Remission of probable depression and associated factors among Hong Kong adolescents–a large-scale longitudinal study

Abstract

Background: Few longitudinal studies investigated the trend and factors of reduction in depression among depressed adolescents. This study investigated the incidence of remission of probable depression among adolescents with probable depression (CES-D scores≥16) during a 1-year follow-up period. Furthermore, the study tested the predictive factors of remission. We hypothesized that increases in perceived family support, self-efficacy, self-esteem and positive affect, and the decreases in conflicts with peer and parents, academic stress, social anxiety, and loneliness would predict remission status. Methods: The study included 5,487 participants (40.8% male; Mage=13.49, SD=1.39) with probable depression at baseline. The above-mentioned factors were assessed by validated scales at both baseline and follow-up. The analyses of frequency, independent t-test, and logistic regression were conducted by SPSS19.0. Findings: Around 39%(35%) of female(male) adolescents with mild depressive, 46%(45%) with moderate depression, and 11%(16%) with severe depression at baseline reported reductions in depression at follow-up. The increases of self-esteem (ORm=1.06; 95%CI:1.03, 1.10) and positive affect (ORm=1.07; 95%CI:1.04, 1.11) and the decreases of loneliness (ORm=.90; 95%CI:.88, .93) and negative events (ORm=.93; 95%CI:.89, .97) predicted depression remission among female adolescents. In addition to these factors, changes in family support (ORm=1.03; 95%CI:1.01, 1.05) and social anxiety (ORm=.97; 95%CI:.95, .99) predicted depression remission among male adolescents. Discussion: The results suggest that individuals are resilient and remission from depression is possible. Gender differences in different predictive variables of depression remission were identified. The significant predictors of depression remission highlighted by the study can be used to design effective interventions for alleviation of adolescent depression.