The study aims to explore the risk of depression in left-behind children in grades four-six in rural China and to identify the factors associated with increased depression risk in this population. In Hubei Xiantao, a school-based sample of 1000 children was recruited with 875 children (590 left-behind children, 285 controls) providing all relevant information. The adjusted mean children's depression inventory (CDI) score of left-behind children was significantly higher than that of controls (P<0.01). Left-behind children's depression risk rate was much higher than control's (P<0.01). Left-behind children had a higher likelihood of depression risk than controls (migrant fathers: adjusted odds ratio (OR)=3.42, 95% confidence interval (CI)=1.86-6.28; migrant mothers: OR=2.62, 95% CI=1.10-6.22; migrant parents: OR=2.73, 95% CI=1.77-4.20). Respondents with low socioeconomic status (SES) (OR=2.64, 95% CI=1.42-4.93) had a higher likelihood of depression risk than the middle SES cohort. With middle levels of social support as the referent, respondents with low levels of social support (OR=5.86, 95% CI=3.90-8.79) had a higher likelihood of depression risk; respondents with high levels of social support (OR=0.50, 95% CI=0.29-0.86) had a lower likelihood of depression risk. The results indicate that the left-behind children are at greater risk for developing depression.
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