Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka

Depression, anxiety, and stress among urban and... | F1000Research "use strict";function _typeof(t){return(_typeof="function"==typeof Symbol&&"symbol"==typeof Symbol.iterator?function(t){return typeof t}:function(t){return t&&"function"==typeof Symbol&&t.constructor===Symbol&&t!==Symbol.prototype?"symbol":typeof t})(t)}!function(){var t=function(){var t,e,o=[],n=window,r=n;for(;r;){try{if(r.frames.__tcfapiLocator){t=r;break}}catch(t){}if(r===n.top)break;r=r.parent}t||(!function t(){var e=n.document,o=!!n.frames.__tcfapiLocator;if(!o)if(e.body){var r=e.createElement("iframe");r.style.cssText="display:none",r.name="__tcfapiLocator",e.body.appendChild(r)}else setTimeout(t,5);return!o}(),n.__tcfapi=function(){for(var t=arguments.length,n=new Array(t),r=0;r 3&&2===parseInt(n[1],10)&&"boolean"==typeof n[3]&&(e=n[3],"function"==typeof n[2]&&n[2]("set",!0)):"ping"===n[0]?"function"==typeof n[2]&&n[2]({gdprApplies:e,cmpLoaded:!1,cmpStatus:"stub"}):o.push(n)},n.addEventListener("message",(function(t){var e="string"==typeof t.data,o={};if(e)try{o=JSON.parse(t.data)}catch(t){}else o=t.data;var n="object"===_typeof(o)&&null!==o?o.__tcfapiCall:null;n&&window.__tcfapi(n.command,n.version,(function(o,r){var a={__tcfapiReturn:{returnValue:o,success:r,callId:n.callId}};t&&t.source&&t.source.postMessage&&t.source.postMessage(e?JSON.stringify(a):a,"*")}),n.parameter)}),!1))};"undefined"!=typeof module?module.exports=t:t()}(); dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://f1000research.com/js/vendor/ckeditor/' window.reactTheme = 'research'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); (function(h,o,t,j,a,r){ h.hj=h.hj||function(){(h.hj.q=h.hj.q||[]).push(arguments)}; h._hjSettings={hjid:2318163,hjsv:6}; a=o.getElementsByTagName('head')[0]; r=o.createElement('script');r.async=1; r.src=t+h._hjSettings.hjid+j+h._hjSettings.hjsv; a.appendChild(r); })(window,document,'https://static.hotjar.com/c/hotjar-','.js?sv='); search file_upload Submit your research search menu close search Browse Gateways & Collections How to Publish Submit your Research My Submissions Article Guidelines Article Guidelines (New Versions) Open Data, Software and Code Guidelines Open Data and Accessible Source Materials Guidelines (HSS) Open Data, Software and Code Guidelines (PSE) Prepublication Checks Production Process Posters and Slides Guidelines Document Guidelines Article Processing Charges Peer Review Finding Article Reviewers About How it Works For Reviewers Our Advisors Policies Glossary FAQs For Developers Newsroom Contact My Research Submissions Content and Tracking Alerts My Details Sign In file_upload Submit your research { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://f1000research.com/articles/12-1583" }, "headline": "Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka", "datePublished": "2023-12-14T12:01:17", "dateModified": "2024-07-12T14:50:25", "author": [ { "@type": "Person", "name": "Ajay Mallya" }, { "@type": "Person", "name": "Raghavendraswamy Koppad" }, { "@type": "Person", "name": "Praveen Kumar" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have behavioural or mental health issues. Addressing mental health issues is very important for the promotion of positive health in adolescents. This study aimed to estimate the prevalence of depression, anxiety and stress among adolescents in urban and rural areas of Shivamogga. Methods A cross-sectional study was conducted among 350 adolescents aged 16 to 19 years each from urban and rural areas of Shivamogga. Results Depression, anxiety and stress were found to be 23.1%, 29.4% and 26.6% in urban areas and 19.1%, 24% and 21.1% in rural areas respectively. Depression was more common among females in both urban and rural settings, with a significant difference observed in rural areas. Anxiety and stress were also more prevalent among females, with anxiety significantly higher in urban females. Urban adolescents exhibited higher levels of depression, anxiety, and stress compared to their rural counterparts. Conclusions About a quarter of the adolescent population suffers from depression anxiety and stress. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/12-1583/v3", "name": "Depression, anxiety, and stress among urban and rural adolescents..." } } ] } Home Browse Depression, anxiety, and stress among urban and rural adolescents... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Mallya A, Koppad R and Kumar P. Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.12688/f1000research.139603.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] Ajay Mallya https://orcid.org/0000-0002-2280-3176 1 , Raghavendraswamy Koppad 2 , Praveen Kumar 2 Ajay Mallya https://orcid.org/0000-0002-2280-3176 1 , Raghavendraswamy Koppad 2 , Praveen Kumar 2 PUBLISHED 12 Jul 2024 Author details Author details 1 Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 2 Department of Community Medicine, Shivamogga Institute of Medical Sciences, Shivamogga, Karnataka, 577201, India Ajay Mallya Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Raghavendraswamy Koppad Roles: Conceptualization, Methodology, Software, Visualization, Writing – Review & Editing Praveen Kumar Roles: Conceptualization, Validation, Writing – Original Draft Preparation OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have behavioural or mental health issues. Addressing mental health issues is very important for the promotion of positive health in adolescents. This study aimed to estimate the prevalence of depression, anxiety and stress among adolescents in urban and rural areas of Shivamogga. Methods A cross-sectional study was conducted among 350 adolescents aged 16 to 19 years each from urban and rural areas of Shivamogga. Results Depression, anxiety and stress were found to be 23.1%, 29.4% and 26.6% in urban areas and 19.1%, 24% and 21.1% in rural areas respectively. Depression was more common among females in both urban and rural settings, with a significant difference observed in rural areas. Anxiety and stress were also more prevalent among females, with anxiety significantly higher in urban females. Urban adolescents exhibited higher levels of depression, anxiety, and stress compared to their rural counterparts. Conclusions About a quarter of the adolescent population suffers from depression anxiety and stress. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health. READ ALL READ LESS Keywords Mental health, Adolescence, Depression, anxiety, stress Corresponding Author(s) Ajay Mallya ( [email protected] ) Close Corresponding author: Ajay Mallya Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Mallya A et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Mallya A, Koppad R and Kumar P. Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.12688/f1000research.139603.3 ) First published: 14 Dec 2023, 12 :1583 ( https://doi.org/10.12688/f1000research.139603.1 ) Latest published: 12 Jul 2024, 12 :1583 ( https://doi.org/10.12688/f1000research.139603.3 ) Revised Amendments from Version 2 The introduction has been comprehensively reviewed and strengthened. The methodology section has been expanded to provide a more detailed information about assessing DAS. Potential limitations of the study have been acknowledged in the strengths and limitation section. The introduction has been comprehensively reviewed and strengthened. The methodology section has been expanded to provide a more detailed information about assessing DAS. Potential limitations of the study have been acknowledged in the strengths and limitation section. See the authors' detailed response to the review by Indranil Saha See the authors' detailed response to the review by Mohammad Meshbahur Rahman READ REVIEWER RESPONSES Introduction Currently, there are 1.3 billion adolescents worldwide, constituting 16% of the global population. 1 In regions like the South-East Asia region (SEAR) of the World Health Organization (WHO) and India, adolescents represent an even larger proportion, with percentages reaching 20% and 21.8% respectively. 2 , 3 This significant demographic is facing a critical challenge: over 20% of adolescents globally are believed to grapple with behavioural or mental health issues, with depression emerging as the leading cause of the global disease burden among this demographic. 4 Studies conducted in India and neighbouring countries highlight the alarming prevalence of depressive disorders among adolescents. For instance, in India, a staggering 40% of adolescents experience depressive disorders, while in Bangladesh, over 80% of college-going adolescents face moderate to severe levels of depression. 5 , 6 Additionally, anxiety disorders affect a significant portion of adolescents, with 3.6% of 10–14-year-olds and 4.6% of 15–19-year-olds experiencing such issues. 7 Stress is another factor that poses problems in adolescent life, with up to 61.5% of adolescents affected according to one study. Family conflicts and academic pressures are identified as the main triggers for stress among Indian adolescents. 8 , 9 Adolescence is a distinct period in human development and crucial for setting the groundwork for long-term health. 4 The consequences of untreated mental health conditions among adolescents are severe, ranging from decreased academic performance and attendance to hindered social relationships and reduced employment opportunities. 10 , 11 Moreover, depression significantly increases the risk of suicide, while smoking, substance abuse, and obesity are more prevalent among depressed adolescents. 12 – 14 Depressive disorders are among the top three causes of adolescent DALYs lost globally, and anxiety is among the top five causes of DALYs lost among adolescent girls. 15 Despite the evident need for intervention, there remains a dearth of research and data on mental health issues among adolescents in specific regions, such as Karnataka. Recognizing this gap, this study aims to estimate the prevalence of depression, anxiety, and stress among adolescents in urban and rural areas of Shivamogga taluk. By gathering more data and understanding the unique challenges faced by adolescents in this region, we can inform targeted interventions and promote positive mental health outcomes among this vulnerable population. Methods Ethics and consent Ethical approval was granted by the Institutional Ethics Committee of Shivamogga Institute of medical Sciences, Shivamogga (ref no. SIMS/IEC/414) on 09/11/2018. Informed consent was taken from study participants and the parents/guardians in case of minors (16-17 years) via Google Forms. Assent was also taken from study participants of age 16-17 years. Study design and data collection A cross-sectional study was conducted from August 2020 to September 2020. The study population is composed of all adolescent males and females aged 16-19 years in rural and urban field areas of Shivamogga taluk. Sample size estimation: Sample size (n) = Z∞ 2 pq/D 2 Z∞ s standard normal deviate at the required confidence level (e.g. Z statistics: 1.96); d is the desired level of precision or level of statistical significance/margin of error the researcher accepts (e.g. 0.05); p is estimated characteristics of target population (variability of population parameters) the researcher assumes; and q is 1-p. According to an Indian study, the prevalence (p) of anxiety among adolescents was found to be 24.4%. 