Abstract
BACKGROUND: With the increasing global incidence of mental illness, depression has become a serious problem among college students. AIM: To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression, examine the effects of binge eating, physical activity, and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction. METHODS: We conducted a cross-sectional survey of 1286 college students in South China. Physical activity level, depressive symptoms, and binge eating behavior were assessed using the Physical Activity Scale-3, Zung Self-Rating Depression Scale, and Dutch Eating Behavior Questionnaire, respectively. The absolute difference between actual body mass index (BMI) and ideal BMI was used to indicate the level of body dissatisfaction. Structural equation modeling (SEM) and receiver operating characteristic (ROC) curve analysis were used to examine the relationships between these variables and depression. RESULTS: The findings showed that female college students reported higher levels of depression. Physical activity, body dissatisfaction, and binge eating behavior were significantly associated with depression. SEM revealed that body dissatisfaction played a mediating role. A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression, with an area under the ROC curve of 70.0%, providing a basis for targeted interventions. CONCLUSION: This study demonstrated a significant positive correlation between body dissatisfaction and depression. Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression. Therefore, promoting physical activity and healthy eating habits among adolescents is essential. Additionally, the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening. Future longitudinal studies are recommended to further refine this diagnostic criterion.