Relationship between self-rated health and depression risk among children: Promoting school-medical care cooperation for child suicide prevention

Background
Japan is facing a markedly high incidence of adolescent suicide. This study examines the relationship between depression and self-rated health, which is a significant factor driving people toward suicide, highlighting the importance of children’s assessments of their health.

Methods
In this cross-sectional study, an original questionnaire combining text and illustrations was administered to 6,421 elementary, junior, and senior high school students. To assess children’s self-rated health, we classified the survey questions into two domains: physical and mental health. We further classified the questions based on symptom duration. Depression assessment was based on the Depression Self-Rating Scale for Children. To provide a basis for the effective use of the self-rated health assessment tool, we classified the respondents into three groups based on physical/mental conditions together with the duration of those conditions and made comparisons. The groups were Favorable Health, Temporarily Poor Health, and Persistently Poor Health, and the results were analyzed using an ANOVA.

Results
Self-rated health levels decreased, and depressive conditions worsened with age. Although most children led physically and mentally healthy school lives, the mean Depression Self-Rating Scale score was significantly higher for the Persistently Poor Health group than the other two, and the Temporarily Poor Health group scored significantly higher than the Favorable Health group for both physical and mental health (all p < 0.001).

Conclusions
As the Temporarily and Persistently Poor Health groups in the domains of physical and mental health are more likely to be depressed, timely cooperation between schools and medical institutions is imperative to prevent depression.