Prevalence Rates of Depression and Anxiety among Young Rural and Urban Australians: A Systematic Review and Meta-Analysis
Open accessAbstract
Globally, depression and anxiety are major public health concerns with onset during adolescence. While rural Australia experiences overall lower health outcomes, variation in mental health prevalence rates between rural and urban Australia is unclear. The aim of this paper was to estimate the pooled prevalence rates for depression and anxiety among young Australians aged between 10 and 24 years. Selected studies from a systematic literature search were assessed for risk of bias. Random effects model using DerSimonian and Laird method with Freeman–Tukey Double Arcsine Transformation was fitted. Sensitivity analyses were performed. Prevalence estimates were stratified by region and disorder. The overall pooled prevalence of depression and anxiety was 25.3% (95% CI, 19.9–31.0%). In subgroup analysis, anxiety prevalence was 29.9% (95% CI, 21.6–39.0%); depression: 21.3% (95% CI, 14.9–28.5%); and depression or anxiety: 27.2% (95% CI, 20.3–34.6%). Depression and anxiety prevalence were higher in urban 26.1% (95% CI, 17.3–35.9%) compared to rural areas 24.9% (95% CI, 17.5–33%), although the difference was not statistically significant. The heterogeneity was high with an I2 score of 95.8%. There is need for further research on healthcare access, mental health literacy and help-seeking attitude in Australia.
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Anxiety disorders are the most common mental health conditions during adolescence.
“Research consistently shows that anxiety disorders (ADs) are the most common mental health conditions during adolescence [2–8]”
From Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol. (2025) · cites this paper as [5]
The Introduction says that depression and anxiety are the most common mental disorders and that both have early onset during adolescence. It does not establish that anxiety disorders alone are the most common mental health condition during adolescence. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · cited 1× · see citing works
“An I2 score of 25% represents low heterogeneity, 75% represents high heterogeneity and 50% represents medium heterogeneity [54].”
BackgroundBias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Operating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955 · see citing works
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099 · see citing works
Santomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02143-7 · Cited by 5,444 · see citing works
Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies
Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., et al. (2022) · Molecular Psychiatry · doi:10.1038/s41380-021-01161-7 · Cited by 3,835 · cited 1× · see citing works
“Studies estimating prevalence of depression and anxiety among young people in UK [70] USA [71] and China [72] have concluded that place of dwelling (rural-urban) does not affect prevalence of depression, consistent with the findings of our meta-analysis.”
ResultMunn, Z., Moola, S., Lisy, K., Riitano, D., & Tufanaru, C. (2015) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000054 · Cited by 3,131 · cited 1× · see citing works
“All the included studies were assessed for risk of bias using the tool from “Methodological Guidance for Systematic Reviews of Observational Epidemiological Studies Reporting Prevalence and Incidence Data”, specifically designed for systematic reviews on prevalence studies [51].”
MethodTransformations Related to the Angular and the Square Root
Freeman, M. F., & Tukey, J. W. (1950) · The Annals of Mathematical Statistics · doi:10.1214/aoms/1177729756 · Cited by 2,634 · cited 1× · see citing works
“The inverse of the Freeman–Tukey double arcsine transformation was used to stabilize the variance of each study [53].”
MethodMetaprop: a Stata command to perform meta-analysis of binomial data
Nyaga, V. N., Arbyn, M., & Aerts, M. (2014) · Archives of Public Health · doi:10.1186/2049-3258-72-39 · Cited by 2,139 · cited 2× · see citing works
“Random effects model using DerSimonian and Laird method was fitted to the data [52].”
MethodPrevalence of and Risk Factors for Depressive Symptoms Among Young Adolescents
Saluja, G., Iachan, R., Scheidt, P. C., Overpeck, M. D., Sun, W., & Giedd, J. N. (2004) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.158.8.760 · Cited by 701 · see citing works
Differences in Rural and Urban Health Information Access and Use
Chen, X., Orom, H., Hay, J. L., Waters, E. A., Schofield, E., Li, Y., & Kiviniemi, M. T. (2018) · The Journal of Rural Health · doi:10.1111/jrh.12335 · Cited by 602 · see citing works
Li, Y., Scherer, N., Felix, L., & Kuper, H. (2021) · PLOS ONE · doi:10.1371/journal.pone.0246454 · Cited by 536 · cited 2× · see citing works
“However, the authors [88] suggest that with non-random sampling techniques, non-face-to-face delivery of assessment techniques would only increase the selection bias, and that future research must use face-to-face methods wherever possible to mitigate the risk of bias.”
BackgroundSocial Media and Well-Being: Pitfalls, Progress, and Next Steps
Kross, E., Verduyn, P., Sheppes, G., Costello, C. K., Jonides, J., & Ybarra, O. (2021) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2020.10.005 · Cited by 474 · cited 1× · see citing works
“With the rapid onset of social media, there has been inconclusive research findings on the influence of social media on mental well-being, with many researchers concluding that it depends on how it is being used [78].”