16 With desired absolute precision of 5% the minimum sample size required was calculated using the formula Z∞ 2 pq/D 2 . With this, we got a sample size of 295 adolescents. Considering 10% as non-respondents, the final sample size was 325 which was rounded off to 350. So, 350 samples were collected in urban and rural areas each. The Block education officer was approached and a list of all pre-university colleges in Shivamogga taluk was collected. Shivamogga taluk has 36 pre-university colleges in the urban area and 10 pre-university colleges in the rural area. Then 50% of the pre-university colleges were randomly selected using the random number table both in urban and rural areas. So, 18 colleges from the urban and 5 colleges from the rural area were selected. From each selected colleges, a class was randomly selected. For each selected class the lottery method was used to select 20 students from each class in the urban area and 70 students from the rural area until the desired sample size was reached. All adolescents in the age group of 16 to 19 years were included in the study. Adolescents who did not fill out the questionnaire completely were excluded from the study. After taking consent, a questionnaire that included basic demographic details (age and sex) with the DASS 21 scale (Depression Anxiety Stress Scale) 17 in the English without any translation or alteration was used to collect data. Given that English is the primary language of instruction at the PU college, we employed the scale without any need for translation. A Google Form of the questionnaire was created, one each for urban and rural areas and the link to fill out the form was shared with students willing to participate in the study via ‘WhatsApp’ mobile application. Adolescents aged 16 completed years and above until the age of 19 were included in the study. The Depression, Anxiety, and Stress Scales (DASS) is a set of self-report measures designed to assess the emotional states of depression, anxiety, and stress. 17 Each scale provides a score that helps to determine the severity of these emotional states. The interpretation of these scores is based on cutoff values that classify the intensity of the symptoms into different categories: normal, mild, moderate, severe, and extremely severe. Normal: Scores within this range indicate that the individual is experiencing a typical level of depression, anxiety, or stress, suggesting no significant symptoms in these areas. Depression: 0-9 Anxiety: 0-7 Stress: 0-14 Mild: Scores in this range suggest the presence of mild symptoms. While these might be noticeable, they typically do not cause significant impairment in daily functioning. Depression: 10-13 Anxiety: 8-9 Stress: 15-18 Moderate: Scores that fall within the moderate range indicate more pronounced symptoms that may affect daily life and functioning. Intervention may be beneficial. Depression: 14-20 Anxiety: 10-14 Stress: 19-25 Severe: Severe scores reflect substantial symptoms that are likely to impair an individual's ability to function in daily life. Professional help is often required. Depression: 21-27 Anxiety: 15-19 Stress: 26-33 Extremely Severe: Scores in this range indicate very intense symptoms that significantly interfere with daily functioning. Immediate and intensive intervention is usually necessary. Depression: 28+ Anxiety: 20+ Stress: 34+ Outcome measure: The DASS consists of 21 items, divided into three self-reported subscales of seven items each, designed to measure depression, anxiety, and stress. Respondents rate each item on a 4-point Likert scale: 0 (“Did not apply to me at all”), 1 (“Applied to me to some extent, or some of the time”), 2 (“Applied to me to a considerable extent, or a good part of the time”), and 3 (“Applied to me very much, or most of the time”), reflecting their feelings over the past week. Each subscale's final score is doubled and assessed according to a severity rating index. The total scores for depression, anxiety, and stress are calculated by summing the values of all items in each of the three subscales, as detailed above. Statistical analysis Data was entered into a Microsoft Excel spreadsheet. SPSS (Version 21) was used to perform statistical analysis. Data analysis was done using appropriate statistical tools. Results were expressed in terms of frequency, percentages, Chi-square values, and P-values. All statistical tests were performed with a confidence level of 95% and a power of 80%. In the significance tests, P value equal to or less than 0.05 was considered as statistically significant. Results As shown in Table 1 : a total of 700 adolescents participated in the study. Out of which 350 (50%) adolescents were from urban areas and another 350 (50%) adolescents were from rural areas. Males and females in urban areas were 153 (44%) and 197 (56%) respectively. In rural areas, males and females were 191 (55%) and 159 (45%) respectively. Table 1. Distribution of study participants according to depression, anxiety and stressed in urban and rural areas. (n=700). Sl. No. Characteristics Urban Rural P value 1 No. of participants 0.004 • Males 153 (44%) 191 (55%) • Females 197 (56%) 159 (45%) 2 Age of the participants 0.011 • 16 years 94 (27%) 60 (17%) • 17 years 142 (40.6%) 159 (45%) • 18 years 100 (29%) 121 (35%) • 19 years 14 (4%) 19 (3%) 3 Depression 0.195 • Mild 25 (7.1%) 32 (9.1%) • Moderate 46 (13.1%) 28 (8%) • Severe 10 (2.9%) 7 (2%) • Not depressed 269 (76.9%) 283 (80.9%) 4 Anxiety 0.105 • Mild 29 (8.2%) 21 (6%) • Moderate 71 (20.3%) 58 (16.6%) • Severe 3 (0.9%) 5 (1.4%) • Not anxious 247 (70.6%) 266 (76%) 5 Stress 0.092 • Mild 63 (18%) 54 (15.4%) • Moderate 24 (6.9%) 13 (3.7%) • Severe 6 (1.7%) 7 (2%) • Not stressed 257 (73.4%) 276 (78.9%) All our study participants were aged between 16 to 19 years. the mean age of the participants in the urban area was 17.10±0.84 years. In the urban area, the majority of the participants (142) were aged 17 years (40.6%). Participants aged 16 years were 94 (27%), 18 years were 100 (29%) and 19 years were 14 (4%). Similarly in rural areas, the mean age of the participants was 17.10 ±0.76 years. The majority (159) of the participants were aged 17 years (45%). Participants aged 16 years were 60 (17%), 18 years were 121 (35%) and 19 years were 10 (3%). Among the adolescents in urban areas, 23.1% were depressed, 29.4% had anxiety and 26.6% had stress. Similarly, among the adolescents in rural areas, 19.1% were depressed, 24% had anxiety and 21.1% were stressed. Among the depressed adolescents, in urban areas the majority (46; 13.1%) had moderate depression, whereas in rural areas the majority (32; 9.1%) had mild depression. Among the adolescents who had anxiety, both in urban and rural areas the majority (71 (20.3%) and 58 (16.6%) respectively) had moderate anxiety. Among the adolescents who were stressed, both in urban and rural areas, the majority (63 (18%) and 54 (15.4%) respectively) had mild stress. Among the study participants from urban areas of Shivamogga, 33 (21.6%) adolescent males and 48 (24.4%) adolescent females were depressed, 33 (21.6%) adolescent males and 70 (35.5%) adolescent females were anxious, and 55 (35.9%) adolescent males and 38 (19.3) adolescent females were stressed (see Table 2 ). A significantly greater number of females were anxious and stressed than males. Table 2. Distribution of study participants based on sex in urban areas of Shivamogga (n=350). Sl. No. Characteristics Males Females P value 1 Not depressed 120 (78.4%) 149 (75.6%) 0.538 Depressed 33 (21.6%) 48 (24.4%) 2 Not anxious 120 (78.4%) 127 (64.5%) 0.005 Anxious 33 (21.6%) 70 (35.5%) 3 Not stressed 98 (64.1%) 159 (80.7%) <0.001 Stressed 55 (35.9%) 38 (19.3%) Among the study participants from rural areas of Shivamogga, 26 (13.6%) adolescent males and 41 (25.8%) adolescent females were depressed, 40 (20.9%) adolescent males and 44 (27.7%) adolescent females were anxious, and 47 (24.6%) adolescent males and 27 (17%) adolescent females adolescents were stressed. A significantly greater number of females were stressed than males; see Table 3 . Table 3. Distribution of study participants based on sex in rural areas of Shivamogga (n=350). Sl. No. Characteristics Males Females P Value 1 Not depressed 165 (86.4%) 118 (74.2%) 0.004 Depressed 26 (13.6%) 41 (25.8%) 2 Not anxious 151 (79.1%) 115 (72.3%) 0.167 Anxious 40 (20.9%) 44 (27.7%) 3 Not stressed 144 (75.4%) 132 (83%) 0.089 Stressed 47 (24.6%) 27 (17%) Discussion Our study attempted to find out the prevalence of depression, anxiety, and stress among adolescents in urban and rural areas. The current study found that the prevalence of depression was 23.13% and 19.14% in urban and rural areas respectively. On average, depression among adolescents in Shivamogga is 21.14%. Similar results were found by Kumar K S et al. and Sahoo S, where depression among adolescents was 19.5%. and 18.5% respectively. 16 , 18 Depression was seen to be higher in females in both urban and rural areas. The difference was statistically significant in rural areas of Shivamogga. Similar observations were made in other studies across India where depression was seen to be higher among female respondents. 16 , 19 , 20 Genetic predisposition and hormonal influences could be the reason why depression was higher in females than males. This could also be due to higher reporting of symptoms by females, whereas fewer males may report symptoms due to societal pressure for males to be more emotionally strong. Depression was more frequently seen in urban adolescents than rural adolescents in the current study (23.1% and 19.4% respectively). Similar observations were made by Bahl R, and Kumari R in their study, where depression among urban adolescents was about 33.3% and depression among rural adolescents was 20.7%. 21 This could be due to higher exposure of adolescents to risk factors like academic competition and failure, anxiety, and substance abuse, etc. Anxiety among adolescents in the current study was found to be 29.2% and 24% in urban and rural areas of Shivamogga respectively. On average, anxiety was found to be 26.6%. This was similar to the study conducted by Kumar K S et al. and Madasu S et al., who found anxiety among adolescents to be 24.4% and 22.7% respectively. 