Association between family assessment tools and depression in adolescents: a cross-sectional
Abstract
Purpose: Adolescents are very vulnerable to depression because adolescence is a period of psychological development. Research on family function in adolescents experiencing depression is still limited. This study aims to determine the association of family assessment tools with depression in adolescents.
Methods: This study was an observational, cross-sectional analysis conducted from October to December 2024. The population of this study was all high school students at SMAN 4 Palembang, and the sample was all 3rd-grade students who met the inclusion and exclusion criteria. A total of 177 respondents were included. The independent variable studied was the family assessment tools, and the dependent variable was depression. The Family function examination is assessed using the APGAR score, which consists of adaptation, partnership, growth, affection, and resolve. In contrast, the SCREEM consists of social, cultural, religious, economic, educational, and medical. Adolescent mental health was measured using the Children's Depression Inventory Questionnaire. The data were then analyzed using the chi-square test, and the Fisher test if the chi-square test did not meet its assumptions.
Results: There were significant relationships between APGAR score (p-value=0.000), social (p-value=0.001), culture (p-value=0.003), religion (p-value=0.000), and education (p-value=0.003) and adolescent depression. There is no relationship between the economy (p-value 0.387) and access to health (p-value=0.797) in depression in adolescents.
Conclusion: APGAR scores can be integrated into family folders within health services to facilitate practitioners' involvement of families in depression management. Families are expected to play a greater role, especially in the social, cultural, religious, and educational spheres.
References
UNICEF. Mental health. UNICEF Data. 2024. Available from: [Website]
Ministry of Health of Republic Indonesia. Profil kesehatan Indonesia 2024. Jakarta: Ministry of Health of Republic Indonesia; 2025. Available from: [Website]
World Health Organization. Mental health of adolescents. Geneva: World Health Organization; 2021. Available from: [Website]
Elita V, Yuniar Sari N, Jumaini, Rustam M. Hubungan fungsi keluarga dengan status mental remaja pada keluarga di daerah pesisir. Jurnal Keperawatan. 2021;16(3):403–10.
Kumara A, Wimbarti S, Fajar Susetyo Y, Kisriyani A. The epidemiology of Indonesian children and adolescent school-based mental health: validation of school-based mental health information system. Universal Journal of Psychology. 2017;5(3):114–21.
Maulidiya AK, Su’udi A, Wibowo W. Emotional, mental disorders and depression in adolescents. Jurnal Edukasi Ilmiah Kesehatan. 2024;2(2):63–70.
Kusmaharani B, Risnawaty W. Hubungan antara fungsi keluarga dengan kontrol diri remaja. Jurnal Muara Ilmu Sosial, Humaniora, dan Seni. 2024;8(1): 174–9.
Galán-González E, Martínez-Pérez G, Gascón- Catalán A. Family functioning assessment instruments in adults with a non-psychiatric chronic disease: A systematic review. Nursing Report. 2021;11(2):341–55.
Karokaro TM, Aprizal A, Yanis A, Hardisman H. The influence of family emotional support on the incidence of depression in adolescents. Jurnal Kesehatan Komunitas. 2025;11(2):201–12.
Feng Y, Zhou Y, Li W, Cheng Q, Gao C, Yan S, et al. The relationship between family functioning and depression among adolescents in China during the normalization stage of the COVID-19 epidemic: The mediating role of resilience. PLoS ONE. 2025;20(5): e0322939.
Wang E, Zhang J, Peng S, Zeng B. The association between family function and adolescents’ depressive symptoms in China: a longitudinal cross-lagged analysis. Frontiers in Psychiatry. 2021; 12:744976.
Petito A, Pop TL, Namazova-Baranova L, Mestrovic J, Nigri L, Vural M, et al. The burden of depression in adolescents and the importance of early recognition. The Journal of Pediatrics. 2020;218: 265–67.e1.
Yulianti Y, Noviar TNA, Muslim RZ. Gambaran fungsi keluarga pada remaja akhir. Anterior Jurnal. 2022;21(3):38–42.
Rahmadi NA, Okvitasari Y, Salsabila S, Halimah N, Zinan R. Identifikasi disfungsi keluarga pada lansia yang tinggal bersama keluarga dengan pengkajian APGAR keluarga. Jurnal Pengabdian Kesehatan Komunitas (Journal of Community Health Service). 2023;3(3):11–9.
Nasution AN, Novia N, Suhartina S. The role of family functions on the quality of life of type 2 diabetes mellitus patients in primary service facilities of PUSKESMAS Medan Johor. International Journal of Health and Pharmaceutical (IJHP). 2025;5(2):193–201.
Ansari Adista M, Aini Z, Natsir Mahmud N, Putri Arsyad A, Arifin R. Optimalisasi preventif sekunder pada pasien paska stroke menggunakan family folder. Jurnal Tyasdarma. 2023;1(1):33–41.
Guerrero-Muñoz D, Salazar D, Constain V, Pérez A, Pineda-Cañar CA, García-Perdomo HA. Association between family functionality and depression: a systematic review and meta-analysis. Korean Journal of Family Medicine. 2021;42:172–80.
