, after she was exposed on Instagram to content about suicide and self-injury.
A coroner rejected a Meta executive's claim that such content was "safe" for children, finding that the girl likely binged on harmful content that normalized the depression she had felt before killing herself.
States also alleged Meta is seeking to expand its harmful practices into virtual reality, including its Horizon Worlds platform and the WhatsApp and Messenger apps.
By suing, authorities are seeking to patch holes left by the U.S. Congress' inability to pass new online protections for children despite years of discussions.
Colorado Attorney General Philip Weiser said the whistleblower's revelations showed that Meta knew how Facebook and Instagram were harming children.
"It is very clear that decisions made by social media platforms, like Meta, are part of what is driving mental health harms, physical health harms, and threats that we can't ignore," he said.
Reporting by Jonathan Stempel in New York, Diane Bartz and David Shepardson in Washington, D.C., and Nate Raymond in Boston; Editing by Chris Sanders, Rod Nickel and Lisa Shumaker
Our Standards: The Thomson Reuters Trust Principles.
Focused on U.S. antitrust as well as corporate regulation and legislation, with experience involving covering war in Bosnia, elections in Mexico and Nicaragua, as well as stories from Brazil, Chile, Cuba, El Salvador, Nigeria and Peru.
Nate Raymond reports on the federal judiciary and litigation. He can be reached at [email protected].
The Ontario Securities Commission (OSC) said it had issued a cease trade order to hedge fund manager Traynor Ridge Capital Inc following the death of its founder, and three failed trading orders last week.
Diana Novak Jones
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* E-mail: [email protected]
Affiliation Department of Behavioral Sciences, de la Salle University, Manila, The Philippines
Affiliation Office of Counselling and Career Services, de la Salle University, Manila, The Philippines
Depression can be prevented if its symptoms are addressed early and effectively. Prevention against depression among university students is rare in the Philippines, but is urgent because of the rising rates of suicide among the group. Evidence is needed to systematically identify and assist students with higher levels of depressive symptoms. We carried out a survey to determine the social and demographic factors associated with higher levels of depressive symptoms among 2,436 Filipino university students. The University Students Depression Inventory with measures on lethargy, cognition-emotion, and academic motivation, was used. Six of the 11 factors analyzed were found to be statistically significantly associated with more intense levels of depressive symptoms. These factors were: frequency of smoking, frequency of drinking, not living with biological parents, dissatisfaction with one’s financial condition, level of closeness with parents, and level of closeness with peers. Sex, age category, course category, year level and religion were not significantly related. In identifying students with greater risk for depression, characteristics related to lifestyle, financial condition, parents and peers are crucial. There is a need to carry out more surveys to develop the pool of local knowledge on student depression.
Citation: Lee RB, Maria MS, Estanislao S, Rodriguez C (2013) Factors Associated with Depressive Symptoms among Filipino University Students. PLoS ONE 8(11): e79825. https://doi.org/10.1371/journal.pone.0079825
Editor: Hamid Reza Baradaran, Iran University of Medical Sciences, Islamic Republic of Iran
Received: June 9, 2013; Accepted: October 4, 2013; Published: November 6, 2013
Copyright: © 2013 Lee et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report. The study was carried out as part of the community engagement activities of the authors.
Competing interests: The authors have declared that no competing interests exist.
Depression is a major source of the burden of disease throughout the world [ 1 ]. In much of the developing world, however, depression is largely unexplored as a research topic. A social mapping revealed that, even though the mental disorder has been recognized as a research priority, only a sparse number of relevant studies have been carried out in low- and middle-income countries [ 2 ]. Roughly 60% of these countries have contributed fewer than five articles to the international mental health indexed literature [ 2 ]. Strategic evidence is needed in order to prevent the occurrence of depression, including its pernicious effects and prohibitive treatment cost.
Prevention of depression, particularly among university students in developing countries, is urgent. With their large student populations and the developmental propensity of students for depression [ 3 ], the burden of the mental disorder is heavy on this demographic sector [ 4 – 6 ]. Preventive efforts in the developing world, however, are rare. Consistent with observations elsewhere [ 7 , 8 ], depression is widely perceived in this part of the world as innocuous and as part and parcel of normal adolescent development. Students with the mental disorder are not only suffering in silence, but are also placing their academic and future life goals in peril. Depression can be averted if students with depressive symptoms, comprising not only physical but also non-physical conditions (e.g., cognition-emotion and motivation) [ 9 ], are promptly and properly identified and helped.
