title: [Regional differences in relationships between depressive symptoms and psychosocial factors among high school students: a comparison of Okinawa and Saga prefectures].
abstract: OBJECTIVE
  This study aims to examine regional differences in relationships between depressive symptoms and psychosocial factors among Japanese high school students in Okinawa and Saga prefectures in Japan.
  
  
  METHODS
  The study sample was 3,234 students from 14 public high schools in Okinawa and 2,503 students from 12 public high schools in Saga. The students completed a self-administered questionnaire between September and November 2000. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). The psychosocial factors examined were participation in community events, life stress, self-esteem, perceived social support, and life environment.
  
  
  RESULTS
  There was no difference in depressive symptoms by region. Students in Saga had higher levels of stress in the academic, teachers' and friends' domains compared to students in Okinawa. Students in Saga also evaluated their natural environment better than their counterparts in Okinawa. On the other hand, students in Okinawa were more likely to participate in community events than those in Saga. After controlling for sociodemographic variables, depressive symptoms were found to be significantly associated with life stress, self-esteem, and social support among students in both Okinawa and Saga. Only among students in Okinawa, however, were depressive symptoms significantly related to participation in community events. The psychosocial factors accounted for the same amount of variance in depressive symptoms for Okinawa and Saga students. Additionally, life stress in the teachers' domain had stronger associations with depressive symptoms among students in Saga than among those in Okinawa. The depressive symptom levels of Okinawa students seemed to be more strongly associated with self-esteem than those affecting their counterparts in the Saga prefecture.
  
  
  CONCLUSIONS
  These findings show that there is similar pattern of associations between depressive symptoms and psychosocial factors among high school students in Okinawa and Saga, except for participation in community events. Life stress, self-esteem, and social support may be common factors associated with depressive symptoms among high school students regardless of region. Overall, the magnitude of the relationship between depressive symptoms and psychosocial factors was similar across Okinawa and Saga students.
authors.affiliation: Department of School Health, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215 Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Takakura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kurihara
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tutumi
mesh_terms: D000293:Adolescent; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D011584:Psychology; D000297:Psychology, Adolescent