BackgroundGender, mental health and ageing
Kiely, K. M., Brady, B., & Byles, J. (2019) · Maturitas · doi:10.1016/j.maturitas.2019.09.004 · Cited by 337 · see citing works
Gender differences in and risk factors for depression in adolescence: A 4-year longitudinal study
Galambos, N. L., Leadbeater, B. J. R., & Barker, E. T. (2003) · International Journal of Behavioral Development · doi:10.1080/01650250344000235 · Cited by 312 · see citing works
Adolescent Depression: National Trends, Risk Factors, and Healthcare Disparities
Lu, W. (2018) · American Journal of Health Behavior · doi:10.5993/ajhb.43.1.15 · Cited by 312 · see citing works
Cheung, M. L., Leung, W. K. S., Aw, E. C., & Koay, K. Y. (2022) · Journal of Retailing and Consumer Services · doi:10.1016/j.jretconser.2022.102940 · Cited by 306 · cited 1× · see citing works
“One of the ways this can be mediated is through awareness spread by social media influencers, who serve as pacesetters in the community, thereby establishing a personal and psychological relationship with their consumers [80].”
BackgroundCharacteristics, correlates, and outcomes of childhood and adolescent depressive disorders
Rao, U., & Chen, L.-A. (2009) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2009.11.1/urao · Cited by 252 · cited 1× · see citing works
“When young people are affected by mental ill-health such as depression and anxiety, it not only affects them individually, but the broader society [32].”
BackgroundSuicide and mental health in rural, remote and metropolitan areas in Australia
Caldwell, T. M., Jorm, A. F., & Dear, K. B. G. (2004) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2004.tb06348.x · Cited by 241 · cited 1× · see citing works
“However, there are some Australian studies that estimate that rural populations have higher rates of mental health conditions than urban population [73,74].”
BackgroundRates of depression and anxiety in urban and rural Canada
Romans, S., Cohen, M., & Forte, T. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0222-2 · Cited by 198 · cited 1× · see citing works
“Several studies have concluded that community belongingness in rural areas and lack of competition that urban youth often face are the reasons for lower prevalence rates in rural areas [76,77].”
BackgroundRural?urban differences in the prevalence of major depression and associated impairment
Wang, J. (2004) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-004-0698-8 · Cited by 193 · cited 1× · see citing works
“However, another study [75] also found that rural young people are less likely to access mental health services.”
BackgroundAre mental disorders more common in urban than rural areas of the United States?
Breslau, J. A., Marshall, G. N., Pincus, H. A., & Brown, R. A. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.05.004 · Cited by 166 · cited 2× · see citing works
“Studies estimating prevalence of depression and anxiety among young people in UK [70] USA [71] and China [72] have concluded that place of dwelling (rural-urban) does not affect prevalence of depression, consistent with the findings of our meta-analysis.”
ResultInfluentialHelp-Negation and Suicidal Ideation: The Role of Depression, Anxiety and Hopelessness
Wilson, C. J., & Deane, F. P. (2010) · Journal of Youth and Adolescence · doi:10.1007/s10964-009-9487-8 · Cited by 163 · see citing works
RISK FACTORS FOR ANXIETY DISORDERS: COMMON AND SPECIFIC EFFECTS IN A NATIONAL SAMPLE
Blanco, C., Rubio, J. M., Wall, M. M., Wang, S., Jiu, C. J., & Kendler, K. S. (2014) · Depression and Anxiety · doi:10.1002/da.22247 · Cited by 157 · cited 1× · see citing works
“Furthermore, studies found that young urban [50,81] and rural females [59,85,86] experience higher rates of depression, anxiety and suicide [85] than their male counterparts.”
BackgroundCanuto, A., Weber, K., Baertschi, M., Andreas, S., Volkert, J., Dehoust, M. C., Sehner, S., Suling, A. I., Wegscheider, K., Ausín, B., et al. (2017) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.08.015 · Cited by 153 · see citing works
Cognitive Behavioral Therapy for Depression
Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_772_19 · Cited by 142 · see citing works
Physical and mental health perspectives of first year undergraduate rural university students
Hussain, R., Guppy, M., Robertson, S., & Temple, E. C. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-848 · Cited by 135 · cited 5× · see citing works
“Of these 10 studies, 3 studies estimated de r ssio prevalence i youth i urban and rural eas (6 separate estimates) [28,45,65], 2 studies stimated nxiety prevalence in urban and rural areas (4 separate estimates) [62,63], 1 study estimated”
BackgroundResultInfluentialHealth and access issues among Australian adolescents: a rural-urban comparison
Quine, S., Bernard, D., Booth, M. J., Kang, M. S., Usherwood, T. P., Alperstein, G., & Bennett, D. N. (2003) · Rural and Remote Health · doi:10.22605/rrh245 · Cited by 128 · see citing works
(2006) · PubMed · Cited by 120 · see citing works
Wang, D., Jiang, Q., Yang, Z., & Choi, J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.108 · Cited by 114 · see citing works
Seeing the Forest by Looking at the Trees: How to Interpret a Meta-Analysis Forest Plot
Dettori, J. R., Norvell, D. C., & Chapman, J. R. (2021) · Global Spine Journal · doi:10.1177/21925682211003889 · Cited by 104 · cited 1× · see citing works
“From the meta-analysis, we derived forest plots, which were deemed appropriate to report the results [67,68].”
