Rumination and Depression in Chinese Adolescents With Mood Disorders: The Mediating Role of Resilience.

Background: Adolescent mood disorders (MD) have become an important public health problem worldwide. However, the psychopathological mechanisms underlying the occurrence of adolescent MD remain poorly elucidated. Therefore, in this study, we explored the mediating role of psychological resilience in the effects of rumination on depression in Chinese adolescents with MD.Methods: A total of 569 adolescent MD patients were included. Recruitment took place between October 2019 and June 2022. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. The 21-item Chinese version of the Ruminative Responses Scale (RRS) was used to assess rumination, and the 10-item Chinese version of the Connor-Davidson Resilience Scale (CD-RISC-10) was used to measure psychological resilience.Results: The prevalence of MD in adolescents with severe depressive symptoms (SDS) was 46.05%. The prevalence of SDS was much higher in females (50.75%) than in males (35.09%). The prevalence of SDS was much higher in adolescents with MD living with grandparents (56.25%) and living in single-parent families (61.36%) than in those living with parents (43.00%) and those having one parent who was away for a long time (40.00%). Adolescents with MD and also with SDS had higher levels of rumination and lower levels of psychological resilience than adolescents without SDS. Resilience partially mediated the relationship between rumination and depression.Conclusions: Lifestyle influences the severity of depressive symptoms in adolescents with MD. Rumination and psychological resilience were the risk and protective factors for SDS in adolescents with MD, respectively. Furthermore, resilience can reduce the impact of rumination on depressive symptoms, suggesting that clinical interventions to improve patients' resilience and reduce rumination may be a viable consideration for adolescents with MD.

Depression and suicide attempts in Chinese adolescents with mood disorders: the mediating role of rumination.

Mood disorders (MD) are often associated with a higher incidence of suicidal behavior, especially in adolescent patients. However, the mechanisms by which depression affects suicide attempts in adolescents with MD remain poorly elucidated. Therefore, the purpose of this study was to determine the incidence, risk factors, and clinical correlates of suicide attempts in Chinese adolescent patients with MD, as well as the inter-relationship between depressive symptoms, rumination, and suicide attempts, and the role of rumination in mediating depression and suicide attempts. A total of 331 MD adolescent patients aged 11 ~ 18 years were recruited from a psychiatric hospital. Suicide attempts were assessed with the MINI Suicide Scale. Depressed symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). To assess rumination, we used the 21-item Chinese version of the Ruminative Responses Scale (RRS). Overall, the percentage of suicide attempts among MD adolescents was 51.96%, with a higher percentage of females (58.62%) than males (36.36%). Compared to non-suicide attempters, suicide attempters had higher scores on PHQ-9, RRS, depression-related, brooding, and reflective pondering. Gender and RRS were independently associated with suicide attempts. Rumination played a fully mediating role between depression and suicide attempts. In addition, the mediating effect of depression between rumination and suicide attempts was not significant. The incidence of suicide attempts was higher in MD adolescents than in general adolescents. Gender and rumination were associated with suicide attempts in MD adolescents. Moreover, rumination mediated the correlation between depressive symptoms and suicide attempts, suggesting that rumination may be an important intervention component for clinical staff to prevent suicidal behavior in adolescents with MD.