Extant studies suggest that students with higher levels of symptoms tend to be women [ 10 , 11 ], older and in their senior year [ 5 ], and Catholics and/or Jews [ 12 , 13 ]. Moreover, research indicates that highly symptomatic students do not reside with their parents in one household [ 14 ], and are smoking [ 15 ] and drinking alcohol [ 16 ], and belong to the low-income bracket [ 6 ]. Furthermore, students with more severe levels of depressive symptoms have lower levels of closeness with their parents or with friends [ 7 ].
The Philippines has a total population of 92.3 million that is very young (median age: 23) and growing at 1.9% annually. In 2009-2010, 2.8 million university students were enrolled in the country’s 2,247 higher education institutions. Of every 10 Filipino students, 6 and 4 are enrolled in private and public universities, respectively. Of these students, 26% are enrolled in business, 16% in medicine and allied programs, and 13% each are in engineering, information science and education [ 17 ]. In contrast to their counterparts throughout most of the world, Filipino students commence their university education at the age of 15 or 16 years.
Filipinos place a high premium on formal education; a university degree is strongly regarded as a primary requirement for social and economic mobility. In the context of the collective aspirations of Filipinos to go abroad for lucrative employments, the need for university education is even more compelling. Individual students are thus pressured to excel or complete a degree, lest they bring dishonor to their family and friends, and endanger their employment and life prospects. In this respect, academic-related matters are salient issues for individual students and in their relationships and conflicts with parents; these, too, can induce higher levels of depressive symptoms in students.
We carried out this research as part of our community engagement activities to help in the prevention of mental disorders, and subsequently, of suicide among Filipino university students. The connection between depression and suicide is well-established [ 18 ]. The spate of suicide events among local students had served as the impetus to conceive and implement this study. There is paucity of data on university student depressive symptomatology in the Philippines, and in the absence of published relevant articles in indexed journals, little is understood about depressive symptoms among Filipino university students at the international level. This survey examined the social and demographic factors associated with higher levels of depressive symptoms among Filipino university students. The University Student Depression Inventory (USDI), a newly-developed and psychometrically sound scale with measures on academic motivation in addition to lethargy and cognition-emotion, was used.
Data were derived from a complete enumeration survey undertaken in 2012 covering all 67 undergraduate classes in general social sciences (e.g., introductory sociology) at a large private university (total student population: >16,000) in Manila, the Philippines. Roughly half of the 67 classes were surveyed in the middle of Term 1 and the other half in the middle of Term 2. A total of 2,591 Filipino students anonymously completed the 10-page self-accomplished questionnaire. Only the questionnaires of 2,436 students were considered for the purpose of this report (126 questionnaires of international students were excluded and 29 questionnaires with at least 10 unanswered items were invalidated). Our sample represents about 15% of the university’s total undergraduate student population.
We utilized the USDI to measure depressive symptoms as a continuous variable. The USDI, developed by Khawaja & Kelly [ 9 ], measures the academic motivational aspect of depressive symptoms in addition to physical and cognitive-emotive dimensions. The USDI has 3 sub-scales having a total of 30 statements: lethargy (9 statements on lethargy, concentration difficulties and task performance); cognitive-emotional (14 statements on suicide ideation, worthlessness, emotional emptiness and sadness); and academic motivation (7 statements on class attendance and motivation to study) ( Table 1 ). Statements have score-bearing response options ranging from “none at all” (1) to “all the time” (5). The USDI has a high level of internal consistency (Cronbach α=0.95) [ 9 ].
Table 1. Statements used for measuring levels of closeness with parents and with peers, and depressive symptoms.
The socio-demographic characteristics include sex, age category, course category, year level, religion, frequency of smoking, frequency of drinking, living/not living with both biological parents, level of satisfaction with one’s financial condition, level of closeness with parents, and level of closeness with peers. The last 2 variables were measured using a series of 8 statements on parents and 9 statements on peers. The statements were drawn from published studies on parental and peer relationships among adolescents [ 7 , 19 ]. Each series had 4 score-bearing response options: definitely not true (1), mostly not true (2), mostly true (3), and definitely true (4) ( Table 1 ).
