What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide.

Adolescence is a vulnerable period for psychological distress. This study aimed to comprehensively investigate the distribution of major stress-causing factors and their correlates in a large population of adolescents. A computerized self-report questionnaire was completed by 291,110 participating adolescents over a 4-year period using a cross-sectional study design. The questionnaire included items assessing demographic variables, major stressors, severity of perceived stress, and mental health outcomes such as depressed mood, suicidal ideation, and attempts. Among the major stressors, schoolwork/career was the most predominant (54.7%). However, the odds ratios for depressed mood and suicidal ideation were the highest in the stressor of conflict with peers (OR = 1.97 for depressed mood and OR = 2.00 for suicidal ideation), followed by family circumstances (OR = 1.77 and 1.94 for depressed mood and suicidal ideation, respectively). Conversely, schoolwork/career presented significantly lower odds ratios of 0.87 and 0.87 for depressed mood and suicidal ideation, respectively. This study provides important information on psychological distress related to adolescents' mental health. Although school/career was the most prevalent source of psychological stress, the odds ratios for negative health outcomes of adolescents were higher in interpersonal problems such as conflicts with parents and peers and family circumstances. The present findings might help parents and clinicians understand the psychological distress of adolescents and improve their mental health.