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Indian Pediatr 2019;56:
686-688 |
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Relationship of Leisure Time Activities and Psychological
Distress in School Children
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Pallavi Bhad, Alpana Awasthi and Gouri Rao Passi*
Department of Pediatrics, Choithram Hospital and
Research Centre, Indore, Madhya Pradesh, India.
Email:*
[email protected]
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This questionnaire study on 400
school children found that severe psychological distress using the K 10
scale was seen in 38 (9.5%), and 162 (40.5%) had less than 2 hours of
leisure time daily. The prevalence of severe distress was lower in
children who had daily time with parents and daily leisure time.
Keywords: Adolescents, Depression, Physical
activity.
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L eisure time appears to be
decreasing with increased academic pressures on urban children,
especially after Class 8. In this study, we aimed to assess the current
levels of leisure time available to school children, and its relation to
levels of psychological distress.
This was an observational, questionnaire-based study
conducted in an urban English-medium school in Indore between November
2017 and April 2018. Inclusion criteria were children studying in class
8-10. Children with known chronic illnesses were excluded. The study
protocol was cleared by the Institutional ethics committee. Permission
was obtained from the principal of the school for conducting the study.
Parental consent and students’ assent was also obtained.
The children were instructed on how to fill the
questionnaire, meaning of questions were clarified, and they were given
20 minutes to complete the questionnaire. Details of the student
(age, sex, class, family and occupation of parents), coaching, frequency
and duration of free time, type of leisure activities, amount of free
time with either parent and questions of the Kessler Psycho-logical
Distress Scale (K10) [1,2] were recorded in English. Scores of 20-24,
25-29 and ³30
were considered mild, moderate and severe psychological distress,
respec-tively. The association of degree of psychological distress with
leisure time activities and other factors were analyzed using chi square
test and odds ratio, as appropriate.
We included 400 children (227 boys) in the survey.
Ages ranged from 12-16 years with 130 (32.5%), 187 (46.8%) and 83
(20.7%) studying in class 8, 9 and 10, respectively. Almost half (196,
49%) of the children belonged to a joint family, and 296 (74%) had
mothers who were homemakers. Majority (332, 83%) children attended
coaching classes after school. The details of leisure time in children
are given in Web Table I. The commonest
indoor activity was television and outdoor was badminton.
A normal K10 score was seen in 194 (48.5%) students.
Mild psychological distress was seen in 109 (27.3%), moderate in 57
(14.3%) and severe in 38 (9.5 %) students. Severe psychological distress
was more common in girls (12.7%) than boys (7%) (OR 1.92, 95% CI 0.97,
3.7; P=0.6) (Table I). The prevalence of severe
distress in children with daily, alternate day or once-a-week free time
was 8.6%, 9.6% and 11.7%, respectively. There was a statistically
significant association between prevalence of severe psychological
distress versus time spent with parents (OR 2.7, 95% CI 1.14,
6.4; P=0.023) with only 5.9% having severe psychological
distress, if they spent time daily with their parents. There was no
statistically significant difference in prevalence of severe
psycho-logical distress with type of family or occupation of mother.
However, children with businessmen as fathers had statistically higher
rates of severe distress (11.4% vs 5.9% (P=0.047). Severe
psychological distress was commoner in children who played indoor games
(13%) vs those who played outdoor games (4.8%) (P<0.01).
TABLE I Class-wise and Gender-wise Distribution of Psychological Distress in
Schoolchildren, Indore 2017-18 (N=400)
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Normal |
Mild distress |
Moderate distress |
Severe distress |
Overall
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Girls (n=173) |
75 (43.3) |
45 (26) |
31 (17.9) |
22 (12.7) |
Boys (n=227) |
119 (52.4) |
64 (28.2) |
28 (12.3) |
16 (7) |
Class 8 (n=130) |
61 (46.9) |
40 (30.8) |
22 (16) |
7 (5.5) |
Girls (n=56) |
26 (46.4) |
16 (28.6) |
9 (16) |
5 (8.9) |
Boys (n=74) |
35(47.3) |
24 (32.4) |
13 (17.6) |
2 (2.7) |
Class 9 (n=187) |
105 (56.1) |
42 (22.5) |
19 (10.2) |
21 (11.2) |
Girls (n=81) |
41 (50.6) |
18 (22.2) |
9 (11.1) |
13 (16) |
Boys (n=106) |
64 (60.4) |
24 (22.6) |
10 (9.4) |
8 (7.5) |
Class 10 (n=83) |
28 (33.7) |
27 (32.5) |
18 (21.7) |
10 (12.1) |
Girls (n=36) |
8 (22.2) |
11 (30.5) |
13 (36.1) |
4 (11.1) |
Boys (n= 47) |
20 (42.6) |
16 (34) |
5 (10.6) |
6 (12.8) |
All values in number (%). |
Earlier studies from India have reported
psychological distress in 13-45% school children [3].
The prevalence across high-income countries varies from 8-57%, and
for low- and middle-income countries, it varies from 10-20% [4,5]. In a
large recent study conducted in 12-19 years olds using the K10 scale in
Kerala, psychological distress was reported in 20% [6]. Prevalence of
mild, moderate and severe distress was 10.5%, 5.4% and 4.9%,
respectively. In this study, older age, not living with both parents,
and urban residence were significantly associated with psychological
distress. A study of 100 adolescents from Chandigarh has also shown an
inverse relationship between amount of leisure time and psychological
distress using the Child Behavior Checklist [7]. Physical activity has
also been shown to be beneficial in reducing psychological distress [8].
The main limitation of our study is that assessment
of psychological distress was based on students’ self-reported
responses. No detailed diagnostic interview was conducted. However, this
study highlights the need to sensitize pediatricians and parents to the
issue of psychological distress among adolescents, and the importance of
allocating time for leisure.
Contributors: PB: acquisition and analysis
of data; AA: conception and design of the study and critical review of
intellectual content; GRP: conception and design of the study, analysis
and interpretation of data, drafting the manuscript.
Funding: None; Competing interests: None
stated.
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