Work

Time‐Variant Patterns of Comorbid Depression and Anxiety Across Early to Late Adolescence: The Sex‐Specific Role of Emotion Regulation

Year: 2026

Type: article

Abstract: Aims: Depression-anxiety comorbidity is common in adolescence, yet prevention efforts often overlook the nonlinear course of psychosocial development. This study mapped the dynamic risk of depression-anxiety comorbidity across adolescence and examined whether emotion regulation moderated these associations by grade and sex. Methods: = 58,622; grades 4-12), to map the dynamic change of comorbid risk and potential moderating role of emotion regulation, with consideration of sex difference. Participants reported depressive and anxiety symptoms through the patient health questionnaire and generalised anxiety disorder questionnaire, respectively. The emotion regulation questionnaire (ERQ) measured two dimensions of emotion regulation, cognitive reappraisal and expression suppression. Results: Overall comorbid risk increased throughout adolescence. Anxiety (OR = 1.67, 95% CI [1.61, 1.74]) and depressive (OR = 1.68, 95% CI [1.50, 1.89]) symptoms had similar overall comorbid risk, while depression-related risk became stronger than anxiety-related risk in late adolescence. Sex-specific patterns revealed higher comorbid risks in females. A gradual risk progression across grades emerged in males, whereas females showed a steeper increase in depression-associated comorbidity and an anxiety-associated peak around grade 8 (OR = 1.74, 95% CI [1.69, 1.80]). The role of emotion regulation is more pronounced in females than males. Cognitive reappraisal had a protective role against anxiety-related comorbid risk (OR = 0.99, 95% CI [0.99, 0.99]) and a maladaptive role for depression-related comorbid risk (OR = 1.01, 95% CI [1.01, 1.01]). The maladaptive role of expressive suppression for anxiety-associated comorbidity peaked during middle school for females and only emerged during early adolescence for males. Interpretation: Depression-anxiety comorbidity showed distinct grade- and sex-specific risk patterns across adolescence. These findings advocate for precise interventions prioritising anxiety management during primary-to-middle school transition and depression prevention during late adolescence. Emotion regulation interventions should be tailored by sex, adolescence stage and existing symptoms.

Source: Depression and Anxiety

DOI: 10.1155/da/7875846

Authors: Dongyu Liu, Xiyu Wei, Luxia Jia, Bao Zhang

Institutions: Guangzhou University, University of Hong Kong

Language: English

Topic: Child and Adolescent Psychosocial and Emotional Development

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,490