Abstract:
Objective To explore the associative characteristics among depressive symptoms, psychological resilience, and mental health literacy in adolescents so as to provide new insights for interventions targeting adolescents depressive symptoms.
Methods A stratified multistage cluster sampling method was employed to select 2723 students aged 10-18 years old from primary and secondary schools at different educational stages in Putuo District of Shanghai from December 2024 to January 2025. The Patient Health Questionnaire-9 (PHQ- 9, total score 0-27, with a score ≥10 indicating positive depressive symptoms), the Resilience Scale for Chinese Adolescents (RSCA, total score 27-135), and a mental health core knowledge awareness questionnaire (total score 0-10) were utilized to assess depressive symptoms, psychological resilience, and mental health literacy, respectively. A network model was constructed using the nine PHQ-9 items, five RSCA dimensions, and the total mental health literacy score as nodes to analyze the association structure among these nodes. Standardized node strength, standardized expected influence, and standardized bridge expected influence were calculated.
Results The PHQ-9 score was 4.62 ±5.27, yielding a positive-screening rate for depressive symptoms of 15.28%. The scores of the RSCA and MHL were 97.71±20.58 and 9.00 (8.00, 10.00), respectively. Network analyses revealed that emotion regulation and depressed mood were core nodes in the network (standardized strength values were 1.74 and 0.97); they constituted the main connection between the depressive symptoms and psychological resilience networks (edge weight was -0.17). Mental health literacy and positive cognition served as the main bridge nodes linking depressive symptoms and psychological resilience (standardized bridge expected influence values were 1.42 and 1.27).
Conclusions Depressed mood, emotion regulation, positive cognition and mental health literacy were closely associated with depressive symptoms, psychological resilience, and mental health literacy in adolescents. Strengthening interventions targeting emotion regulation, positive cognition and mental health literacy may contribute to the prevention and control of depressive symptoms among adolescents.