School nurses are the most accessible health care providers for many young people including adolescents and young adults. Early identification of depression results in improved outcomes, but little information is available comprehensively describing depressive symptoms specific to this population. The aim of this study was to develop a taxonomy of depressive symptoms that were manifested and described by young people based on a scoping review and content analysis. Twenty-five journal articles that included narrative descriptions of depressive symptoms in young people were included. A total of 60 depressive symptoms were identified and categorized into five dimensions: behavioral (n = 8), cognitive (n = 14), emotional (n = 15), interpersonal (n = 13), and somatic (n = 10). This comprehensive depression symptom taxonomy can help school nurses to identify young people who may experience depression and will support future research to better screen for depression.
AchterberghL.PitmanA.BirkenM.PearceE.SnoH.JohnsonS. (2020). The experience of loneliness among young people with depression: A qualitative meta-synthesis of the literature. BMC Psychiatry, 20(1), 415. https://doi.org/10.1186/s12888-020-02818-3
AngstJ.GammaA.BenazziF.SilversteinB.Ajdacic-GrossV.EichD.RösslerW. (2006). Atypical depressive syndromes in varying definitions. European Archives of Psychiatry and Clinical Neuroscience, 256(1), 44–54. https://doi.org/10.1007/s00406-005-0600-z
4.
ArkseyH.O’MalleyL. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
5.
AuerbachR. P.MortierP.BruffaertsR.AlonsoJ.BenjetC.CuijpersP.DemyttenaereK.EbertD. D.GreenJ. G.HaskingP.MurrayE.NockM. K.Pinder-AmakerS.SampsonN. A.SteinD. J.VilagutG.ZaslavskyA. M.KesslerR. C. (2018). WHO world mental health surveys international college student project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623–638. https://doi.org/10.1037/abn0000362
6.
Barnett-PageE.ThomasJ. (2009). Methods for the synthesis of qualitative research: A critical review. BMC Medical Research Methodology, 9(1), 59. https://doi.org/10.1186/1471-2288-9-59
7.
BernarasE.JaureguizarJ.GaraigordobilM. (2019). Child and adolescent depression: A review of theories, evaluation instruments, prevention programs, and treatments. Frontiers in Psychology, 10(543). https://doi.org/10.3389/fpsyg.2019.00543
8.
BjørnsenH. N.EspnesG. A.EilertsenM. B.RingdalR.MoksnesU. K. (2019). The relationship between positive mental health literacy and mental well-being among adolescents: Implications for school health services. The Journal of School Nursing, 35(2), 107–116. https://doi.org/10.1177/1059840517732125
9.
BorgheroF.MartínezV.ZitkoP.VöhringerP. A.CavadaG.RojasG. (2018). Screening depressive episodes in adolescents. Validation of the Patient Health Questionnaire-9 (PHQ-9). Revista medica de Chile, 146(4), 479–486. https://doi.org/10.4067/s0034-98872018000400479
10.
BurkeP. J.Katz-WiseS. L.SpaldingA.ShrierL. A. (2018). Intimate relationships and sexual behavior in young women with depression. The Journal of Adolescent Health, 63(4), 429–434. https://doi.org/10.1016/j.jadohealth.2018.05.022
CheungH. N.PowerM. J. (2012). The development of a new multidimensional depression assessment scale: Preliminary results. Clinical Psychology and Psychotherapy, 19(2), 170–178. https://doi.org/10.1002/cpp.1782
14.
CoutureM. E.PearsonR.HalloranJ.StewartS. H. (2020). A qualitative study of the perceived effects of alcohol on depressive symptoms among undergraduates who drink to cope with depression. Drug and Alcohol Review, 39(2), 180–188. https://doi.org/10.1111/dar.13003
15.
DreherA.HahnE.DiefenbacherA.NguyenM. H.BögeK.BurianH.DettlingM.BurianR.TaT. M. T. (2017). Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients. Journal of Psychosomatic Research, 102, 71–77. https://doi.org/10.1016/j.jpsychores.2017.09.010
16.
EspilF. M.VianaA. G.DixonL. J. (2016). Post-traumatic stress disorder and depressive symptoms among inpatient adolescents: The underlying role of emotion regulation. Residential Treatment for Children and Youth, 33(1), 51–68. https://doi.org/10.1080/0886571X.2016.1159939
17.
