Effect of family cohesion and adaptability on suicide risk in adolescent inpatients with depression： the mediating role of depressive symptoms and the moderating role of resilience
10.11886/scjsws20260209001
- VernacularTitle:家庭亲密度及适应性对住院青少年抑郁症患者自杀风险的影响：抑郁症状的中介作用与心理弹性的调节作用
- Author:
Can KE
1
;
Guo CHEN
2
;
Jie ZHANG
2
;
Min YU
2
Author Information
1. Guangzhou Medical University， Guangzhou 510182， China
2. Affiliated Brain Hospital of Guangzhou Medical University， Guangzhou 510140， China
- Publication Type:Journal Article
- Keywords:
Adolescents;
Depression;
Suicide risk;
Resilience;
Family cohesion;
Family adaptability
- From:
Sichuan Mental Health
2026;39(4):337-344
- CountryChina
- Language:Chinese
-
Abstract:
BackgroundSuicide is the second leading cause of death in adolescents. Patients with depression have a high risk of suicide， and family dysfunction is an important contributing factor of suicide. However， the mechanisms among these variables remain unclear. ObjectiveTo explore the influence of family cohesion and adaptability on the risk of suicide in adolescent inpatients with depression， and the mediating effect of depressive symptoms and the moderating effect of resilience， so as to provide references for suicide prevention and intervention. MethodsA total of 335 adolescent inpatients with depression were consecutively enrolled from October 2024 to August 2025 in a tertiary Grade A psychiatric hospital in Guangzhou. All participants met the diagnostic criteria for depression in the International Classification of Diseases， tenth edition （ICD-10）. They were assessed using the Family Adaptability and Cohesion Scale Ⅱ-Chinese Version （FACES Ⅱ-CV）， the Self-rating Depression Scale （SDS）， the Connor-Davidson Resilience Scale （CD-RISC）， the Suicidal Behaviors Questionnaire-Revised （SBQ-R） and the suicide module of the Mini-International Neuropsychiatric Interview （MINI）. A comprehensive suicide risk index was constructed. Model 4 and model 7 in the SPSS macro program Process 4.1 were used to test the mediating effect and the moderating effect， respectively. ResultsCorrelation analysis revealed that the SDS score was positively correlated with the composite suicide risk index （rs=0.663， P<0.01） but negatively correlated with the family cohesion and adaptability dimensions scores of the FACES II-CV and the CD-RISC score （rs=-0.448， -0.386， -0.576， P<0.01）. Depressive symptoms fully mediated the association between family cohesion and suicide risk， with an indirect effect of -0.491 （95% CI： -0.646–-0.352）， accounting for 89.76% of the total effect. Depressive symptoms also fully mediated the association between family adaptability and suicide risk， with an indirect effect of -0.442 （95% CI： -0.603–-0.293）， accounting for 89.11% of the total effect. Resilience significantly moderated the effect of family cohesion on depressive symptoms （β=-0.006， P<0.01） and the effect of family adaptability on depressive symptoms （β=-0.007， P<0.05）. ConclusionIn adolescent inpatients with depression， depressive symptoms may play a fully mediating role in the relationships between family cohesion/family adaptability and suicide risk， respectively， and resilience moderated the first stage of this mediating pathway. ［Funded by Guangzhou Science and Technology Plan Project （number， 2024A03J0299）］
