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<p>Adolescent depression is increasingly prevalent in China, yet studies examining depressive symptoms through the lens of family cohesion and adaptability remain limited. This study explores the association between family cohesion/adaptability and depressive symptoms in adolescents diagnosed with depression, while also assessing the influence of family types on symptom severity, to inform prevention and intervention strategies. Using a multicenter stratified convenience sampling approach, we surveyed 540 adolescents with depression across eight provinces in China. Participants completed the Family Adaptability and Cohesion Evaluation Scales II (FACES II) and the Patient Health Questionnaire-9 (PHQ-9). Adolescents with greater family cohesion and adaptability displayed reduced depressive symptoms severity and lower recurrence rates (t = 6.982, 2.645; <i>p</i> &lt; 0.05). Family cohesion and adaptability scores were significantly and negatively correlated with PHQ-9 scores (r =  − 0.31 to − 0.36, <i>p</i> &lt; 0.01). Females, adolescents on “sick leave” academically, and those from families with low cohesion, rigid adaptability, or extreme-type structures reported elevated PHQ-9 scores (<i>p</i> &lt; 0.05). Linear regression analysis confirmed that extreme-type families were significantly associated with increased depressive symptom severity (β = 0.26; <i>p</i> &lt; 0.001) after adjusting for demographic factors. Family cohesion and adaptability are inversely related to depressive symptoms in adolescents with depression, with family type emerging as a key associated factor of symptom severity.</p>

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The impact of family cohesion and adaptability on depressive symptoms in adolescents with depression: a cross-sectional study in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Jiu-Ju Li,
  • Bing-Jie Zhou,
  • Jia-Qi Zhu,
  • Yue Yu,
  • Hai-Yan He,
  • Ning Wang,
  • Jing Gao,
  • Gang Wang,
  • Dan-Ning Zhang,
  • Li Li

摘要

Adolescent depression is increasingly prevalent in China, yet studies examining depressive symptoms through the lens of family cohesion and adaptability remain limited. This study explores the association between family cohesion/adaptability and depressive symptoms in adolescents diagnosed with depression, while also assessing the influence of family types on symptom severity, to inform prevention and intervention strategies. Using a multicenter stratified convenience sampling approach, we surveyed 540 adolescents with depression across eight provinces in China. Participants completed the Family Adaptability and Cohesion Evaluation Scales II (FACES II) and the Patient Health Questionnaire-9 (PHQ-9). Adolescents with greater family cohesion and adaptability displayed reduced depressive symptoms severity and lower recurrence rates (t = 6.982, 2.645; p < 0.05). Family cohesion and adaptability scores were significantly and negatively correlated with PHQ-9 scores (r =  − 0.31 to − 0.36, p < 0.01). Females, adolescents on “sick leave” academically, and those from families with low cohesion, rigid adaptability, or extreme-type structures reported elevated PHQ-9 scores (p < 0.05). Linear regression analysis confirmed that extreme-type families were significantly associated with increased depressive symptom severity (β = 0.26; p < 0.001) after adjusting for demographic factors. Family cohesion and adaptability are inversely related to depressive symptoms in adolescents with depression, with family type emerging as a key associated factor of symptom severity.