Gijzen MWM, Rasing SPA, Creemers DHM, Smit F, Engels RCME, De Beurs D. Suicide ideation as a symptom of adolescent depression. a network analysis. Journal of Affective Disorders. 2021;278: 68–77.
Reyes-Rojas M, Campo-Arias A, Caballero- Domínguez C. Association between family functioning and depressive symptoms among Colombian high-school adolescents. Revista Interamericana de Psicología/Interamerican Journal of Psychology. 2023;57(1):e1617.
Rahmawati L, Elita V. Hubungan dukungan keluarga dengan tingkat depresi remaja di lembaga permasyarakatan. Jurnal Online Mahasiswa Program Studi Ilmu Keperawatan Universitas Riau. 2015;2(2):1221–30.
Giawa D, Sari NY, Huda N. The relationship between family communication patterns and the incidence of depression in adolescents. Jurnal Pinang Masak. 2023;2(2):27-41.
Fasha NM, Rochmani S, Faridah I. Hubungan antara dukungan sosial dengan tingkat depresi pada remaja di Islamic Centre Kota Tangerang. Gudang Jurnal Ilmu Kesehatan. 2024;2(1):334–40.
Khodijah N. Pendidikan karakter dalam kultur Islam Melayu (studi terhadap pola asuh orang tua, faktor-faktor yang mempengaruhinya, dan pengaruhnya terhadap religiusitas remaja pada suku Melayu Palembang). Tadrib. 2018;4(1):21–39.
Prihatmono IG. Faktor-faktor yang mempengaruhi kejadian depresi pada remaja di Indonesia dengan pendekatan teori lingkungan. Journal Scientific of Mandalika (JSM). 2025;6(3):2809–543.
Obimakinde AM, Shabir M. The family dynamics of children on the streets of Ibadan, Southwest Nigeria. South African Family Practice. 2023;65(1): a5774.
Hariyono ANR, Ardityawati CT, Kurniawan EH, Annam FK, Anam M, Candrasari A, et al. Complexity of the tuberculosis chain in extended families with collectivist culture: a case report. Proceedings of the International Conference of Community Health and Medical Sciences. 2024;1(1):137–47.
Dewi Y, Relaksana R, Siregar AYM. Analisis faktor socioeconomic status (SES) terhadap kesehatan mental: gejala depresi di Indonesia. Jurnal Ekonomi Kesehatan Indonesia. 2020;5(2):17–24.
iagian IO, Abia M. Hubungan tingkat religiusitas dengan tingkat depresi pada mahasiswa kos sarjana keperawatan Sekolah Tinggi Ilmu Kesehatan Immanuel Bandung. Journal of Nursing and Midwifery Sciences. 2022;1(2):49–55.
Hasanah N, Hartini S, Rustiyaningsih A, Machira CR. Hubungan dukungan sosial dengan kecenderungan depresi remaja pada 7 tahun pasca-erupsi gunung Merapi. Jurnal Keperawatan Klinis dan Komunitas (Clinical and Community Nursing Journal). 2018;2 (2):84–93.
Andriani JA, Romadhon YA, Herawati E, Candrasari A. Pengaruh bentuk keluarga dan tingkat pendidikan orang tua terhadap tingkat depresi remaja di era pandemi COVID-19. Proceedings of the 13th University Research Colloquium; 2021 Apr 15; Magelang, Indonesia. Magelang: LPPM Universitas Muhammadiyah Magelang; 2021. p. 1092–1098. Available from: [Website]
Xiang Y, Cao R, Li X. Parental education level and adolescent depression: A multi-country meta- analysis. Journal of Affective Disorders. 2024; 347:645–55.
Muslimahayati M, Rahmy HA. Depresi dan kecemasan remaja ditinjau dari perspektif kesehatan dan Islam. DEMOS: Journal of Demography, Ethnography and Social Transformation. 2021;1(1):35–44.
Yuelin Z, Hashim H, Alias R. The nexus of family, school, and society in adolescent mental health. International Journal of Research and Innovation in Social Science (IJRISS). 2025;7(10):1175–89.
Lynch BA, Lewis CP, Vande Voort JL, Nandakumar AL, Brennan RAM, Cole KC, et al. Impact of family structure on adolescent depression outcomes in a collaborative care program. Journal of Primary Care and Community Health. 2024;15:1–9.
Widiyanto J, Putri SE, Yarnita Y, Nugraha A. Implementasi penyuluhan kesehatan berbasis self help group terhadap pencegahan depresi pada remaja di SMA 1 Muhammadiyah Pekanbaru. Jurnal Medika: Media Ilmiah Medik Rehabitasi Psikiatri dan Kesehatan Jiwa. 2024;3(2):283–9.
Copyright (c) 2026 Putri Rizki Amalia Badri, Resy Asmalia, Dientyah Nur Anggina, Ardi Artanto, Erwin Maulana, Ahmad Ghifari, Puput Nafdyla Murti
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