FarmerT. J. (2002). The experience of major depression: Adolescents’ perspectives. Issues in Mental Health Nursing, 23(6), 567–585. https://doi.org/10.1080/01612840290052776
18.
FornosL. B.MikaV. S.BaylesB.SerranoA. C.JimenezR. L.VillarrealR. (2005). A qualitative study of Mexican American adolescents and depression. The Journal of School Health, 75(5), 162–170.
19.
GultekinL. E.BrushB. L.GinierE.CordomA.DowdellE. B. (2020). Health risks and outcomes of homelessness in school-age children and youth: A scoping review of the literature. The Journal of School Nursing, 36(1), 10–18. https://doi.org/10.1177/1059840519875182
20.
HankinB. L.FraleyR. C.LaheyB. B.WaldmanI. D. (2005). Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. Journal of Abnormal Psychology, 114(1), 96–110. https://doi.org/10.1037/0021-843x.114.1.96
21.
HindinM. J.GultianoS. (2006). Associations between witnessing parental domestic violence and experiencing depressive symptoms in Filipino adolescents. American Journal of Public Health, 96(4), 660–663. https://doi.org/10.2105/AJPH.2005.069625
22.
HsiehH.-F.ShannonS. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687
23.
HumenskyJ.KuwabaraS. A.FogelJ.WellsC.GoodwinB.Van VoorheesB. W. (2010). Adolescents with depressive symptoms and their challenges with learning in school. The Journal of School Nursing, 26(5), 377–392. https://doi.org/10.1177/1059840510376515
24.
IbrahimA. K.KellyS. J.AdamsC. E.GlazebrookC. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47(3), 391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015
25.
InamdarS. C.SiomopoulosG.OsbornM.BianchiE. C. (1979). Phenomenology associated with depressed moods in adolescents. The American Journal of Psychiatry, 136(2), 156–159. https://doi.org/10.1176/ajp.136.2.156
26.
JacksonJ.KuppensP.SheeberL. B.AllenN. B. (2011). Expression of anger in depressed adolescents: The role of the family environment. Journal of Abnormal Child Psychology, 39(3), 463–474. https://doi.org/10.1007/s10802-010-9473-3
JungH.ParkH. A.SongT. M. (2017). Ontology-based approach to social data sentiment analysis: Detection of adolescent depression signals. Journal of Medical Internet Research, 19(7), e259. https://doi.org/10.2196/jmir.7452
29.
KazdinA. E.Esveldt-DawsonK.SherickR. B.ColbusD. (1985). Assessment of overt behavior and childhood depression among psychiatrically disturbed children. Journal of Consulting and Clinical Psychology, 53(2), 201–210. https://doi.org/10.1037//0022-006x.53.2.201
30.
KempferS. S.FernandesG. C.ReisdorferE.GirondiJ. B.SeboldL. F.PorporattiA. L.CantoG. D. (2017). Epidemiology of depression in low income and low education adolescents: A systematic review and meta-analysis. The Grant Medical Journals, 2(4), 67–77.
31.
KleinD. A.ParadiseS. L.LandisC. A. (2020). Screening and counseling adolescents and young adults: A framework for comprehensive care. American Family Physician, 101(3), 147–158.
32.
LandisJ. R.KochG. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.
33.
LawW. C.McClanahanR.WeismullerP. C. (2017). Depression screening in the school setting: Identification of the depressed adolescent. NASN School Nurse, 32(6), 364–370. https://doi.org/10.1177/1942602x17726095
34.
LevacD.ColquhounH.O’BrienK. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69
35.
LimC.RiceE.RhoadesH. (2016). Depressive symptoms and their association with adverse environmental factors and substance use in runaway and homeless youths. Journal of Research on Adolescence, 26(3), 403–417. https://doi.org/10.1111/jora.12200
36.
LindseyM. A.KorrW. S.BroitmanM.BoneL.GreenA.LeafP. J. (2006). Help-seeking behaviors and depression among African American adolescent boys. Social Work, 51(1), 49–58. https://doi.org/10.1093/sw/51.1.49
37.
LockwoodC.TriccoA. C. (2020). Preparing scoping reviews for publication using methodological guides and reporting standards. Nursing and Health Sciences, 22(1), 1–4. https://doi.org/10.1111/nhs.12673
38.
