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research letter

Indian Pediatr 2019;56: 686-688

Relationship of Leisure Time Activities and Psychological Distress in School Children

 

Pallavi Bhad, Alpana Awasthi and Gouri Rao Passi*

Department of Pediatrics, Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India.

Email:* [email protected]

   


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.



Leisure 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)
Normal Mild distress Moderate distress Severe distress
Overall        
  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.

References

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2. Chan SM,ChakT, Fung T. Reliability and validity of K10 and K6 in screening depressive symptoms in Hong Kong adolescents. Vulnerable Child Youth Stud. 2013;9:75-85.

3. Kumar V, Talwar R. Determinants of psychological stress and suicidal behavior in Indian adolescents: a literature review. J Indian Assoc Child Adolesc Ment Health. 2014;10:47-68.

4. Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378:1515-25.

5. Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: A global public-health challenge. Lancet. 2007;1369:1302-13.

6. Jaisoorya TS, Geetha D, Beena KV, Beena M, Ellangovan K, Thennarasu K. Prevalence and correlates of psychological distress in adolescent students from India. East Asian Arch Psychiatry. 2017;27:56-62.

7. Verma S, Sharma D, Larson RW. School stress in India: Effects on time and daily emotions. Int J Behav Dev. 2002;26:500-8.

8. Teychenne M, Ball K, Salmon J. Physical activity and likelihood of depression in adults: A review. Prev Med. 2008;46:397-411. 

 

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