16 , 22 These studies also found that the prevalence of anxiety was higher among females when compared to males. Similar findings were seen in our study in both urban and rural areas. The prevalence of anxiety was significantly higher among females than males in urban areas. Higher anxiety among females could be due to higher exposure to risk factors like academic competition and societal pressure on women to work and prove themselves as equals to males in the modern world. Anxiety was more frequently seen in urban adolescents than rural adolescents in our study (29.4% and 24% respectively). Similar results were observed by Vs P et al. 23 This could be due to more academic competitiveness in an urban area than in a rural area. While the parental expectation and societal pressure to perform better academically and excel in the future and have a well-paying job is higher for males than females, in the modern world the same pressure is higher in females as well in urban areas. This could be the reason why anxiety was more prevalent among urban females than males. As this study was conducted during the pandemic, the increased awareness of COVID in urban areas with better education could also be the reason why anxiety was higher among urban adolescents. Stress among the adolescents in our study was found to be 26.6% and 21.1% in urban and rural areas respectively. On average 23.85% of the adolescents were stressed in Shivamogga. Sahoo and Saddicha, in their study, also found that the prevalence of stress among adolescents was 20%. 18 Prevalence of stress was found to be higher in urban areas compared to rural areas. Similar observations were made by Dey BK 24 in Bangladesh. No studies from the Indian setting could be found that compared the prevalence of stress in urban and rural areas. Stress was more frequently seen in males than females in both urban and rural areas of Shivamogga. This was contrary to observations made in other studies, where they found that stress was more prevalent among female participants. 16 , 24 This difference could be due to underreporting of symptoms by female participants. The ongoing pandemic at the time of the study could have contributed to these findings. Strengths and limitations The strength of the study lies in its robust methodology, extensive sample size and comprehensive data analysis. This study employed a well-designed survey or assessment tool to gather data, ensuring the accuracy and reliability of the results. The measurement of depression, anxiety, and stress was conducted using a standardized scale rather than through assessment by a trained psychiatrist. Factors affecting DAS were not investigated in our study. Future research should include an examination of these factors to provide a more comprehensive understanding of DAS. While we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer, it is worth noting that some participants from rural areas may commute and study in a college situated in urban areas, and vice versa. Conclusions About a quarter of the adolescent population suffers from depression anxiety and stress. It’s crucial to detect these symptoms among adolescents and take proper action to avoid compromising their education and development. Those detected to have these symptoms must be referred to be seen by a psychiatrist for clinical evaluation. Further studies are necessary to learn about the causative factors of these mental health disorders. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health. Data availability Underlying data figshare: DASS.xlsx. https://doi.org/10.6084/m9.figshare.23652477.v2 25 This project contains the underlying data file. Extended data figshare: Questionnaire - Depression, anxiety, and stress among adolescents in Shivamogga, Karnataka. https://doi.org/10.6084/m9.figshare.23996670.v2 . 26 This project contains the blank questionnaire. Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). References 1. Adolescents Statistics: UNICEF DATA.[cited 2023 Apr 1]. Reference Source 2. Adolescent health: [cited 2023 Apr 1]. Reference Source 3. Behal S, Debarati M, Oommen K: Investing in Adolescent Health: Harnessing India’s Demographic Dividend. ORF. [cited 2023 Apr 1]. Reference Source 4. UNICEF, editor. Adolescence: an age of opportunity. New York, NY: UNICEF; 2011; 138 p. (The state of the world’s children). 5. Singh MM, Gupta M, Grover S: Prevalence & factors associated with depression among schoolgoing adolescents in Chandigarh, north India. Indian J. Med. Res. 2017 Aug; 146 (2): 205–215. PubMed Abstract | Publisher Full Text 6. Siddik MAB, Munmun MS, Hasan N, et al. : Physio-psychosocial risk of depression among college-going adolescents: A cross-sectional study in Bangladesh. J. Affect. Disord. Rep. 2024 Apr 1; 16 : 100768. Publisher Full Text 7. Mental health of adolescents [Internet]: [cited 2024 Jun 17]. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health 8. Roy SK, Jahan K, Alam N, et al. : Perceived stress, eating behavior, and overweight and obesity among urban adolescents. J Health Popul Nutr. 2021 Dec 17; 40 (1): 54. PubMed Abstract | Publisher Full Text | Free Full Text 9. Nagabharana T, Joseph S, Rizwana A, et al. : What stresses adolescents? A qualitative study on perceptions of stress, stressors and coping mechanisms among urban adolescents in India. Wellcome Open Res. 2021 May 11; 6 : 106. PubMed Abstract | Publisher Full Text | Free Full Text 10. Moksnes UK, Moljord IEO, Espnes GA, et al. : The association between stress and emotional states in adolescents: The role of gender and self-esteem. Personality and Individual Differences. 2010 Oct 1; 49 (5): 430–435. 11. Keenan-Miller D, Hammen CL, Brennan PA: Health Outcomes Related to Early Adolescent Depression. J. Adolesc. Health. 2007 Sep 1; 41 (3): 256–262. PubMed Abstract | Publisher Full Text | Free Full Text 12. Systematic Review and Meta-Analysis: Adolescent Depression and Long-Term Psychosocial Outcomes - ClinicalKey [Internet]. [cited 2024 Jun 17]. https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0890856718319063?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0890856718319063%3Fshowall%3Dtrue&referrer= 13. Suicide in juveniles and adolescents in the United Kingdom - Windfuhr: Journal of Child Psychology and Psychiatry - Wiley Online Library [Internet]. 2008 [cited 2024 Jun 17]. https://acamh.onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2008.01938.x 14. Depressive symptoms during childhood and adult obesity: The Zurich Cohort Study|Molecular Psychiatry [Internet]. [cited 2024 Jun 17]. https://www.nature.com/articles/4001671 15. World Health Organization: Global accelerated action for the health of adolescents (AA-HA!): guidance to support country implementation [Internet]. Geneva: World Health Organization; 2017 [cited 2023 Apr 1]. 176 p. https://apps.who.int/iris/handle/10665/255415 16. Kumar KS, Akoijam BS: Depression, Anxiety and Stress Among Higher Secondary School Students of Imphal, Manipur. Indian J. Community Med. 2017; 42 (2): 94–96. PubMed Abstract | Publisher Full Text | Free Full Text 17. Depression Anxiety Stress Scales (DASS): [cited 2023 Sep 8]. Reference Source 18. Sahoo S, Khess CRJ: Prevalence of Depression, Anxiety, and Stress Among Young Male Adults in India: A Dimensional and Categorical Diagnoses-Based Study. J. Nerv. Ment. Dis. 2010 Dec; 198 (12): 901–904. Publisher Full Text 19. Singhal M, Manjula M, Vijay Sagar KJ: Subclinical depression in Urban Indian adolescents: Prevalence, felt needs, and correlates. Indian J. Psychiatry. 2016; 58 (4): 394–402. PubMed Abstract | Publisher Full Text | Free Full Text 20. Mishra SK, Srivastava M, Tiwary NK, et al. : Prevalence of depression and anxiety among children in rural and suburban areas of Eastern Uttar Pradesh: A cross-sectional study. J. Family Med. Prim. Care. 2018; 7 (1): 21–26. Publisher Full Text 21. Bahl R, Kumari R: Mental Health Profile of Urban and Rural Adolescents in Jammu District of J&K.2016; 18 : 3. 22. Madasu S, Malhotra S, Kant S, et al. : Anxiety Disorders among Adolescents in a Rural Area of Northern India using Screen for Child Anxiety-Related Emotional Disorders Tool: A Community-based Study. Indian J. Community Med. 2019; 44 (4): 317–321. PubMed Abstract | Publisher Full Text 23. Prabha VS, Rao VB, Kanakabushanam GVVS: A comparative study of anxiety and depression among adolescents from rural and urban areas. J. Med. Sci. Res. 2017 Jan 3; 5 (1): 29–32. Publisher Full Text 24. Dey BK, Rahman A, Bairagi A, et al. : Stress and Anger of Rural and Urban Adolescents. Psychology. 2014 Mar 18 [cited 2023 Apr 23]; 2014 . Reference Source 25. Mallya A: Responses - Depression, anxiety, and stress among adolescents in Shivamogga, Karnataka. [Dataset]. figshare. 2023. Publisher Full Text 26. Mallya A: Questionnaire - Depression, anxiety, and stress among adolescents in Shivamogga, Karnataka. Dataset. figshare. 2023. Publisher Full Text Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 14 Dec 2023 ADD YOUR COMMENT Comment Author details Author details 1 Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 2 Department of Community Medicine, Shivamogga Institute of Medical Sciences, Shivamogga, Karnataka, 577201, India Ajay Mallya Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Raghavendraswamy Koppad Roles: Conceptualization, Methodology, Software, Visualization, Writing – Review & Editing Praveen Kumar Roles: Conceptualization, Validation, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 12 Jul 2024, 12:1583 https://doi.org/10.12688/f1000research.139603.3 version 2 Revised Published: 21 May 2024, 12:1583 https://doi.org/10.12688/f1000research.139603.2 version 1 Published: 14 Dec 2023, 12:1583 https://doi.org/10.12688/f1000research.139603.1 Copyright © 2024 Mallya A et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Mallya A, Koppad R and Kumar P. Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.12688/f1000research.139603.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 12 Jul 2024 Revised Views 0 Cite How to cite this report: Rahman MM. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.168246.r302320 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v3#referee-response-302320 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 13 Jul 2024 Mohammad Meshbahur Rahman , Department of Biostatistics, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.168246.r302320 The authors has improved the manuscript. But there are some additional comments that can improve the quality of the manuscript. 1. In abstract, the methods section is still needs to improve. The sample size is 700 (350 ... Continue reading READ ALL The authors has improved the manuscript. But there are some additional comments that can improve the quality of the manuscript. 1. In abstract, the methods section is still needs to improve. The sample size is 700 (350 from both urban and rural). Therefore, revise the first sentence of the methods. In addition, please report the study time, questionnaire tool (DAS) in one sentence. Finally, report the data analysis and software use information in third and last sentence. The author can follow the Methods section of abstract of the paper of Das et al., 2023 [Ref-1]. 