Lopez MolinaM. A.JansenK.DrewsC.PinheiroR.SilvaR.SouzaL. (2014). Major depressive disorder symptoms in male and female young adults. Psychology, Health and Medicine, 19(2), 136–145. https://doi.org/10.1080/13548506.2013.793369
39.
Martínez-HernáezA.DiGiacomoS. M.Carceller-MaicasN.Correa-UrquizaM.Martorell-PovedaM. A. (2014). Non-professional-help-seeking among young people with depression: A qualitative study. BMC Psychiatry, 14(1), 124. https://doi.org/10.1186/1471-244X-14-124
40.
MatteyB. (2019). Power of the past, celebrate the present, force of the future part 4: 50 years of school nursing practice—from then until now. NASN School Nurse, 34(1), 44–54. https://doi.org/10.1177/1942602x18815443
41.
MazzucaA.NagarchiD.RamanaikS.RaghavendraT.JavalkarP.RottiS.BhattacharjeeP.IsacS.CohenA.BeattieT. (2019). Developing a mental health measurement strategy to capture psychological problems among lower caste adolescent girls in rural, South India. Transcult Psychiatry, 56(1), 24–47. https://doi.org/10.1177/1363461518789540
42.
MojtabaiR.OlfsonM.HanB. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6). https://doi.org/10.1542/peds.2016-1878
43.
MorehS.O’LawrenceH. (2016). Common risk factors associated with adolescent and young adult depression. Journal of Health and Human Services Administration, 39(2), 283–310.
44.
Morey-NaseC.PhillipsL. J.BryceS.HetrickS.WrightA. L.CaruanaE.AllottK. (2019). Subjective experiences of neurocognitive functioning in young people with major depression. BMC Psychiatry, 19(1), 209. https://doi.org/10.1186/s12888-019-2197-1
45.
MullarkeyM. C.MarchettiI.BeeversC. G. (2019). Using network analysis to identify central symptoms of adolescent depression. Journal of Clinical Child and Adolescent Psychology, 48(4), 656–668. https://doi.org/10.1080/15374416.2018.1437735
46.
National Association of School Nurses. (2020). Framework for 21st century school nursing practice™: Clarifications and updated definitions. NASN School Nurse, 35(4), 225–233. https://doi.org/10.1177/1942602x20928372
Nussbaumer-StreitB.KleringsI.WagnerG.HeiseT. L.DobrescuA. I.Armijo-OlivoS.StratilJ. M.PersadE.LhachimiS. K.Van NoordM. G.MittermayrT.ZeebH.HemkensL.GartlehnerG. (2018). Abbreviated literature searches were viable alternatives to comprehensive searches: A meta-epidemiological study. Journal of Clinical Epidemiology, 102, 1–11. https://doi.org/10.1016/j.jclinepi.2018.05.022
49.
O’BeaglaoichC.McCutcheonJ.ConwayP. F.HanafinJ.MorrisonT. G. (2020). Adolescent suicide ideation, depression and self-esteem: Relationships to a new measure of gender role conflict. Frontiers in Psychology, 11(111). https://doi.org/10.3389/fpsyg.2020.00111
50.
OrchardF.PassL.MarshallT.ReynoldsS. (2017). Clinical characteristics of adolescents referred for treatment of depressive disorders. Child and Adolescent Mental Health, 22(2), 61–68. https://doi.org/https://doi.org/10.1111/camh.12178
Reed-BerendtR.ShafranR.LangdonD.ChristieD.HoughR.CoughtreyA. (2019). Experiences of low mood in young people with cancer: A qualitative study. Journal of Pediatric Oncology Nursing, 36(6), 424–435. https://doi.org/10.1177/1043454219844232
53.
RiceF.RiglinL.LomaxT.SouterE.PotterR.SmithD. J.ThaparA. K.ThaparA. (2019). Adolescent and adult differences in major depression symptom profiles. Journal of Affective Disorders, 243, 175–181. https://doi.org/10.1016/j.jad.2018.09.015
54.
SelphS. S.McDonaghM. S. (2019). Depression in children and adolescents: Evaluation and treatment. American Family Physician, 100(10), 609–617.
55.
SheanG.BaldwinG. (2008). Sensitivity and specificity of depression questionnaires in a college-age sample. The Journal of Genetic Psychology, 169(3), 281–288. https://doi.org/10.3200/gntp.169.3.281-292
56.
