Trajectory and predictors of depressive symptoms among adolescent survivors following the Wenchuan earthquake in China: a cohort study.

OBJECTIVE: To investigate the trajectory of depressive symptoms among adolescents exposed to the Wenchuan earthquake as well as predictors after the earthquake.

METHODS: A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan city was followed-up periodically for 2 years. Participants were assessed at 6, 12, 18, and 24 months after the earthquake. Adolescents completed the Depression Self-rating Scale for Children, Adolescent Self-Rating Life Event Checklist, Resilience Scale, and earthquake exposure questionnaire.

RESULTS: The prevalence rates of depressive symptoms at 6, 12, 18 and 24 months were 27.4, 41, 31.9, and 38.3 %, respectively. The number of adolescents who kept no depressive symptoms and persistent depressive symptoms at each stage was stable, accounted for almost 50 and 20 % of the total, respectively. Adolescents turning no depressive symptoms to depressive symptoms were mostly in 6-12 months, followed by 18-24 months. Additionally, girls (OR 1.24-1.37), post-disaster negative life events (OR for high vs. low = 5.54-15.06), resilience (OR for low vs. high = 9.40-13.69), and depressive symptoms at previous stage (OR 4.96-6.03) had a long-term effect on depressive symptoms, while the impact of earthquake exposure diminished with the passage of time and could not predict depressive symptoms after one and a half years after the earthquake.

CONCLUSIONS: Among adolescent survivors, the resistance and persistence of depressive symptoms were common. Moreover, depressive symptoms tended to outbreak close to the anniversary date, showing the anniversary reaction. Adolescent girls, adolescents who encountered high levels of life events, had low levels of resilience and a history of depressive symptoms should be provided with psychological intervention.