Empathy And Its Clinical Correlates In Adolescents With Depression

Objective: The incidence of psychological and behavioral problems and depression in adolescents is increasing every year,which has become an important public health problem.Patients with depression often have cognitive and affective processing disorders,and an important aspect of their impaired social cognitive functioning is empathy.Empathy,as an important susceptibility factor of depression in adolescents,may contribute to the occurrence,development and recurrence of depression to some extent.However,there are no domestic studies on empathy in adolescents with depression.The aim of this study was to investigate the empathy of adolescent depression and its related influencing factors,and to provide theoretical references for clinical treatment and prevention.Methods: Two hundred and forty two cases of adolescent patients were enrolled in 7hospitals in Anhui Province from January 2021 to July 2021,as well as 106 healthy adolescents were taken as control.A self-administered questionnaire was used to collect general demographic information,such as gender and age,etc.Clinical information included age at first presentation,total duration of illness,etc.The clinical characteristics of the participants were assessed by the CTQ,PANSI,ASLEC,CES-D,IRI,and TAS.Results: There were significant differences in mean academic performance,academic stress,relationship with peers and family economic status in the patient group compared to the healthy control group（all p<0.05）.The patient group had significantly higher scores on various clinical symptom scales,including the CTQ,PANSI,and TAS scales（all p<0.001）.In addition,the patient group had significantly lower empathy concern（EC）and perspective taking（PT）scores and significantly higher personal distress（PD）scores（both p<0.05）.In the patient group,PD scores were significantly higher in girls than in boys,PT scores were significantly lower in only child than in non-only child,and patients who had experienced school bullying had significantly higher total scores on the FS,PD and IRI scales than those who hadn’t（all p<0.05）.As academic stress increased,their total scores on the FS,EC,PD and IRI scales increased significantly;the worse the relationship with peers,the lower their PT and EC scores and the higher their PD scores;the higher the total PD and IRI scores for patients with alexithymia（all p<0.05）.PT scores were negatively correlated with emotional neglect factor（EN）and positively correlated with externally-oriented thinking;FS scores were positively correlated with externally-oriented thinking,total TAS score,interpersonal relationship factor,learning stress factor,punishment factor,health and adaptation factor and total ASLEC score;EC scores were negatively correlated with EN and positive suicidal ideation,and positively correlated with externally-oriented thinking and total TAS score;positive correlations were found for PD scores with the emotional abuse factor（EA）,total CTQ scores,PANSI,TAS,and ASLEC（except for the loss of relatives,friends and property factors）scales;total IRI scale scores were negatively correlated with EN scores and positively correlated with TAS,ASLEC（except for the loss of relatives,friends and property factors and other factors）scales（all p<0.05）.Conclusion: Patients with adolescent depression have significantly reduced empathy,accompanied by varying degrees of altered cognitive,emotional,behavioural and social processes.Reduced empathy was strongly associated with gender,peer relationships,alexithymia,suicidal ideation,childhood trauma,and negative life events in adolescents.The personality traits and behaviours associated with empathy disorders in turn affect the physical and mental health of adolescents,affect interpersonal interactions and lead to social isolation,thereby increasing the risk of self-harm and suicide.Therefore,families,schools and society should give more support and attention to adolescents with depression,improve empathy thinking and introduce alexithymia screening,which is important for the clinical diagnosis,treatment and prevention of adolescent depression.