MethodDepressive symptoms and help-seeking intentions in young people
Wilson, C. J., Rickwood, D., & Deane, F. P. (2007) · Clinical Psychologist · doi:10.1080/13284200701870954 · Cited by 103 · see citing works
A Systematic Review of the Prevalence and Risk Factors of Depression among Iranian Adolescents
Sajjadi, H., Kamal, S. H. M., Rafiey, H., Vameghi, M., Forouzan, A. S., & Rezaei, M. (2013) · Global Journal of Health Science · doi:10.5539/gjhs.v5n3p16 · Cited by 95 · see citing works
Yang, Y., Liu, K., Li, S., & Shu, M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238931 · Cited by 93 · see citing works
Ying, M., Wang, S.-J., Bai, C., & Li, Y. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240194 · Cited by 89 · see citing works
Epidemic Rates of Child and Adolescent Mental Health Disorders Require an Urgent Response
Shim, R. S., Szilagyi, M. A., & Perrin, J. M. (2022) · PEDIATRICS · doi:10.1542/peds.2022-056611 · Cited by 87 · see citing works
DOES ONE SIZE REALLY FIT ALL? WHY THE MENTAL HEALTH OF RURAL AUSTRALIANS REQUIRES FURTHER RESEARCH
Fraser, C., Judd, F. K., Jackson, H. J., Murray, G., Humphreys, J., & Hodgins, G. A. (2002) · Australian Journal of Rural Health · doi:10.1046/j.1440-1584.2002.00463.x · Cited by 83 · cited 1× · see citing works
“However, there are some Australian studies that estimate that rural populations have higher rates of mental health conditions than urban population [73,74].”
BackgroundMental health literacy as a function of remoteness of residence: an Australian national study
Griffiths, K. M., Christensen, H. M., & Jorm, A. F. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-92 · Cited by 80 · cited 1× · see citing works
“This gap in availability of intervention programs and yet a high prevalence in depression and anxiety can be explained by the lack of selfawareness of the symptoms resulting in many young people not being diagnosed [7,39].”
BackgroundHandley, T. E., Rich, J., Davies, K., Lewin, T. J., & Kelly, B. J. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15050928 · Cited by 74 · cited 1× · see citing works
“Furthermore, studies found that young urban [50,81] and rural females [59,85,86] experience higher rates of depression, anxiety and suicide [85] than their male counterparts.”
BackgroundJamieson, L., Paradies, Y., Gunthorpe, W., Cairney, S. J., & Sayers, S. M. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-656 · Cited by 63 · cited 1× · see citing works
“Furthermore, studies found that young urban [50,81] and rural females [59,85,86] experience higher rates of depression, anxiety and suicide [85] than their male counterparts.”
BackgroundRalph, A., & Sanders, M. R. (2003) · Advances in Mental Health · doi:10.5172/jamh.2.3.169 · Cited by 63 · see citing works
Rural - Urban Differences in Health Care Quality Assessment
Spasojević, N., Vasilj, I., Hrabac, B., & Čelik, D. (2015) · Materia Socio Medica · doi:10.5455/msm.2015.27.409-411 · Cited by 55 · see citing works
Predictors of mental health literacy in older people
Piper, S. E., Bailey, P. E., Lam, L. T.-M., & Kneebone, I. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.07.010 · Cited by 51 · see citing works
Healthy minds for country youth: Help‐seeking for depression among rural adolescents
Hernan, A. L., Philpot, B., Edmonds, A., & Reddy, P. (2010) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2010.01136.x · Cited by 50 · see citing works
Griffiths, K. M., Crisp, D. A., Christensen, H. M., Mackinnon, A. J., & Bennett, K. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-20 · Cited by 48 · see citing works
The roles of sex and gender in child and adolescent mental health
Martin, J., & Hadwin, J. A. (2022) · JCPP Advances · doi:10.1002/jcv2.12059 · Cited by 48 · see citing works
Black, G., Roberts, R., & Li-Leng, T. (2012) · Rural and Remote Health · doi:10.22605/rrh2092 · Cited by 46 · cited 8× · see citing works
“Existing literature suggests that female gender is a risk factor for depression and anxiety [81–84], and that women seek help [59,65] and take anti-depressants [50] more than males.”
