The relationship between chronic disease and depressive symptoms in Chinese adolescents: emotion regulation as a moderator

This study aimed to examine the association of chronic disease with depressive symptoms, while taking emotion regulation as a moderator, and to further explore gender and grade differences in the moderating effects of emotion regulation among Chinese adolescents. An extensive online survey was carried out in northwestern China. Our analyses included a total of 20,432 students. Multivariable linear regression analyses were performed to explore the relationship between chronic disease and depressive symptoms, as well as the impact of emotion regulation on these associations. This study discovered that chronic disease could significantly increase depressive symptoms in adolescents [β = 0.108, 95% CI (0.096, 0.120)]. Suppression strengthened the relationship between chronic disease and depressive symptoms [β = 0.116, 95% CI (0.104, 0.128), p < 0.001]. The positive moderating effects of reappraisal were only found in girls [β = -0.022, 95% CI (-0.041, -0.004)], whereas its reversed moderating impact was observed in boys [β = 0.022, 95% CI (0.006, 0.037)]. In terms of grade difference, suppression was significant only for middle school and high school students. Chronic disease is the risk factor for depressive symptoms among adolescents in northwestern China. Suppression and reappraisal moderated this relationship in different ways depending on gender and grade. The mental health of adolescents with chronic diseases should be closely monitored. Relative interventions aimed at improving emotion regulation may effectively reduce depressive symptoms.