The study was approved by the ethics review committee of the university. After evaluating the contents of the survey instrument, the Committee assessed that the study would have no known risk to research participants. Verbal consent was thus obtained; however, students were informed that they could decline participation and that they could stop completing the questionnaire if they wished to. The benefits of the study (i.e., findings would be used to draw attention towards mental health in Filipino students) were especially stressed in order to trigger a sense of social responsibility and citizenship, and therefore, research participation among students. These instructions were written on the cover page of the survey instrument that was administered. On the same cover page, we also included our full names and contact numbers in which we enjoined students to ask us questions about the study and related matters.
We did not seek the consent of the students’ parents anymore. The survey focused on real-life conditions (e.g., feeling bored and having low energy) which are normally shared between and among Filipino students. During our pre-test of the questionnaire, student-respondents perceived the topic of the study as personally acceptable, one they felt they would not be asking their parents for permission should they decide to discuss it. The foregoing ethical standards, especially with respect to studies with no known harmful risks and the waiving of a signed certification of consent, are in line with the practices of most Institutional Review Boards elsewhere.
We conducted the survey in classrooms during the first quarter of the 90-minute classes. Each class was informed about the importance and rationale, and the anonymity and confidentiality of the study. Afterwards, students were invited to participate and were each given a questionnaire to accomplish. Students were reminded not to write any mark in the instrument that would identify them. Whether completely accomplished or not, all questionnaires were collected. Students were thanked for their participation. No incentive of any form was given.
Using the Statistical Package for the Social Sciences Version 20, differences in the mean depressive symptoms scores were examined based on social and demographic characteristics. The characteristics that were statistically significantly related with higher levels of depressive symptoms were further examined at the sub-scale levels. The analysis of variance was used.
The independent variables, except for sex (male, female), were recoded into variables with 2-3 categories each ( Table 2 ). The levels of closeness with parents and with peers were constructed by adding the scores corresponding to responses given to the series of statements. For level of closeness with parents, the score range is 8 to 32 (low-moderate, 8-23; high, 24-32); and for level of closeness with peers, the range is 9 to 36 (low-moderate, 9-26; high, 27-36). Our analyses revealed a high level of internal consistency for both series (parents: α=0.77; peers α=0.79).
Table 2. Means and standard deviations for depressive symptoms scale scores by social and demographic characteristics.
Table 3. Means, F-values and p-values for depressive symptoms sub-scale scores by selected social and demographic characteristics.
The dependent variable (levels of depressive symptoms) was constructed by adding the scores corresponding to the responses given to the series of statements. The scale score ranges from 30 to 150 while the sub-scale scores range from 9 to 45 for lethargy, 14 to 70 for cognition-emotion, and 7 to 35 for academic motivation; higher scores suggest higher levels of depressive symptoms Our analyses revealed a high level of internal consistency for the USDI (α=0.93).
The majority were female while 43.6% were male. 42.5% were 16 years of age or younger, 29.8% were 17 years old and a similar number were older. 39.0% were in social sciences/humanities; 29.6% were in business/economics/management and 23.2% were in engineering/natural/computer sciences. Seven of every 10 were first year students. Most were Catholic (80.9%) and reported not having smoked in the past 30 days prior to the survey. In the past 30 days, about 6 of every 10 students had taken alcohol for more than 10 days, while 4 for ≤10 days. Most respondents (77.9%) currently lived with both biological parents. About 70% were satisfied and very satisfied with their financial condition; the rest were not or were only somewhat satisfied. Most had high levels of closeness with parents (82.5%) and peers (88.1%).
The means and standard deviations for depressive symptoms scale scores are shown in Table 2 . Higher means suggest higher or more severe levels of depressive symptoms. Results indicate that male and female students did not differ in their symptoms levels. No significant differences were observed across age groups. The level of depressive symptoms statistically significantly varied according to course category but only marginally (F (3,2410) =2.54, p<.06). Means were not significantly dissimilar across year level and religion.