BackgroundInfluentialZhuang, X., Wong, D. F. K., Cheng, C.-W., & Pan, S.-M. (2017) · International Journal of Social Psychiatry · doi:10.1177/0020764017719303 · Cited by 46 · cited 1× · see citing works
“However, there is conflicting research on the difference in prevalence of depression and anxiety between rural and urban Australians, especially in the age group of 15–24 years [44,46,47].”
BackgroundButterworth, P., & Leach, L. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx353 · Cited by 39 · cited 1× · see citing works
“This ripple effect is because depression and anxiety are associated with poor school performance, school dropouts, substance abuse followed by unemployment and poverty, and suicide [1,33,34].”
BackgroundSociodemographic correlates of antidepressant utilisation in Australia
Page, A., Swannell, S., Martin, G., Hollingworth, S., Hickie, I. B., & Hall, W. (2009) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2009.tb02522.x · Cited by 37 · cited 1× · see citing works
“This study finds a slight difference in urban-rural prevalence among young people in Australia, which is consistent with the findings from previous studies that compared urban-rural mental health outcomes among young people [45,62,69] However, these studies also found that the use of anti-depressants is more common am…”
ResultJohnston, L., Dear, B. F., Gandy, M., Fogliati, V. J., Kayrouz, R., Sheehan, J., Rapee, R. M., & Titov, N. (2014) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867414527524 · Cited by 36 · see citing works
Fitzpatrick, S. J., Handley, T. E., Powell, N., Read, D. M. Y., Inder, K., Perkins, D. A., & Brew, B. K. (2021) · PLoS ONE · doi:10.1371/journal.pone.0245271 · Cited by 36 · cited 1× · see citing works
“This ripple effect is because depression and anxiety are associated with poor school performance, school dropouts, substance abuse followed by unemployment and poverty, and suicide [1,33,34].”
BackgroundMental Health and Illness in the City
Okkels, N., Kristiansen, C. B., & Munk‐Jørgensen, P. (2017) · Mental health and illness worldwide · doi:10.1007/978-981-10-2327-9 · Cited by 35 · see citing works
Childhood anxiety in rural and urban areas: Presentation, impact and help seeking
Lyneham, H. J., & Rapee, R. M. (2007) · Australian Journal of Psychology · doi:10.1080/00049530701317082 · Cited by 34 · cited 8× · see citing works
“The first sensitivity analysis was conducted by removing the three studies that reported very large ranges of age groups: 5–12 years [63] and 15–85 years [45] and 4–18 years [60].”
BackgroundMethodInfluentialPsychological health among Chinese college students: a rural/urban comparison
Zhang, J., Qi, Q., & Delprino, R. (2017) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2017.1345745 · Cited by 34 · cited 1× · see citing works
“Studies estimating prevalence of depression and anxiety among young people in UK [70] USA [71] and China [72] have concluded that place of dwelling (rural-urban) does not affect prevalence of depression, consistent with the findings of our meta-analysis.”
ResultMaggi, S., Ostry, A., Callaghan, K., Hershler, R., Chen, L., D’Angiulli, A., & Hertzman, C. (2010) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-4-13 · Cited by 32 · see citing works
Newcombe, P. A., Dunn, T. L., Casey, L. M., Sheffield, J. K., Petsky, H., Anderson‐James, S., & Chang, A. B. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1997 · Cited by 31 · see citing works
Depression and remoteness from health services in South Australia
Goldney, R. D., Taylor, A. W., & Bain, M. A. (2007) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2007.00885.x · Cited by 26 · cited 7× · see citing works
“The first sensitivity analysis was conducted by removing the three studies that reported very large ranges of age groups: 5–12 years [63] and 15–85 years [45] and 4–18 years [60].”
BackgroundMethodResultInfluentialYoung adult problem behaviour outcomes of adolescent bullying
McGee, T. R., Scott, J. G., McGrath, J. J., Williams, G. M., O'Callaghan, M. J., Bor, W., & Najman, J. M. (2011) · Journal of Aggression Conflict and Peace Research · doi:10.1108/17596591111132936 · Cited by 25 · see citing works
Hains, A. R., Janackovski, A., Deane, F. P., & Rankin, K. N. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12452 · Cited by 22 · cited 6× · see citing works
“Of the 10 studies, 2 studies [64,66] calculated the prevalence of either depression or anxiety, or prevalence of depression and anxiety together, 5 studies focused only on depression [28,45,59,61,65], 2 studies focused only on anxiety [60,63] and 1 study focused on depression and anxiety separately [62].”
