SOCIAL RELATIONSHIPS AND LEISURE TIME ACTIVITIES IN ADOLESCENCE AND THE RECURRENCE OF DEPRESSION AMONG FORMER ADOLESCENT PSYCHIATRIC INPATIENTS IN NORTHERN FINLAND

Background: The recurrence of depression among adolescents is a common phenomenon, for which the risk factors are not fully understood. The role of social environment and depressive symptoms has been studied previously. More research is needed to explore the underlying mechanisms of recurrent depression in adolescents. Objective: The aim of this study was to identify whether social relationships and leisure time activities are associated with a recurrent course of depression among former adolescent psychiatric inpatients. Method: We examined interview data of former adolescent psychiatric inpatients (n=508) in Northern Finland hospitalized between 2001 and 2006, and analysed the course of depression with national Finnish Care Register for Health Care data on psychiatric diagnoses until year 2016, when the age of study participants ranged from 23 to 33 years. We compared the features of social relationships and leisure time activities between those study participants with a single episode of depression and those with a recurrent course of depression. Results:Among 508 study participants, 235 (46.2%) were diagnosed with depression, and of those 35.7% had a recurrent course of depression. Adolescent female patients who reported spending leisure time mostly alone had a higher likelihood of recurrent depression (OR 4.07, 95% CI 1.23-13.45) compared to non-recurrent depression. The likelihood was also higher among those adolescent female patients who reported dissatisfaction with leisure time (OR 3.02; 95% CI 1.38-6.58). Surprisingly, adolescent male patients who reported spending time mostly with friends had a higher likelihood of recurrent depression (OR 9.36; 95% CI 1.23-71.34). Conclusions: Dissatisfaction with leisure time and loneliness were associated with a higher likelihood of recurrent depression among adolescent female patients. This finding highlights the importance of considering adolescents' social environment and potential loneliness when treating depression in this group.