Means comparison related to frequency of smoking suggests significant differences among the categories (F (2,2411) =9.65, p<.01). Results of post-hoc Tukey test indicate that those who smoked for ≤10 days had a higher level of depressive symptoms than those who did not smoke in the past 30 days (p<.01). Significant means differences were observed based on frequency of drinking (F (1,2424) =14.31, p<.01). Students not living with both parents had a significantly higher level of symptoms compared to those living with parents (F (1,2432) =4.87, p<.05). Moreover, depressive symptoms level significantly varied according to satisfaction with one’s financial condition (F (3,2423) =52.03, p<.01). Based on post-hoc Tukey test findings, students who were not satisfied with their financial status had a more elevated level of depressive symptoms than those who were somewhat satisfied (p<.05), satisfied (p<.01) and very satisfied (p<.01).
Students with a low to a moderate level of closeness with parents had a significantly higher level of depressive symptoms than students with a high level of closeness with parents (F (1,2431) =165.76, p<.01). Students with a low-moderate level of closeness with peers had a significantly higher level of symptoms than those with a high level of closeness with peers (F (1,2425) =176.91, p<.01).
The 6 independent variables with statistically significant relationships with higher levels of depressive symptoms were further examined for their interactions. The two-way analysis of variance results indicate an absence of any interaction.
Additional analyses using the one-way analysis of variance were performed to determine if the statistically significant associations of the 6 independent variables (i.e., frequency of smoking, frequency of drinking, living/not living with both biological parents, level of satisfaction with financial condition, level of closeness with parents, and level of closeness with peers) would hold at the sub-scale level. The means, F-values and p-values are given in Table 3 .
Results indicate that the associations of the 5 variables (i.e., frequency of drinking, level of satisfaction with financial condition, and levels of closeness with parents and with peers) persisted at all sub-scales of depressive symptoms (p-values at <0.01 or <0.05). The significant sub-scale association of the remaining variable (i.e., living/not living with both biological parents) was confined only to the cognitive-emotional sub-scale.
This survey identified a set of social and demographic factors that are statistically significantly associated with higher levels of depressive symptoms among Filipino university students. The aim is to help prevent depression among the domestic university student population. If students with elevated risks are known and assisted early, their depression would be promptly averted. Data suggest that the factors with significant associations with depressive symptoms, mostly at both the scale and sub-scale levels, were frequency of smoking, frequency of drinking, living/not living with both biological parents, level of satisfaction with one’s financial condition, and levels of closeness with parents and with peers.
The significant associations of frequencies of smoking and of drinking with depressive symptoms are aligned with extant empirical findings [ 20 , 21 ]. The present study revealed that Filipino students who smoked for some days (against those who did not smoke) and who took alcohol for some days (against those who consumed alcohol for longer durations) had higher depressive symptoms levels. In explaining the associations of smoking and drinking, some studies tend to highlight the psychopharmacological [ 20 ] and symbiotic [ 22 ] dimensions of these bivariate relationships. This implies that students could have smoked or taken alcohol as an escape route from the burdens of psychosocial difficulties. In the case of drinking, in particular, the use of alcohol usually precedes the symptoms of lethargy and social difficulties associated with depression [ 23 , 24 ]. Caution should be taken in appreciating these interpretations, however. The variables were measured in this study based on the number of days of smoking and drinking rather than the quantities of cigarettes and alcohol consumed (these two are not necessarily equivalent indicators). Considering that the rates of smoking and drinking among the Filipino youth are relatively high (21.0% and 41.4%, respectively) [ 25 ], these twin behaviors, specifically their frequencies, need closer examination vis-à-vis depressive symptoms.
The association between not living in the household with both biological parents and having more serious levels of depressive symptoms has ample empirical support [ 14 , 26 ]. Across the country, many Filipino students do not reside with both parents while pursuing their university education, because they live away from home in dormitories and/or their biological parents are single, separated, or are working abroad. Either as a permanent or a temporary condition, not living with both biological parents may induce depressive symptoms, primarily in cognitive-emotive terms as this study revealed, probably as a result of having restricted access to parental presence and support.
Satisfaction or dissatisfaction with one’s financial condition is well-confirmed in several other investigations for its significant role in mental health [ 27 ]. It is usually expensive to study in a private Philippine university compared to studying in the country’s state colleges and universities. Students in private universities would generally belong to higher levels of socioeconomic status and may influence a peer culture that promotes greater awareness of a person’s socioeconomic standing in society. Such an educational environment is, in turn, likely to enhance sensitivities about one’s own social status in comparison to one’s peers. Those who perceive themselves as higher in status also have higher levels of optimism and perceived control, and therefore, are also likely to exhibit lower levels of depressive symptoms [ 28 , 29 ].