2. The author reported that "Depression was more common among females in both urban and rural settings, with a significant difference observed in rural areas. Anxiety and stress were also more prevalent among females, with anxiety significantly higher in urban females. Urban adolescents exhibited higher levels of depression, anxiety, and stress compared to their rural counterparts." This findings has wrongly interpreted. We can not compare the findings without performing inferential statistics like t-test, proportion z-test or regression. Therefore, this article needs expert statistical assistance. The authors can consult to a statistician to improve this part. In the full-text article, the sample size estimation formula is not correctly reported. The authors can follow the Methods section of the work of Das et al. (2023) [ Ref-1] mentioned above. 3. The discussion of the manuscript still needs substantial improving. I hope the above comments will help to improve the manuscript further. References 1. Das SK, Tamannur T, Nesa A, Noman AA, et al.: Exploring the knowledge and practices on road safety measures among motorbikers in Dhaka, Bangladesh: a cross-sectional study. Inj Prev . 2023. PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Public Health, Global Health, Biostatistics, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Rahman MM. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.168246.r302320 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v3#referee-response-302320 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 21 May 2024 Revised Views 0 Cite How to cite this report: Rajamanickam S. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287888 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287888 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Jun 2024 Saranya Rajamanickam , PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.164841.r287888 Methodology: 1. Operational definition of dependent variable such as depression, stress and anxiety can be mentioned. 2. Type of sampling can be mentioned. 3. Need for separate google forms for urban and rural area can be explained. ... Continue reading READ ALL Methodology: 1. Operational definition of dependent variable such as depression, stress and anxiety can be mentioned. 2. Type of sampling can be mentioned. 3. Need for separate google forms for urban and rural area can be explained. 4. Scoring of depression, anxiety and stress to categorize it into mild, moderate an severe is not clear. Result: 5. A table depicting the frequency of depression, anxiety and stress among the urban and rural area explaining the objective will be appreciated. 6. Significant p value can be highlighted in all the tables and the level of confidence interval can be written below each table. Competing Interests: Nil Close Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: NCDs, I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Rajamanickam S. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287888 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287888 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Motappa R. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287883 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287883 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 24 Jun 2024 Rohith Motappa , Department of Community Medicine, Kasturba Medical College, Kasturba Medical College Hospital, Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, Karnataka, Manipal, 576 104, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.164841.r287883 This cross-sectional study aimed to assess the extent of depression, anxiety, and stress among adolescents residing in urban and rural areas of Shivamogga Taluk. Data was gathered over August and September 2020 through surveys involving 700 teens aged 16 to ... Continue reading READ ALL This cross-sectional study aimed to assess the extent of depression, anxiety, and stress among adolescents residing in urban and rural areas of Shivamogga Taluk. Data was gathered over August and September 2020 through surveys involving 700 teens aged 16 to 19. The results showed that these mental health issues were common in both urban and rural adolescents, with higher rates observed in urban areas. Females consistently showed rates across all mental health conditions. The author should consider expanding on the following areas: 1. If a selected student was absent during the data collection, how was the situation handled to maintain the desired sample size? What specific steps were taken in such cases? 2. The author may include the implications of this study in the discussion. 3. The author may also include some additional limitations of the study. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Non-Communicable Diseases, Mental Health, Geriatrics, Tuberculosis. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Motappa R. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287883 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287883 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Rahman MM. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287885 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287885 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Jun 2024 Mohammad Meshbahur Rahman , Department of Biostatistics, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.164841.r287885 I want to thank the editor for inviting me to review the study. The sample size of this study is sufficient and the study design is appropriate. However, the study methods is not technically sound. The quire from the reviewer ... Continue reading READ ALL I want to thank the editor for inviting me to review the study. The sample size of this study is sufficient and the study design is appropriate. However, the study methods is not technically sound. The quire from the reviewer are pointed out below: 1. This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. 2. The study just presented frequency distribution, and no inferential statistics has presented. 3. The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But, it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. 4. The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. 5. In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] 6. The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. 7. To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. 8. In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. 9. The discussion should be revised according to the new results. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Siddik M, Munmun M, Hasan N, Syfullah M, et al.: Physio-psychosocial risk of depression among college-going adolescents: A cross-sectional study in Bangladesh. Journal of Affective Disorders Reports . 2024; 16 . Publisher Full Text 2. Mridha MK, Hossain MM, Khan MSA, Hanif AAM, et al.: Prevalence and associated factors of depression among adolescent boys and girls in Bangladesh: findings from a nationwide survey. BMJ Open . 2021; 11 (1): e038954 PubMed Abstract | Publisher Full Text 3. Singh MM, Gupta M, Grover S: Prevalence & factors associated with depression among schoolgoing adolescents in Chandigarh, north India. Indian J Med Res . 2017; 146 (2): 205-215 PubMed Abstract | Publisher Full Text 4. Bhattarai D, Shrestha N, Paudel S: Prevalence and factors associated with depression among higher secondary school adolescents of Pokhara Metropolitan, Nepal: a cross-sectional study. BMJ Open . 2020; 10 (12): e044042 PubMed Abstract | Publisher Full Text 5. Haque M, Anjum A, Mousum S, Salwa M, et al.: Prevalence of and factors associated with depression, anxiety and stress among adolescents in Bangladesh during the COVID-19 pandemic: A population-based study. F1000Research . 2023; 12 . Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Public Health, Global Health, Biostatistics, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Rahman MM. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287885 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287885 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 12 Jul 2024 Ajay Mallya , Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 12 Jul 2024 Author Response F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic ... Continue reading F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. Author’s Response: The study was conducted on 700 adolescents with 350 adolescents in urban and rural areas respectively. The sample size estimation for this study is clearly mentioned in the methodology and the number was not chosen arbitrarily. We have already agreed that measurement of depression, anxiety and stress among adolescents with a standard scale and not by a trained psychiatrist is a limitation of the study. Study of factors that affect DAS among adolescents was not in the scope of this study. This may be incorporated into future studies. Comment: The study just presented frequency distribution, and no inferential statistics has presented. Author’s Response: We believe that presenting the frequency distribution serves as a critical first step in understanding the scope of these mental health issues in the region. It offers a clear and immediate representation of the data, which is particularly valuable for an area that has been under-researched in this context. While we acknowledge the value of inferential statistics in drawing broader conclusions from the data, the primary aim of our study was to highlight the prevalence rates and lay the groundwork for future research that may include more sophisticated statistical analyses. In future studies, we plan to incorporate inferential statistics to explore the relationships between various demographic variables and DAS among adolescents. Comment: The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: We have added more information in the result section of the abstract. The aim of the study is now placed at the end of the Introduction section. The same has been incorporated into the introduction and methodology sections of the main article as well. We have also added details of DAS calculation in the methodology section. Comment: The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. Author’s Response: Study of factors affecting DAS was not in the scope of our study. We will try to incorporate this into future studies in the area. Comment: In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] Author’s Response: We agree with your comment and necessary changes have been made in the manuscript. Action taken in the manuscript: Introduction has been revised with suggested reference. Comment: The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. Author’s Response: We aim to conduct future studies with a robust methodology, incorporating the factors affecting DAS in our study Sample size estimation and DAS computation has been added in the