Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies

J Affect Disord. 2014 Dec;169:61-75. doi: 10.1016/j.jad.2014.08.006. Epub 2014 Aug 12.

Abstract

Background: Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. To fill this gap, a review was carried out to identify risk and protective factors for depression during adolescence that are modifiable by the young person.

Methods: Employing the PRISMA method, we conducted a systematic review and meta-analysis of longitudinal studies to identify risk and protective factors during the adolescent period (aged 12-18 years) that are potentially modifiable by the young person without professional intervention or assistance. Stouffer׳s method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations.

Results: We identified 113 publications which met the inclusion criteria. Putative risk factors implicated in the development of depression for which there is a sound evidence base, and which are potentially modifiable during adolescence without professional intervention, are: substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; negative coping strategies; and weight. Modifiable protective factors with a sound evidence base are healthy diet and sleep.

Limitations: Limitations include not systematically reviewing moderators and mediators, the lack of generalisability across cultures or to younger children or young adults, and the inability to conduct a meta-analysis on all included studies.

Conclusions: Findings from this review suggest that future health education campaigns or self-help prevention interventions targeting adolescent depression should aim to reduce substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; and negative coping strategies; and promote healthy weight; diet; and sleep patterns.

Keywords: Adolescent; Depression; Longitudinal studies; Prevention; Review; Risk and protective factors.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Depressive Disorder, Major / prevention & control*
  • Humans
  • Life Style
  • Longitudinal Studies
  • Protective Factors
  • Risk Factors
  • Substance-Related Disorders / psychology