SiuA. L. (2016). Screening for depression in children and adolescents: U.S. preventive services task force recommendation statement. Annals of Internal Medicine, 164(5), 360–366. https://doi.org/10.7326/m15-2957%m26858097
57.
SlimmerL. (2005). Adolescents’ conceptualisations of depression (a helpful label, chronic medical problem, or personality characteristic) affected their attitudes and decisions about treatment. Evidence Based Nursing, 8(3), 93–93. https://doi.org/10.1136/ebn.8.3.93
58.
SullivanA. L.SimonsonG. R. (2016). A systematic review of school-based social–emotional interventions for refugee and war-traumatized youth. Review of Educational Research, 86(2), 503–530. https://doi.org/10.3102/0034654315609419
59.
TriccoA. C.LillieE.ZarinW.O’BrienK. K.ColquhounH.LevacD.MoherD.PetersM. D. J.HorsleyT.WeeksL.HempelS.AklE. A.ChangC.McGowanJ.StewartL.HartlingL.AldcroftA.WilsonM. G.GarrittyC.…StrausS. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/m18-0850
60.
TrudeauL.SpothR.MasonW. A.RandallG. K.RedmondC.SchainkerL. (2016). Effects of adolescent universal substance misuse preventive interventions on young adult depression symptoms: Mediational modeling. Journal of Abnormal Child Psychology, 44(2), 257–268. https://doi.org/10.1007/s10802-015-9995-9
61.
TwengeJ. M. (2020). Increases in depression, self-harm, and suicide among U.S. adolescents after 2012 and links to technology use: Possible mechanisms. Psychiatric Research and Clinical Practice, 2(1), 19–25. https://doi.org/10.1176/appi.prcp.20190015
VieraA. J.GarrettJ. M. (2005). Understanding interobserver agreement: The kappa statistic. Family Medicine, 37(5), 360–363.
64.
WallinA. M.AhlströmG. I. (2005). Unaccompanied young adult refugees in Sweden, experiences of their life situation and well-being: A qualitative follow-up study. Ethnicity and Health, 10(2), 129–144. https://doi.org/10.1080/13557850500071145
65.
WaltersK. S.BulmerS. M.TroianoP. F.ObiakaU.BonhommeR. (2018). Substance use, anxiety, and depressive symptoms among college students. Journal of Child and Adolescent Substance Abuse, 27(2), 103–111. https://doi.org/10.1080/1067828X.2017.1420507
66.
WatsonR.HarveyK.McCabeC.ReynoldsS. (2020). Understanding anhedonia: A qualitative study exploring loss of interest and pleasure in adolescent depression. European Child & Adolescent Psychiatry, 29(4), 489–499. https://doi.org/10.1007/s00787-019-01364-y
67.
WeinbergerA. H.GbedemahM.MartinezA. M.NashD.GaleaS.GoodwinR. D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: Widening disparities in vulnerable groups. Psychological Medicine, 48(8), 1308–1315. https://doi.org/10.1017/s0033291717002781
68.
WhitbeckL. B.HoytD. R.BaoW. N. (2000). Depressive symptoms and co-occurring depressive symptoms, substance abuse, and conduct problems among runaway and homeless adolescents. Child Development, 71(3), 721–732. https://doi.org/10.1111/1467-8624.00181
69.
WillisN.MavhuW.WogrinC.MutsinzeA.KageeA. (2018). Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe. PLoS One, 13(1), e0190423. https://doi.org/10.1371/journal.pone.0190423
70.
YbarraM. L. (2004). Linkages between depressive symptomatology and Internet harassment among young regular Internet users. Cyberpsychology and Behavior, 7(2), 247–257. https://doi.org/10.1089/109493104323024500
71.
YilmazA. T.WeissM. G. (2000). Cultural formulation: Depression and back pain in a young male Turkish immigrant in Basel, Switzerland. Culture, Medicine and Psychiatry, 24(2), 259–272. https://doi.org/10.1023/a:1005613923929
72.
YuwenW.ChenA. C. (2013). Chinese American adolescents: Perceived parenting styles and adolescents’ psychosocial health. International Nursing Review, 60(2), 236–243. https://doi.org/10.1111/inr.12002
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