manuscript. Action taken in the manuscript: Sample size formula has been explained in the methodology section of the manuscript in detail. DAS computation has been already added as per the suggestion in the previous comment. Comment: To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: More details have been added to the methodology. The outcome measure has been described in detail as suggested by the reviewer, as demonstrated in the quoted sample studies. Comment: In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. Author’s Response: The study of risk factors for DAS was outside the scope of our research, and therefore, no data on these factors was collected. We plan to incorporate this aspect into our future studies. Comment: The discussion should be revised according to the new results. Author’s Response: As previously mentioned, no data was collected to study the factors associated with DAS. Therefore, it is not possible to add any new results. We will incorporate this aspect into future studies. Action taken in the manuscript: Same has been added as the limitation of the study F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. Author’s Response: The study was conducted on 700 adolescents with 350 adolescents in urban and rural areas respectively. The sample size estimation for this study is clearly mentioned in the methodology and the number was not chosen arbitrarily. We have already agreed that measurement of depression, anxiety and stress among adolescents with a standard scale and not by a trained psychiatrist is a limitation of the study. Study of factors that affect DAS among adolescents was not in the scope of this study. This may be incorporated into future studies. Comment: The study just presented frequency distribution, and no inferential statistics has presented. Author’s Response: We believe that presenting the frequency distribution serves as a critical first step in understanding the scope of these mental health issues in the region. It offers a clear and immediate representation of the data, which is particularly valuable for an area that has been under-researched in this context. While we acknowledge the value of inferential statistics in drawing broader conclusions from the data, the primary aim of our study was to highlight the prevalence rates and lay the groundwork for future research that may include more sophisticated statistical analyses. In future studies, we plan to incorporate inferential statistics to explore the relationships between various demographic variables and DAS among adolescents. Comment: The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: We have added more information in the result section of the abstract. The aim of the study is now placed at the end of the Introduction section. The same has been incorporated into the introduction and methodology sections of the main article as well. We have also added details of DAS calculation in the methodology section. Comment: The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. Author’s Response: Study of factors affecting DAS was not in the scope of our study. We will try to incorporate this into future studies in the area. Comment: In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] Author’s Response: We agree with your comment and necessary changes have been made in the manuscript. Action taken in the manuscript: Introduction has been revised with suggested reference. Comment: The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. Author’s Response: We aim to conduct future studies with a robust methodology, incorporating the factors affecting DAS in our study Sample size estimation and DAS computation has been added in the manuscript. Action taken in the manuscript: Sample size formula has been explained in the methodology section of the manuscript in detail. DAS computation has been already added as per the suggestion in the previous comment. Comment: To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: More details have been added to the methodology. The outcome measure has been described in detail as suggested by the reviewer, as demonstrated in the quoted sample studies. Comment: In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. Author’s Response: The study of risk factors for DAS was outside the scope of our research, and therefore, no data on these factors was collected. We plan to incorporate this aspect into our future studies. Comment: The discussion should be revised according to the new results. Author’s Response: As previously mentioned, no data was collected to study the factors associated with DAS. Therefore, it is not possible to add any new results. We will incorporate this aspect into future studies. Action taken in the manuscript: Same has been added as the limitation of the study Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 12 Jul 2024 Ajay Mallya , Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 12 Jul 2024 Author Response F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic ... Continue reading F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. Author’s Response: The study was conducted on 700 adolescents with 350 adolescents in urban and rural areas respectively. The sample size estimation for this study is clearly mentioned in the methodology and the number was not chosen arbitrarily. We have already agreed that measurement of depression, anxiety and stress among adolescents with a standard scale and not by a trained psychiatrist is a limitation of the study. Study of factors that affect DAS among adolescents was not in the scope of this study. This may be incorporated into future studies. Comment: The study just presented frequency distribution, and no inferential statistics has presented. Author’s Response: We believe that presenting the frequency distribution serves as a critical first step in understanding the scope of these mental health issues in the region. It offers a clear and immediate representation of the data, which is particularly valuable for an area that has been under-researched in this context. While we acknowledge the value of inferential statistics in drawing broader conclusions from the data, the primary aim of our study was to highlight the prevalence rates and lay the groundwork for future research that may include more sophisticated statistical analyses. In future studies, we plan to incorporate inferential statistics to explore the relationships between various demographic variables and DAS among adolescents. Comment: The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: We have added more information in the result section of the abstract. The aim of the study is now placed at the end of the Introduction section. The same has been incorporated into the introduction and methodology sections of the main article as well. We have also added details of DAS calculation in the methodology section. Comment: The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. Author’s Response: Study of factors affecting DAS was not in the scope of our study. We will try to incorporate this into future studies in the area. Comment: In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] Author’s Response: We agree with your comment and necessary changes have been made in the manuscript. Action taken in the manuscript: Introduction has been revised with suggested reference. Comment: The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. Author’s Response: We aim to conduct future studies with a robust methodology, incorporating the factors affecting DAS in our study Sample size estimation and DAS computation has been added in the manuscript. Action taken in the manuscript: Sample size formula has been explained in the methodology section of the manuscript in detail. DAS computation has been already added as per the suggestion in the previous comment. Comment: To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: More details have been added to the methodology. The outcome measure has been described in detail as suggested by the reviewer, as demonstrated in the quoted sample studies. Comment: In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. Author’s Response: The study of risk factors for DAS was outside the scope of our research, and therefore, no data on these factors was collected. We plan to incorporate this aspect into our future studies. Comment: The discussion should be revised according to the new results. Author’s Response: As previously mentioned, no data was collected to study the factors associated with DAS. Therefore, it is not possible to add any new results. We will incorporate this aspect into future studies. Action taken in the manuscript: Same has been added as the limitation of the study F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. Author’s Response: The study was conducted on 700 adolescents with 350 adolescents in urban and rural areas respectively. The sample size estimation for this study is clearly mentioned in the methodology and the number was not chosen arbitrarily. We have already agreed that measurement of depression, anxiety and stress among adolescents with a standard scale and not by a trained psychiatrist is a limitation of the study. Study of factors that affect DAS among adolescents was not in the scope of this study. This may be incorporated into future studies. Comment: The study just presented frequency distribution, and no inferential statistics has presented. Author’s Response: We believe that presenting the frequency distribution serves as a critical first step in understanding the scope of these mental health issues in the region. It offers a clear and immediate representation of the data, which is particularly valuable for an area that has been under-researched in this context. While we acknowledge the value of inferential statistics in drawing broader conclusions from the data, the primary aim of our study was to highlight the prevalence rates and lay the groundwork for future research that may include more sophisticated statistical analyses. In future studies, we plan to incorporate inferential statistics to explore the relationships between various demographic variables and DAS among adolescents. Comment: The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: We have added more information in the result section of the abstract. The aim of the study is now placed at the end of the Introduction section. The same has been incorporated into the introduction and methodology sections of the main article as well. We have also added details of DAS calculation in the methodology section. Comment: The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. Author’s Response: Study of factors affecting DAS was not in the scope of our study. We will try to incorporate this into future studies in the area. Comment: In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] Author’s Response: We agree with your comment and necessary changes have been made in the manuscript. Action taken in the manuscript: Introduction has been revised with suggested reference. Comment: The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. Author’s Response: We aim to conduct future studies with a robust methodology, incorporating the factors affecting DAS in our study Sample size estimation and DAS computation has been added in the manuscript. Action taken in the manuscript: Sample size formula has been explained in the methodology section of the manuscript in detail. DAS computation has been already added as per the suggestion in the previous comment. Comment: To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: More details have been added to the methodology. The outcome measure has been described in detail as suggested by the reviewer, as demonstrated in the quoted sample studies. Comment: In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. Author’s Response: The study of risk factors for DAS was outside the scope of our research, and therefore, no data on these factors was collected. We plan to incorporate this aspect into our future studies. Comment: The discussion should be revised according to the new results. Author’s Response: As previously mentioned, no data was collected to study the factors associated with DAS. Therefore, it is not possible to add any new results. We will incorporate this aspect into future studies. Action taken in the manuscript: Same has been added as the limitation of the study Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 14 Dec 2023 Views 0 Cite How to cite this report: Saha I. