Background: Major depressive disorder is a highly prevalent disorder in adolescence that entails significant
lifetime risk for repeated episodes of depression and other disorders Furthermore, it can have a negative impact on academic
and psycho-social functioning with long-lasting effects. Thus, identification of the most relevant risk factors for the
continuation of major depressive disorder is important.
Method: Seventy one female adolescents between 10 and 18 years who were identified from a community sample as having
major depressive disorder were assessed regarding stress vulnerability, stress symptoms, coping behavior and physical
complaints. These variables were tested as risk factors for the persistence of major depression six months later.
Results: Factors having the highest predictive power for the continuation of major depression were avoidant coping, stress
vulnerability and stress related psychic symptoms.
Conclusions: Stress symptoms, stress vulnerability, and a strategy of avoidant coping behavior are risk factors for the prolonged
existence of major depression and should particularly be considered in prevention of major depression and intervention
for depressive symptoms.