BackgroundMethodInfluentialReceipt of evidence-based care for children and adolescents with anxiety in Australia
Gandhi, E., OGradey-Lee, M., Jones, A., & Hudson, J. L. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211068780 · Cited by 22 · cited 6× · see citing works
“The first sensitivity analysis was conducted by removing the three studies that reported very large ranges of age groups: 5–12 years [63] and 15–85 years [45] and 4–18 years [60].”
BackgroundMethodInfluentialMental Health Literacy of Australian Rural Adolescents: An Analysis Using Vignettes and Short Films
Marshall, J. M., & Dunstan, D. A. (2011) · Australian Psychologist · doi:10.1111/j.1742-9544.2011.00048.x · Cited by 21 · cited 1× · see citing works
“However, there is conflicting research on the difference in prevalence of depression and anxiety between rural and urban Australians, especially in the age group of 15–24 years [44,46,47].”
BackgroundUrban-Rural Differences in Major Mental Health Conditions
Solmi, F., Dykxhoorn, J. L., & Kirkbride, J. B. (2016) · Mental health and illness worldwide · doi:10.1007/978-981-10-0752-1_7-1 · Cited by 21 · cited 1× · see citing works
“4 times), hospitalisations (almost 2 times), prevalence of chronic diseases (cancer, asthma, coronary heart conditions, respiratory conditions) [9] and cost of healthcare access than urban areas, and life expectancy, primary health access such as General Practitioners visits and healthcare workforce are lesser in rura…”
BackgroundEckert, K. A., Kutek, S. M., Dunn, K. I., Air, T., & Goldney, R. D. (2010) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2010.01135.x · Cited by 20 · cited 4× · see citing works
“Of these 10 studies, 3 studies estimated de r ssio prevalence i youth i urban and rural eas (6 separate estimates) [28,45,65], 2 studies stimated nxiety prevalence in urban and rural areas (4 separate estimates) [62,63], 1 study estimated”
BackgroundInfluentialKim, J.-E., Choi, J., Park, J., Lee, J., Shin, A., Park, S. M., Kang, D., & Choi, J. (2018) · Maturitas · doi:10.1016/j.maturitas.2018.12.012 · Cited by 19 · see citing works
Rajkumar, R. P. (2022) · Cureus · doi:10.7759/cureus.28284 · Cited by 19 · see citing works
A population view of mental illness in South Australia: broader issues than location
Eckert, K. A., Wilkinson, D., Taylor, A. W., Stewart, S., & Tucker, G. R. R. (2006) · Rural and Remote Health · doi:10.22605/rrh541 · Cited by 14 · cited 1× · see citing works
“However, there is conflicting research on the difference in prevalence of depression and anxiety between rural and urban Australians, especially in the age group of 15–24 years [44,46,47].”
BackgroundAdvancing health promotion in rural and remote Australia: Strategies for change
Smith, J. A., Canuto, K. J., Canuto, K., Campbell, N., Schmitt, D., Bonson, J., Smith, L., Connolly, P., Bonevski, B., Rissel, C. E., et al. (2022) · Health Promotion Journal of Australia · doi:10.1002/hpja.569 · Cited by 13 · cited 1× · see citing works
“This gap in availability of intervention programs and yet a high prevalence in depression and anxiety can be explained by the lack of selfawareness of the symptoms resulting in many young people not being diagnosed [7,39].”
BackgroundImpact of rurality and substance use on young people at ultra high risk for psychosis
Stain, H. J., Halpin, S. A., Baker, A., Startup, M., Carr, V. J., Schall, U., Crittenden, K., Clark, V. L., Lewin, T. J., & Bucci, S. (2017) · Early Intervention in Psychiatry · doi:10.1111/eip.12437 · Cited by 10 · cited 6× · see citing works
“Of the 10 studies, 2 studies [64,66] calculated the prevalence of either depression or anxiety, or prevalence of depression and anxiety together, 5 studies focused only on depression [28,45,59,61,65], 2 studies focused only on anxiety [60,63] and 1 study focused on depression and anxiety separately [62].”
BackgroundMethodInfluentialPapandrea, K., Winefield, H. R., & Livingston, A. G. (2010) · Rural and Remote Health · doi:10.22605/rrh1524 · Cited by 9 · cited 4× · see citing works
“Of the 10 studies, 2 studies [64,66] calculated the prevalence of either depression or anxiety, or prevalence of depression and anxiety together, 5 studies focused only on depression [28,45,59,61,65], 2 studies focused only on anxiety [60,63] and 1 study focused on depression and anxiety separately [62].”