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.152891.r257925 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v1#referee-response-257925 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Mar 2024 Indranil Saha , ICMR-Centre for Ageing and Mental Health (I-CAM), Indian Council of Medical Research, Kolkata, West Bengal, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.152891.r257925 The manuscript needs following clarifications: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant As per rule the adolescents ... Continue reading READ ALL The manuscript needs following clarifications: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant As per rule the adolescents with completed 19 years should have been included as study participants Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. How socioeconomic status was measured in both the colleges? Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z ∞ 2 . In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Epidemiology, Non-communicable disease, Mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Saha I. Reviewer Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.152891.r257925 ) The direct URL for this report is: https://f1000research.com/articles/12-1583/v1#referee-response-257925 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 21 Jun 2024 Ajay Mallya , Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 21 Jun 2024 Author Response Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree ... Continue reading Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree with your comment. The suggested correction has been made. Action Taken in the manuscript: The suggested correction has been made. Comment: As per rule the adolescents with completed 19 years should have been included as study participants Author’s Response: We agree with your comment. We would like to clarify that adolescents who have completed 19 years were included in the study. Action Taken in the manuscript: we have mentioned that adolescents aged 19 years have included in the study in the methodology section. Comment: Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. Author’s Response: In the data collection process, we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer. However, we acknowledge that some participants may commute and study in a college that does not accurately represent the demography (urban and rural). This can be seen as a limitation of the study. Action Taken in the manuscript: Necessary changes have been done in the strengths and limitation section. Comment: How socioeconomic status was measured in both the colleges? Author’s Response: We have not measured the socioeconomic status of the participants in the study. Action Taken in the manuscript: As socioeconomic status was not included in the original study instrument we have not included it in the study. Comment: Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z∞ 2 Author’s Response: We agree with your observation. Action Taken in the manuscript: Necessary changes have been done in the manuscript. Comment: In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Author’s Response: DASS21 Scale was used in English in our study without any translation or alteration. As the students studying in PU college have English as their first language we used the scale without any translations. DASS21 scale in English is already validated among adolescents. Action Taken in the manuscript: We have duly incorporated this information into the methodology section of the manuscript for clarity. Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree with your comment. The suggested correction has been made. Action Taken in the manuscript: The suggested correction has been made. Comment: As per rule the adolescents with completed 19 years should have been included as study participants Author’s Response: We agree with your comment. We would like to clarify that adolescents who have completed 19 years were included in the study. Action Taken in the manuscript: we have mentioned that adolescents aged 19 years have included in the study in the methodology section. Comment: Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. Author’s Response: In the data collection process, we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer. However, we acknowledge that some participants may commute and study in a college that does not accurately represent the demography (urban and rural). This can be seen as a limitation of the study. Action Taken in the manuscript: Necessary changes have been done in the strengths and limitation section. Comment: How socioeconomic status was measured in both the colleges? Author’s Response: We have not measured the socioeconomic status of the participants in the study. Action Taken in the manuscript: As socioeconomic status was not included in the original study instrument we have not included it in the study. Comment: Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z∞ 2 Author’s Response: We agree with your observation. Action Taken in the manuscript: Necessary changes have been done in the manuscript. Comment: In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Author’s Response: DASS21 Scale was used in English in our study without any translation or alteration. As the students studying in PU college have English as their first language we used the scale without any translations. DASS21 scale in English is already validated among adolescents. Action Taken in the manuscript: We have duly incorporated this information into the methodology section of the manuscript for clarity. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 21 Jun 2024 Ajay Mallya , Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 21 Jun 2024 Author Response Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree ... Continue reading Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree with your comment. The suggested correction has been made. Action Taken in the manuscript: The suggested correction has been made. Comment: As per rule the adolescents with completed 19 years should have been included as study participants Author’s Response: We agree with your comment. We would like to clarify that adolescents who have completed 19 years were included in the study. Action Taken in the manuscript: we have mentioned that adolescents aged 19 years have included in the study in the methodology section. Comment: Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. Author’s Response: In the data collection process, we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer. However, we acknowledge that some participants may commute and study in a college that does not accurately represent the demography (urban and rural). This can be seen as a limitation of the study. Action Taken in the manuscript: Necessary changes have been done in the strengths and limitation section. Comment: How socioeconomic status was measured in both the colleges? Author’s Response: We have not measured the socioeconomic status of the participants in the study. Action Taken in the manuscript: As socioeconomic status was not included in the original study instrument we have not included it in the study. Comment: Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z∞ 2 Author’s Response: We agree with your observation. Action Taken in the manuscript: Necessary changes have been done in the manuscript. Comment: In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Author’s Response: DASS21 Scale was used in English in our study without any translation or alteration. As the students studying in PU college have English as their first language we used the scale without any translations. DASS21 scale in English is already validated among adolescents. Action Taken in the manuscript: We have duly incorporated this information into the methodology section of the manuscript for clarity. Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree with your comment. The suggested correction has been made. Action Taken in the manuscript: The suggested correction has been made. Comment: As per rule the adolescents with completed 19 years should have been included as study participants Author’s Response: We agree with your comment. We would like to clarify that adolescents who have completed 19 years were included in the study. Action Taken in the manuscript: we have mentioned that adolescents aged 19 years have included in the study in the methodology section. Comment: Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. Author’s Response: In the data collection process, we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer. However, we acknowledge that some participants may commute and study in a college that does not accurately represent the demography (urban and rural). This can be seen as a limitation of the study. Action Taken in the manuscript: Necessary changes have been done in the strengths and limitation section. Comment: How socioeconomic status was measured in both the colleges? Author’s Response: We have not measured the socioeconomic status of the participants in the study. Action Taken in the manuscript: As socioeconomic status was not included in the original study instrument we have not included it in the study. Comment: Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z∞ 2 Author’s Response: We agree with your observation. Action Taken in the manuscript: Necessary changes have been done in the manuscript. Comment: In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Author’s Response: DASS21 Scale was used in English in our study without any translation or alteration. As the students studying in PU college have English as their first language we used the scale without any translations. DASS21 scale in English is already validated among adolescents. Action Taken in the manuscript: We have duly incorporated this information into the methodology section of the manuscript for clarity. