Protective factors against depression in high-risk children and adolescents: a systematic review of longitudinal studies.

Background: Depression is a significant global disability, and early adverse experiences (EAE) represent consistent risk factors in children. However, protective factors play a vital role in promoting healthy development and mitigating these risks.

Methods: We conducted a thorough literature search on Pubmed, APA, Emcare, and EMBASE from 1946 to August 25, 2023. We included longitudinal studies analyzing protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies.

Outcomes: Our analysis comprised 29 studies with 62,405 participants, identifying 38 protective factors. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics and intrinsic religiosity were associated with reduced depressive outcomes.

Interpretation: These findings have important implications for developing preventive strategies in this population. Addressing protective factors can contribute to preventing depression and enhancing mental well-being across the lifespan.