A study on the correlation between family dynamic factors and depression in adolescents

Jiali Shi; Yiran Tao; Caiying Yan; Xudong Zhao; Xueqing Wu; Tingting Zhang; Cheng Zhong; Jinhua Sun; Manji Hu

doi:10.3389/fpsyt.2022.1025168

A study on the correlation between family dynamic factors and depression in adolescents

Front Psychiatry. 2023 Jan 24:13:1025168. doi: 10.3389/fpsyt.2022.1025168. eCollection 2022.

Authors

Jiali Shi¹, Yiran Tao², Caiying Yan¹, Xudong Zhao¹, Xueqing Wu¹, Tingting Zhang¹, Cheng Zhong¹, Jinhua Sun³, Manji Hu¹

Affiliations

¹ Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
² Department of General Medicine, Zhoupu Health Service Center, Shanghai, China.
³ Department of Psychological Medicine, Children's Hospital of Fudan University, Shanghai, China.

Abstract

Objectives: To evaluate the relationship between systemic family dynamics and adolescent depression.

Methods: An offline survey was distributed to 4,109 students in grades 6-12, with the final analysis including 3,014 students (1,524 boys and 1,490 girls) aged 10-18 years. The questionnaire included the Self-Rating Scale of Systemic Family Dynamics (SSFD), the Self-Rating Depression Scale (SDS), and demographic characteristics.

Results: Family dynamics were negatively correlated with depressive symptoms, with better family dynamics (high scores) associated with lower levels of depression based on the SDS score. After adjusting for sociodemographic characteristics, an ordinal multiclass logistic regression analysis identified family atmosphere (OR = 0.952, 95% CI: 0.948-0.956, p < 0.001) as the most important protective family dynamic against depression, followed by individuality (OR = 0.964, 95% CI: 0.960-0.968, p < 0.001). Latent class analysis (LCA) created the low family dynamic and high family dynamic groups. There were significant differences in the mean SDS scores between the two groups (45.52 ± 10.57 vs. 53.78 ± 11.88; p < 0.001) that persisted after propensity matching. Family atmosphere and individuation had a favorable diagnostic value for depression, with AUCs of 0.778 (95% CI: 0.760-0.796) and 0.710 (95% CI: 0.690-0.730), respectively. The diagnostic models for depression performed well.

Conclusion: Poor family dynamics may be responsible for adolescent depression. A variety of early intervention strategies focused on the family may potentially avoid adolescent depression.

Keywords: adolescents; depression; diagnosis model; latent class analysis; systemic family dynamics.

Grants and funding

This study was supported by grants from the foundation of the Shanghai Municipal Commission of Health and Family Planning (Grant No. 201940161), the Medical Discipline Construction Project of Pudong Health Committee of Shanghai (Grant No. PWYgy2021-02), Three-Year Action Plan from 2020 to 2022 for the Construction of Shanghai Public Health System (Grant No. GWV-10.2-XD31), and Clinical Science and Technology Innovation Projects of Shanghai Shenkang Hospital Development Center (Grant No. SHDC12020126).