BackgroundInfluentialStanton, R., Rebar, A. L., & Rosenbaum, S. (2019) · Australian Journal of Rural Health · doi:10.1111/ajr.12551 · Cited by 4 · cited 1× · see citing works
“4 times), hospitalisations (almost 2 times), prevalence of chronic diseases (cancer, asthma, coronary heart conditions, respiratory conditions) [9] and cost of healthcare access than urban areas, and life expectancy, primary health access such as General Practitioners visits and healthcare workforce are lesser in rura…”
BackgroundThe acceptability of using MoodGYM to treat depression in adolescents: A pilot study
Long, J. R. (2016) · The Mathematics Enthusiast · Cited by 1 · see citing works
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García, M. D. L. A. C., Díez-Gómez, A., Pérez‐Albéniz, A., Lucas‐Molina, B., & Fonseca‐Pedrero, E. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.047 · Cited by 78 · see citing works
Mao, B., Xie, Z., Liu, M., Gong, Y., Wang, H., Yang, S., Liao, M., Xiao, T., Tang, S., Wang, Y., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.188 · Cited by 27 · see citing works
Zimmer‐Gembeck, M. J., & Skinner, E. A. (2024) · Adolescents · doi:10.3390/adolescents4010009 · Cited by 19 · see citing works
“The high rates of mental health problems among youth [1] are thought to be partly due to experiences of stressful life events and significant daily hassles [2].”
BackgroundChang, K.-J., Wu, H.-Y., Chiang, P.-H., Hsu, Y., Weng, P., Yu, T.-H., Li, C.-Y., Chen, Y., Dai, H.-J., Tsai, H.-Y., et al. (2024) · Journal of Advanced Research · doi:10.1016/j.jare.2024.03.015 · Cited by 18 · see citing works
Bazargan, M., Dehghani, A., Ramezani, M. A., & Ramezani, A. (2023) · Health Science Reports · doi:10.1002/hsr2.1584 · Cited by 13 · see citing works
“Mental disorders are one of the serious public health challenges worldwide that affect all age groups.(1) These disorders affect children's development and growth, as well as academic performance and their potential for productive and fulfilling lives.”
BackgroundSamaan, L., Klock, L., Weber, S., Reidick, M. C., Ascone, L., & Kühn, S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21050598 · Cited by 13 · see citing works
“Furthermore, given the high prevalence of depression and anxiety worldwide [33], especially in urban environments [34], finding ways to improve these mental health outcomes is a globally relevant public health concern.”
BackgroundA survey of autonomous monitoring systems in mental health
Gopalakrishnan, A., Gururajan, R., Zhou, X., Venkataraman, R., Chan, K. C., & Higgins, N. (2024) · Wiley Interdisciplinary Reviews Data Mining and Knowledge Discovery · doi:10.1002/widm.1527 · Cited by 11 · see citing works
Chen, Y., Zhang, L., Zhang, S., Zhang, J., Hong, Y., Li, Q., & Zhou, Y. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.129 · Cited by 9 · see citing works
Zhuang, X., Chan, J. C. P., & Yang, X. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117628 · Cited by 7 · see citing works
Smout, S., Newton, N. C., O’Dean, S., Champion, K. E., & Gardner, L. A. (2025) · Australian and New Zealand Journal of Public Health · doi:10.1016/j.anzjph.2025.100243 · Cited by 6 · see citing works
Wendt, A. T., Machado, A. K. F., Costa, C. S., Rachadel, D., Crochemore‐Silva, I., Brazo‐Sayavera, J., Hembecker, P. K., & Ricardo, L. I. C. (2023) · Health Science Reports · doi:10.1002/hsr2.1761 · Cited by 5 · see citing works
“37 Community belong-ingness may lead to better mental health status in rural adolescents.”
BackgroundLukersmith, S., Salvador‐Carulla, L., Woods, C., Niyonsenga, T., Gutiérrez-Colosía, M. R., Mohanty, I., GARCÍA-ALONSO, C. R., Díaz-Milanés, D., Salinas-Perez, J. A., Davey, R., et al. (2025) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2025.152578 · Cited by 5 · see citing works
Self-citationXie, C., Zhao, Z., Gao, L., Yuan, L., & Liu, L. (2025) · Psychology Research and Behavior Management · doi:10.2147/prbm.s499487 · Cited by 4 · see citing works
“14,38 Consequently, further exploration is needed to understand the primary factors contributing to the urban-rural disparity in depressive symptoms.”
Yang, H., Zhang, J., Yang, M., Luan, L.-S., Liu, J.-J., & Zhang, X.-B. (2026) · World Journal of Psychiatry · doi:10.5498/wjp.v16.i2.112996 · Cited by 3 · see citing works
Wang, Y., & Su, Y. (2024) · Personality and Individual Differences · doi:10.1016/j.paid.2024.112841 · Cited by 3 · see citing works
Peritogiannis, V., Mantziou, A., Vaitsis, N., Aggelakou-Vaitsi, S., Bakola, M., & Jelastopulu, E. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13195985 · Cited by 3 · see citing works
“Furthermore, a recent meta-analysis on the prevalence of depression and anxiety among young persons in Australia revealed no differences between rural and urban residents [8].”