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 14 Dec 2023 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 3 (revision) 12 Jul 24 read Version 2 (revision) 21 May 24 read read read Version 1 14 Dec 23 read Indranil Saha , Indian Council of Medical Research, Kolkata, India Mohammad Meshbahur Rahman , National Institute of Preventive and Social Medicine, Dhaka, Bangladesh Rohith Motappa , Kasturba Medical College Hospital, Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India Saranya Rajamanickam , PSG Institute of Medical Sciences & Research, Coimbatore, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Rahman M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Jul 2024 | for Version 3 Mohammad Meshbahur Rahman , Department of Biostatistics, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh 0 Views copyright © 2024 Rahman M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors has improved the manuscript. But there are some additional comments that can improve the quality of the manuscript. 1. In abstract, the methods section is still needs to improve. The sample size is 700 (350 from both urban and rural). Therefore, revise the first sentence of the methods. In addition, please report the study time, questionnaire tool (DAS) in one sentence. Finally, report the data analysis and software use information in third and last sentence. The author can follow the Methods section of abstract of the paper of Das et al., 2023 [Ref-1]. 2. The author reported that "Depression was more common among females in both urban and rural settings, with a significant difference observed in rural areas. Anxiety and stress were also more prevalent among females, with anxiety significantly higher in urban females. Urban adolescents exhibited higher levels of depression, anxiety, and stress compared to their rural counterparts." This findings has wrongly interpreted. We can not compare the findings without performing inferential statistics like t-test, proportion z-test or regression. Therefore, this article needs expert statistical assistance. The authors can consult to a statistician to improve this part. In the full-text article, the sample size estimation formula is not correctly reported. The authors can follow the Methods section of the work of Das et al. (2023) [ Ref-1] mentioned above. 3. The discussion of the manuscript still needs substantial improving. I hope the above comments will help to improve the manuscript further. References 1. Das SK, Tamannur T, Nesa A, Noman AA, et al.: Exploring the knowledge and practices on road safety measures among motorbikers in Dhaka, Bangladesh: a cross-sectional study. Inj Prev . 2023. PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Public Health, Global Health, Biostatistics, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Rahman MM. Peer Review Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.168246.r302320) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1583/v3#referee-response-302320 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Rajamanickam S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Jun 2024 | for Version 2 Saranya Rajamanickam , PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu, India 0 Views copyright © 2024 Rajamanickam S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Methodology: 1. Operational definition of dependent variable such as depression, stress and anxiety can be mentioned. 2. Type of sampling can be mentioned. 3. Need for separate google forms for urban and rural area can be explained. 4. Scoring of depression, anxiety and stress to categorize it into mild, moderate an severe is not clear. Result: 5. A table depicting the frequency of depression, anxiety and stress among the urban and rural area explaining the objective will be appreciated. 6. Significant p value can be highlighted in all the tables and the level of confidence interval can be written below each table. Competing Interests: Nil Close Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise NCDs, I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Rajamanickam S. Peer Review Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287888) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287888 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Motappa R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 24 Jun 2024 | for Version 2 Rohith Motappa , Department of Community Medicine, Kasturba Medical College, Kasturba Medical College Hospital, Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, Karnataka, Manipal, 576 104, India 0 Views copyright © 2024 Motappa R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This cross-sectional study aimed to assess the extent of depression, anxiety, and stress among adolescents residing in urban and rural areas of Shivamogga Taluk. Data was gathered over August and September 2020 through surveys involving 700 teens aged 16 to 19. The results showed that these mental health issues were common in both urban and rural adolescents, with higher rates observed in urban areas. Females consistently showed rates across all mental health conditions. The author should consider expanding on the following areas: 1. If a selected student was absent during the data collection, how was the situation handled to maintain the desired sample size? What specific steps were taken in such cases? 2. The author may include the implications of this study in the discussion. 3. The author may also include some additional limitations of the study. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Non-Communicable Diseases, Mental Health, Geriatrics, Tuberculosis. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Motappa R. Peer Review Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287883) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287883 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Rahman M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Jun 2024 | for Version 2 Mohammad Meshbahur Rahman , Department of Biostatistics, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh 0 Views copyright © 2024 Rahman M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I want to thank the editor for inviting me to review the study. The sample size of this study is sufficient and the study design is appropriate. However, the study methods is not technically sound. The quire from the reviewer are pointed out below: 1. This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. 2. The study just presented frequency distribution, and no inferential statistics has presented. 3. The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But, it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. 4. The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. 5. In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] 6. The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. 7. To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. 8. In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. 9. The discussion should be revised according to the new results. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Siddik M, Munmun M, Hasan N, Syfullah M, et al.: Physio-psychosocial risk of depression among college-going adolescents: A cross-sectional study in Bangladesh. Journal of Affective Disorders Reports . 2024; 16 . Publisher Full Text 2. Mridha MK, Hossain MM, Khan MSA, Hanif AAM, et al.: Prevalence and associated factors of depression among adolescent boys and girls in Bangladesh: findings from a nationwide survey. BMJ Open . 2021; 11 (1): e038954 PubMed Abstract | Publisher Full Text 3. Singh MM, Gupta M, Grover S: Prevalence & factors associated with depression among schoolgoing adolescents in Chandigarh, north India. Indian J Med Res . 2017; 146 (2): 205-215 PubMed Abstract | Publisher Full Text 4. Bhattarai D, Shrestha N, Paudel S: Prevalence and factors associated with depression among higher secondary school adolescents of Pokhara Metropolitan, Nepal: a cross-sectional study. BMJ Open . 2020; 10 (12): e044042 PubMed Abstract | Publisher Full Text 5. Haque M, Anjum A, Mousum S, Salwa M, et al.: Prevalence of and factors associated with depression, anxiety and stress among adolescents in Bangladesh during the COVID-19 pandemic: A population-based study. F1000Research . 2023; 12 . Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Public Health, Global Health, Biostatistics, Epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 12 Jul 2024 Ajay Mallya, Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India F1000 research article response Comment: This was a very simple study where the authors just assessed DAS among 350 adolescents. There is a major limitation of demographic variables in this study. There are many factors that affects DAS of adolescents. Author’s Response: The study was conducted on 700 adolescents with 350 adolescents in urban and rural areas respectively. The sample size estimation for this study is clearly mentioned in the methodology and the number was not chosen arbitrarily. We have already agreed that measurement of depression, anxiety and stress among adolescents with a standard scale and not by a trained psychiatrist is a limitation of the study. Study of factors that affect DAS among adolescents was not in the scope of this study. This may be incorporated into future studies. Comment: The study just presented frequency distribution, and no inferential statistics has presented. Author’s Response: We believe that presenting the frequency distribution serves as a critical first step in understanding the scope of these mental health issues in the region. It offers a clear and immediate representation of the data, which is particularly valuable for an area that has been under-researched in this context. While we acknowledge the value of inferential statistics in drawing broader conclusions from the data, the primary aim of our study was to highlight the prevalence rates and lay the groundwork for future research that may include more sophisticated statistical analyses. In future studies, we plan to incorporate inferential statistics to explore the relationships between various demographic variables and DAS among adolescents. Comment: The abstract of the study is insufficient and lack of key information. In abstract, the authors reported their study objectives in methods section. But it should be place at the end of Background/Introduction section. In the methods section, the authors should report about DAS 21 and its' computational ways, and appropriate statistical analysis. