Determinants of enduring major depressive episodes in the youth population of Hong Kong: The roles of comorbid psychopathology and stressful life events
Determinants of enduring major depressive episodes in the youth population of Hong Kong: The roles of comorbid psychopathology and stressful life events

Determinants of enduring major depressive episodes in the youth population of Hong Kong: The roles of comorbid psychopathology and stressful life events

Psychol Med. 2025 Nov 20;55:e352. doi: 10.1017/S0033291725102468.

ABSTRACT

BACKGROUND: Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population.

METHODS: We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview-Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors.

RESULTS: At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14-14.38), depression (aOR = 3.92, CI = 1.79-8.62), and generalized anxiety (aOR = 2.27, CI = 1.21-4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98-4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90-3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81-9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year.

CONCLUSIONS: Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.

PMID:41262032 | DOI:10.1017/S0033291725102468