Background: Depression is under-recognized among adolescents because depressive symptoms often mimic behavioural and hormonal changes of adolescence. Depression affects relationships within the family and school, lowers academic performance and can even lead to suicide, which is now the second leading cause of death among adolescents.This study aimed to assess the prevalence of depression and its associated risk factors among rural school-going adolescents in Ramnagara District, Karnataka.

Method: A cross-sectional study was carried out among adolescents aged 10-19 years from three government schools, where self-administered Patient Health Questionnaire-9 was used to screen for depression. Risk factors for depression including family factors, academic performance and extra-curricular activities were also recorded.

Results: Of the 223 participants, 87 (39%) screened positive for depression (28.3% mild depression, 7.2% moderate depression and 3.5% moderately severe depression). Factors which had statistically significant association with depression after multivariate logistic regression were: having more than four family members; OR=11.9 (1.1-129.3), feeling that parents fight frequently; OR=4.2 (1.1-16.9), having a family member suffering from serious illness; OR= 3.4 (1.3-8.8), feeling pressurised by parents to perform well in exams; OR=2.9 (1.4-6.1) and non-participation in sports; OR=10.0 (2.6-38.6).

Conclusion: The prevalence of depression among school-going adolescents was found to be high at 39%. There is need for introduction of screening for depression at school level, sensitization of school management and teachers to this issue and setting up referral pathways for dealing with adolescent depression.