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: We have added more information in the result section of the abstract. The aim of the study is now placed at the end of the Introduction section. The same has been incorporated into the introduction and methodology sections of the main article as well. We have also added details of DAS calculation in the methodology section. Comment: The results section in abstract is incomplete. The author should report associated factors of DAS among adolescents. Author’s Response: Study of factors affecting DAS was not in the scope of our study. We will try to incorporate this into future studies in the area. Comment: In the main text, the writings of introduction is very poor. The author are requested to add the recent literature and statistics in the introduction, avoiding orphan paragraphs. The introduction would be sound if the author would report the DAS of adolescents in the similar socio-demographics in South-Asia. [Ref.: Siddik M, et al., 2024 [Ref- 1]; Mridha MK et al., 2021 [Ref- 2]; Singh MM, et al., 2017 [Ref-3]; Bhattarai D, et al., 2020 [Ref-4]] Author’s Response: We agree with your comment and necessary changes have been made in the manuscript. Action taken in the manuscript: Introduction has been revised with suggested reference. Comment: The methods of the study is very poor. The sample size estimation formula should write appropriately. The should report the scaling and scoring techniques of DAS 21. Author’s Response: We aim to conduct future studies with a robust methodology, incorporating the factors affecting DAS in our study Sample size estimation and DAS computation has been added in the manuscript. Action taken in the manuscript: Sample size formula has been explained in the methodology section of the manuscript in detail. DAS computation has been already added as per the suggestion in the previous comment. Comment: To enrich the Methods of the study, the authors are requested to follow any standard approach of writing Methods [e.g,. Haque M, et al., 2023 [Ref- 5]; Siddik M, et al., 2024 [Ref-1]]. Author’s Response: We agree with your comment. The suggested correction has been made. Action taken in the manuscript: More details have been added to the methodology. The outcome measure has been described in detail as suggested by the reviewer, as demonstrated in the quoted sample studies. Comment: In the results section, the authors are strongly recommended to add inferential statistics to identify the associated risk factors of DAS among adolescents. Author’s Response: The study of risk factors for DAS was outside the scope of our research, and therefore, no data on these factors was collected. We plan to incorporate this aspect into our future studies. Comment: The discussion should be revised according to the new results. Author’s Response: As previously mentioned, no data was collected to study the factors associated with DAS. Therefore, it is not possible to add any new results. We will incorporate this aspect into future studies. Action taken in the manuscript: Same has been added as the limitation of the study View more View less Competing Interests None reply Respond Report a concern Rahman MM. Peer Review Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.164841.r287885) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1583/v2#referee-response-287885 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Saha I. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Mar 2024 | for Version 1 Indranil Saha , ICMR-Centre for Ageing and Mental Health (I-CAM), Indian Council of Medical Research, Kolkata, West Bengal, India 0 Views copyright © 2024 Saha I. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The manuscript needs following clarifications: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant As per rule the adolescents with completed 19 years should have been included as study participants Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. How socioeconomic status was measured in both the colleges? Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z ∞ 2 . In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Epidemiology, Non-communicable disease, Mental health I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 21 Jun 2024 Ajay Mallya, Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Comment: “p-values less than 0.05 were considered significant” – please correct as p value equal to or less than 0.05 was considered as statistically significant Author’s Response: We agree with your comment. The suggested correction has been made. Action Taken in the manuscript: The suggested correction has been made. Comment: As per rule the adolescents with completed 19 years should have been included as study participants Author’s Response: We agree with your comment. We would like to clarify that adolescents who have completed 19 years were included in the study. Action Taken in the manuscript: we have mentioned that adolescents aged 19 years have included in the study in the methodology section. Comment: Colleges situated in urban and rural area: whether urban college truly represent urban adolescents? There may be so may students from rural area studying in urban college and the vice versa may be true. Author’s Response: In the data collection process, we ensured that the collected data is properly segregated into urban and rural categories based on the list of colleges obtained from the block education officer. However, we acknowledge that some participants may commute and study in a college that does not accurately represent the demography (urban and rural). This can be seen as a limitation of the study. Action Taken in the manuscript: Necessary changes have been done in the strengths and limitation section. Comment: How socioeconomic status was measured in both the colleges? Author’s Response: We have not measured the socioeconomic status of the participants in the study. Action Taken in the manuscript: As socioeconomic status was not included in the original study instrument we have not included it in the study. Comment: Please edit the sample size formula – “n=4pq/D2” instead of 4, please mention as Z∞ 2 Author’s Response: We agree with your observation. Action Taken in the manuscript: Necessary changes have been done in the manuscript. Comment: In which language this DASS 21 scale was used? Was it validated and reliable in that settings? Author’s Response: DASS21 Scale was used in English in our study without any translation or alteration. As the students studying in PU college have English as their first language we used the scale without any translations. DASS21 scale in English is already validated among adolescents. Action Taken in the manuscript: We have duly incorporated this information into the methodology section of the manuscript for clarity. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Saha I. Peer Review Report For: Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka [version 3; peer review: 1 approved, 3 approved with reservations] . F1000Research 2024, 12 :1583 ( https://doi.org/10.5256/f1000research.152891.r257925) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-1583/v1#referee-response-257925 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with F1000Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Depression, anxiety, and stress among urban...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://f1000research.com/articles/12-1583/v3" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://f1000research.com/articles/12-1583/v3&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://f1000research.com/articles/12-1583/v3" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Mallya A et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://f1000research.com/articles/12-1583/v3/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://f1000research.com/articles/12-1583", templates : { twitter : "Depression, anxiety, and stress among urban and rural adolescents.... Mallya A et al., published by " + "@F1000Research" + ", https://f1000research.com/articles/12-1583/v3" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/139603/168246") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "168246"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "257923": 0, "257922": 0, "257921": 0, "257920": 0, "257927": 0, "257926": 0, "257925": 16, "257924": 0, "287884": 0, "287885": 17, "287886": 0, "287887": 0, "287881": 0, "287882": 0, "287883": 7, "235795": 0, "235794": 0, "235793": 0, "235792": 0, "235799": 0, "287888": 6, "235798": 0, "264977": 0, "287889": 0, "235797": 0, "287890": 0, "235796": 0, "235801": 0, "235800": 0, "231343": 0, "231342": 0, "231341": 0, "231347": 0, "231346": 0, "231345": 0, "231344": 0, "231350": 0, "231349": 0, "231348": 0, "280765": 0, "249167": 0, "249166": 0, "249165": 0, "249171": 0, "249170": 0, "249169": 0, "249168": 0, "249174": 0, "249173": 0, "249172": 0, "239835": 0, "239839": 0, "239838": 0, "239837": 0, "239836": 0, "239843": 0, "239842": 0, "239841": 0, "239840": 0, "239844": 0, "302317": 0, "302318": 0, "302319": 0, "302320": 10, "257919": 0, "257918": 0, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "a3f54fc9-c6b6-437e-b5e9-6804447d9f4b"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); An innovative open access publishing platform offering rapid publication and open peer review, whilst supporting data deposition and sharing. Browse Gateways Collections How it Works Contact For Developers Cookie Notice Privacy Notice RSS Submit Your Research Follow us © 2012-2026 F1000 Research Ltd. ISSN 2046-1402 | Legal | Partner of Research4Life • CrossRef • ORCID • FAIRSharing R.templateTests.simpleTemplate = R.template(' $text $text $text $text $text '); R.templateTests.runTests(); var F1000platform = new F1000.Platform({ name: "f1000research", displayName: "F1000Research", hostName: "f1000research.com", id: "1", editorialEmail: "[email protected]", infoEmail: "[email protected]", usePmcStats: true }); $(function(){R.ui.dropdowns('.dropdown-for-authors, .dropdown-for-about, .dropdown-for-myresearch');}); // $(function(){R.ui.dropdowns('.dropdown-for-referees');}); $(document).ready(function () { if ($(".cookie-warning").is(":visible")) { $(".sticky").css("margin-bottom", "35px"); $(".devices").addClass("devices-and-cookie-warning"); } $(".cookie-warning .close-button").click(function (e) { $(".devices").removeClass("devices-and-cookie-warning"); $(".sticky").css("margin-bottom", "0"); }); $("#tweeter-feed .tweet-message").each(function (i, message) { var self = $(message); self.html(linkify(self.html())); }); $(".partner").on("mouseenter mouseleave", function() { $(this).find(".gray-scale, .colour").toggleClass("is-hidden"); }); }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });