The P Factor Outweighs the Specific Internalizing Factor in Predicting Recurrences of Adolescent Depression

BackgroundThe early prediction of adolescent depression recurrence poses a significant challenge in the field. This study aims to investigate and compare the abilities of two psychopathology factors, namely the general psychopathology factor (p) and the specific internalizing factor, in predicting depression recurrence over a 2-year course, as well as identifying remitted depression patients from healthy adolescents. Longitudinal changes of these two factors in different trajectory groups were also tracked to examine their sensitivity to sustained remission and relapse. MethodsWe included 255 baseline-remitted depression patients and a healthy control group (n=255) matched in age, sex, and race, sourced from the Adolescent Brain Cognitive Development Study. The Linear Mixed Model was employed to differentiate between healthy controls and remitted depression patients, predict depression recurrence, and track longitudinal changes over a subsequent 2-year course using the p factor and the specific internalizing factor respectively. ResultsThe p factor not only effectively discriminated between remitted depression patients and healthy controls, but also robustly predicted the depression recurrence over a subsequent 2-year course. The specific internalizing factor could only differentiate remitted depression patients from healthy controls. Additionally, a noteworthy longitudinal decline of the p factor in the sustained-remission group was observed. ConclusionsPsychopathology factors serve as the inherent and enduring measurement of long-term mental health aberrations. Longitudinal results indicate that the p factor is more sensitive to respond to sustained remission than the internalizing factor. The ability of the overall p factor to anticipate depression relapse, unlike the specific internalizing factor, suggests clinical interventions should monitor and mitigate the coincident symptoms across all dimensions to preempt relapse of adolescent depression, rather than an exclusive focus on internalizing symptoms.