Determinants of enduring major depressive episodes in the youth population of Hong Kong: the roles of comorbid psychopathology and stressful life events

Ming Yin Wong, Stephanie, Yu Hai Chen, Eric, Nam Suen, Yi, van Os, Jim, McGorry, Patrick D., Hing Lam, Tai, Morgan, Craig, McDaid, David ORCID: 0000-0003-0744-2664, Chung Sham, Pak, Chiu Wa Lam, Linda, Tsui, Cindy, Cheung, Charlton, Ho Ming Lee, Edwin, Kit Wa Chan, Sherry and Lai Ming Hui, Christy (2025) Determinants of enduring major depressive episodes in the youth population of Hong Kong: the roles of comorbid psychopathology and stressful life events. Psychological Medicine, 55. ISSN 0033-2917

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Abstract

Background Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population. Methods We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview–Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors. Results At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14–14.38), depression (aOR = 3.92, CI = 1.79–8.62), and generalized anxiety (aOR = 2.27, CI = 1.21–4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98–4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90–3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81–9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year. Conclusions Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.

Item Type:	Article
Additional Information:	© 2025 The Author(s)
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry B Philosophy. Psychology. Religion > BF Psychology
Date Deposited:	18 Nov 2025 12:21
Last Modified:	16 Dec 2025 08:38
URI:	http://eprints.lse.ac.uk/id/eprint/130239

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