BackgroundLi, L. Y., Napp, A.-K., Adedeji, A., Erhart, M., Kaman, A., Boecker, M., Kloster, T., Krefis, A. C., Reiß, F., & Ravens‐Sieberer, U. (2024) · PLoS ONE · doi:10.1371/journal.pone.0313652 · Cited by 3 · see citing works
Figueiredo, D. V., Salvador, M. D. C., Rijo, D., & Vagos, P. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02608-2 · Cited by 2 · see citing works
Baldes, A., May, T., Brignell, A., & Williams, K. J. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01710-5 · Cited by 2 · see citing works
Hilal, N. A.-D. M., & Al-Aghbari, N. (2025) · International Journal of Environmental Health Research · doi:10.1080/09603123.2025.2498063 · Cited by 2 · see citing works
“People of all ages are affected by mental health issues worldwide (Kasturi et al. 2023), and depression has been identified as a major health concern and one of the leading causes of death and disability, especially in low-and middle-income nations (Cuijpers et al. 2019; Wootton et al. 2020;…”
Ebo, T. O., Olawade, D. B., Ebo, D. M., Egbon, E., & Ayoola, F. I. (2025) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2025.102920 · Cited by 2 · see citing works
Jaafar, K., Nabhan, E. M., Daoud, R., & Nasser, Z. (2024) · BMC Women s Health · doi:10.1186/s12905-024-02897-4 · Cited by 2 · see citing works
“…but less likely to develop anxiety, this harmonizes with some studies dealing with this issue showing a higher level of depression in rural areas 6.1% versus 5.2% in one study [27],other stating that: “Depression and anxiety prevalence were higher in urban 26.1% compared to rural areas 24.9%” [28].”
ResultInfluentialKusi‐Mensah, K., Inuwa, K. I., Otu‐Ansah, C., Ekremet, P. A., Sackey, R. C., Owusu‐Antwi, R., Ohene, S., & Omigbodun, O. O. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01799-8 · Cited by 2 · see citing works
Suanes, G. P. S., García-Villamisar, D. A., & Armentia, A. D. P. (2023) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.37329 · Cited by 2 · see citing works
“El TEA presenta una elevada concurrencia entre el autismo y otras enfermedades médicas y trastornos psiquiátricos, tales como los trastornos internalizados (Happé y Frith, 2020; Khachadourian et al., 2023; Morales et al., 2014).”
Modanloo, M., Halakou, S., Khoddam, H., & Nikpeyma, N. (2023) · Payām-i naw. · doi:10.61186/jgbfnm.20.1.61 · Cited by 1 · see citing works
“Anxiety, the most common health problem and the second leading cause of disability worldwide (1, 2), is a common experience in patients before surgery (3, 4).”
Boyd‐Bais, R. L., Papps, F. A., & Sipes, J. B. A. (2025) · The Journal of Rural Health · doi:10.1111/jrh.70025 · Cited by 1 · see citing works
Wang, X., Yang, X., & Li, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1482079 · Cited by 1 · see citing works
“In the Nigerian population, the incidence of depression in rural areas was higher than that in urban areas, while some studies suggest no signi fi cant association, such as Kasturi S et al (40).”
Depression and Anxiety Among Women in Lesotho: A Multilevel Analysis of the 2023–2024 LSDHS
Endalew, H. L., Bazezew, A. M., Alemu, E. A., Mekonen, E., Mengistie, B. A., Zeleke, G., Ayele, D., Yirsaw, A. N., Aragaw, G. M., Abuhay, A. E., et al. (2026) · Depression and Anxiety · doi:10.1155/da/1572451 · Cited by 1 · see citing works
“Standard severity categories include minimal (0 – 4), mild [5 – 9], moderate [10 – 14], moderately severe [15 – 19], and severe [20 – 27] depressive symptoms.”
Impact of Education, Sex, and Residence on Tinnitus Distress, Depression, and Anxiety
Molnár, A., Mavrogeni, P., & Maihoub, S. (2026) · Audiology Research · doi:10.3390/audiolres16030078 · Cited by 1 · see citing works
Contrasting urban and rural pathways linking green areas to mental health
Morato, K. V., Rhodes, J. R., Wang, Y., ANDRADE, L. H. S. G., Mauad, T., Giulio, G. M. D., Prist, P. R., & Metzger, J. P. (2026) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2026.103088 · Cited by 2 · see citing works
Impact of healthy lifestyles on mental health indicators in adolescents after the COVID-19 pandemic
Carrizales, L. M., Vilca, L. W., Santiago-Vizcarra, C., Fernández, Y. S., & Caycho‐Rodríguez, T. (2024) · Mental Health & Prevention · doi:10.1016/j.mhp.2024.200371 · Cited by 1 · see citing works
Relaxation or stress? The impact of household chores on depression in Chinese adolescents
Xu, J., & Zhang, L. (2024) · Current Psychology · doi:10.1007/s12144-024-06963-w · Cited by 1 · see citing works
“Additionally, a study on Australian adolescents found that mental health issues are more prevalent among rural youth (Kasturi et al., 2023).”