The current study findings on the significant associations between the levels of closeness with parents and peers and depressive symptoms are to be expected; these are within the realm of the evidence widely reported in other investigations [ 7 , 30 ]. That most of the Filipino university students who participated in this study had high closeness levels with their parents and peers is hardly unexpected. Parents and friends are basic yet very significant primary groups for Filipino adolescents. Their provisions, including the immediate care, security and support that they bestow and the secure attachments that they consequently foster, are effective protectors and buffers of university students against depressive symptoms [ 31 , 32 ].
In the absence of high level of closeness of Filipino students with parents, in which the parent-child relationship would be characterized by communication problems, excessive parental control, low levels of cohesion, and high levels of conflict in the families, adolescents are bound to experience depressive symptoms [ 33 , 34 ]. Without high level of closeness with peers, local students are also predisposed to be at risk. Students are in a stage when they mostly need their peers for emotional support. Peer acceptance is important to the growing individual and is therefore associated with depressive symptoms [ 35 ]. Compared to the association of the lack of parental warmth and acceptance with adolescents’ depressive symptoms, which is largely unidirectional, the association between depressive symptoms and peer-relational problems tends to be bidirectional [ 36 ]. Filipino students exhibiting depressive symptoms are likely to be spending less time interacting with their peers and are prone to relate with them aggressively. This interaction pattern, in turn, is likely to cultivate further peer rejection and neglect.
Sex, age category, course category, year level and religion were not statistically significant factors as our analyses revealed. As a general rule, females show higher rates of depression than males [ 37 , 38 ] due to their tendency to be more expressive and more sensitive to the support provided by their social networks [ 39 ]. However, this normative rule on gender differences does not seem to hold true for university students [ 37 ]. The exception may be accounted for by the homogeneous university life experiences, similarities in parental education, or common socio-demographic conditions among the youth in general [ 37 , 39 ]. The lack of significant associations of age category, course category and year level among Filipino students could be due to this homogeneity factor as well, particularly that most of them were young, freshmen and completing general education rather than major subjects at the time of their interview. Religion was not significantly associated with depressive symptoms and this is to be expected: the Filipino youth, including university students, are largely nominal Catholics who seldom practice their faith [ 40 ]. Elsewhere, one’s religiousness rather than religious affiliation per se has been observed to be significantly related with lower levels of depressive symptoms in students [ 41 ].
The survey has some limitations. Since the study’s respondents were from general education classes with mostly first year students from middle- and high-income backgrounds, the findings cannot be generalized to the entire student population of the university surveyed or student populations from other universities in the Philippines. Another limitation of the survey is that it did not include other factors that may have potential relationships with higher levels of depressive symptoms. For instance, since completing a university degree is culturally valued among Filipinos, the academic performance of students could be a critical factor for assessing depressive symptoms. Also, the study is cross-sectional, and as such, its conclusions only refer to associations rather than causal relationships between the independent and dependent variables. Moreover, the level of depressive symptoms measured through the USDI pertains not to the sequence of the occurrence of high levels of depressive symptoms, but to the amount of depressive symptoms weighted by frequency of occurrence students experienced in the past fortnight.
More surveys using the USDI are needed in the Philippines. Future studies have to involve representative samples of Filipino university students from other socio-economic backgrounds. If feasible, longitudinal studies, which will provide repeated observations of the levels and associated factors of depressive symptoms, are a better alternative. Variables related to students’ academic performance should be included as well. Some variable measures (e.g., frequency of smoking) need to capture more nuanced dimensions of the social and demographic conditions of students at greater risk, For example, variables related to smoking and drinking should ask follow-up questions regarding the specific quantities of cigarettes and alcohol consumed by students in a given period. In addition, the association of religion with depressive symptoms will be better understood by a follow-up question on religiousness.
The present survey is a pioneering large-scale research on the social and demographic factors of higher levels of depressive symptoms among Filipino university students. These initial findings can help guide the development of a campus-based prevention program at the university surveyed. Towards addressing depressive symptoms and depression in students, lifestyle and factors related to financial condition and parental and peer relationships are important considerations for identifying those at greater risk. More research is needed towards building additional local knowledge on the topic.
Conceived and designed the experiments: RBL MS SE CR. Analyzed the data: RBL MS SE CR. Wrote the manuscript: RBL MS SE CR.