Protective and vulnerability factors predicting new-onset depressive episode in a representative of U.S. adolescents.
OBJECTIVE
Depressive episodes cause considerable morbidity and mortality in adolescents. We sought to identify factors predicting new onset depressive episode in a representative sample of U.S. adolescents.


METHODS
We conducted logistic regression analyses to identify baseline individual, family, school/peer and community factors predicting new-onset depressive episode at a 1-year follow-up in a longitudinal cohort study of 4791 U.S. adolescents. Potential protective and vulnerability factors included individual (sociodemographics, general health and maturity, coping behavior, self-concept, and affect regulation), family (connectedness and conflict), school/peers (acceptance and performance), and community (engagement, delinquency, and adverse events).


RESULTS
African American and Hispanic ethnicity, female gender, and low-income status predicted higher risk of onset of a depressive episode. Active coping and positive self-concept, predicted lower risk, whereas poor affect regulation and greater depressed mood predicted higher risk. Family "connectedness," parental warmth, peer acceptance, better school performance, and religious activities were protective, whereas parental conflict, delinquent activities, and greater numbers of adverse events increased risk of depressive episodes.


CONCLUSIONS
Female gender, nonwhite ethnicity, low-income status, poor health, and parental conflict, increase risk of a depressive episode. Physicians should consider recommending behaviors that enhance perceived fitness, favorable self-concept, family connectedness, peer acceptance, and community engagement to youth as means a of mitigating this risk for developing a depressive episode.
Van Voorhees
Benjamin W
BW
Section of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, Illinois 60637, USA. bvanvoor@medicine.bsd.uchicago.edu
Paunesku
David
D
Kuwabara
Sachiko A
SA
Basu
Anirban
A
Gollan
Jackie
J
Hankin
Benjamin L
BL
Melkonian
Stephanie
S
Reinecke
Mark
M
D000223:Adaptation, Psychological; D000293:Adolescent; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005190:Family; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D010379:Peer Group; D012307:Risk Factors; D012649:Self Concept; D014481:United States / Q000453:epidemiology