Zhao, J., Pozzi, E., Lin, S. C., Kehoe, C. E., Havighurst, S. S., & Whittle, S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1497007 · Cited by 1 · see citing works
Macauley, J., Bower, M., Teesson, M., Webster, E., & Chapman, C. (2025) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674251385365 · Cited by 1 · see citing works
“Most mental health research with Australian youth has been conducted in metro areas, despite nearly one-quarter of young people living in regional, rural or remote areas (Australian Institute of Health and Welfare, 2021b; Hielscher et al., 2024; Kasturi et al., 2023).”
Lukersmith, S., Salvador‐Carulla, L., Woods, C., Niyonsenga, T., Gutiérrez-Colosía, M. R., Mohanty, I., GARCÍA-ALONSO, C. R., Díaz-Milanés, D., Pérez, J. A. S., Davey, R., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-4008980/v1 · Cited by 1 · see citing works
Self-citationTrastornos depresivos en niños y adolescentes: enfoque epidemiológico actual
Prado–Molina, D. G., Serna–Trejos, J. S., Correa-Martinez, V., & Flores-Álvarez, L. K. (2023) · Revista de Psiquiatría Infanto-Juvenil · doi:10.31766/revpsij.v40n3a5
Psychological Symptoms in Palliative Care
Crawford, G. B. (2024) · Springer eBooks · doi:10.1007/978-3-319-31738-0_21-2
Koomson, I. (2024) · Sustainable development goals series · doi:10.1007/978-981-97-6132-6_4
Hetrick, S. E., Berk, M., Dean, O. M., Chanen, A., McGorry, P., Cotton, S. M., Torok, M., Catania, L. S., Davey, C. G., & Witt, K. G. (2026) · European Child and Adolescent Psychiatry · doi:10.1007/s00787-026-03032-4
Psychological Symptoms in Palliative Care
Crawford, G. B. (2024) · Springer eBooks · doi:10.1007/978-3-031-48991-4_21
Early markers of adult symptoms of depression and anxiety in the Raine Study
Byg, L. M., Wang, C. A., Whitehouse, A., & Pennell, C. E. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.052
Himmelseher, S., Nnaji, C. T., & Millen, A. M. E. (2025) · Neuromethods · doi:10.1007/978-1-0716-4599-4_11
Maher, M., & barker, C. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5397391
Machingura, T., & Hurley, C. (2025) · BENTHAM SCIENCE PUBLISHERS eBooks · doi:10.2174/9789815313710125010011
Williams, L., Bartik, W. J., & Cosh, S. (2025) · Advances in Mental Health · doi:10.1080/18387357.2025.2583704
Hossain, M. A., Arafat, Y., & Rahman, M. A. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120884
Depression in Cape Verdean adolescents: prevalence and associated factors
Lopes, E. D., Mendonça, M. D. L. L., Soares, J. D. J. X., & Ribeiro, A. L. L. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07829-0
“Mental disorders represent a significant global public health challenge, affecting all age groups [5].”
Bond, D. M., Huben, A. V., Lain, S. J., Colagiuri, R., Chaitow, J., James, R., Tiller, G., Singh‐Grewal, D., Colagiuri, S., & Nassar, N. (2026) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2026.115246
Growing Up Rural: Rurality as a Predictor of Child Mental Health in an Australian Cohort
Galbally, M., Bobevski, I., Werner, E., Coleman, M., Padmanabhan, V., & Lewis, A. J. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-02056-w
Zhamaliyeva, L. M., Brimkulov, N. N., & Aiganysh, M. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1888761
- Authors
- Kasturi, S., Oguoma, V. M., Grant, J. B., Niyonsenga, T., & Mohanty, I.
- Affiliations
- University of Canberra (AU)
- The University of Queensland (AU)
- Corresponding author
- Kasturi, Sushmitha
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2023-01-01
- Volume
- 20
- Issue
- 1
- Pages
- 800
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC9819515
- OpenAlex
- W4313471787
- Cited by
- 50
- References
- 72
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 20 · 2023: 5
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, anxiety, prevalence, adolescents, young adults, urban-rural differences, mental health, Australia, help-seeking, mental health literacy
- MeSH terms
- Adolescent, Adult, Anxiety, Anxiety Disorders, Australia, Child, Depression, Humans, Prevalence, Young Adult
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