European Child & Adolescent Psychiatry

, Volume 24, Issue 6, pp 695–703 | Cite as

Risk and protective factors for the development of depressive symptoms in children and adolescents: results of the longitudinal BELLA study

  • Fionna Klasen
  • Christiane Otto
  • Levente Kriston
  • Praveetha Patalay
  • Robert Schlack
  • Ulrike Ravens-Sieberer
  • The BELLA study group
Original Contribution


Mental health problems in children and adolescents are frequent, with a high risk of persistence into adulthood. Therefore, the investigation of determinants of onset and course of mental health problems is of high importance. The present paper investigates the impact of protective and risk factors on the development of depressive symptoms in children and adolescents. The BELLA study is the mental health module of the German National Health Interview and Examination Survey for children and adolescents (KIGGS). Based on the first three measurement points of the BELLA study (covering a period of 2 years), the present analysis focused on children and adolescents aged 11–17 years at baseline (n = 1,643; 50.6 % female). A longitudinal growth modelling approach was used. Mental health problems in parents (parent-reports) predicted depressive symptoms in children and adolescents (self-reports) as well as the development of these symptoms over time. Further, child-reported protective factors of self-efficacy, positive family climate and social support were associated with less depressive symptoms at baseline. Additionally, positive changes in protective factors were associated with the development of less depressive symptoms over time. Finally, family climate and social support moderated the detrimental influence of parental psychopathology on child’s depressive symptoms. The addressed determinants for the development of depressive symptoms in children and adolescents are highly relevant for prevention and intervention strategies. Future research should investigate specific risk and protective factors focusing in detail on further mental health disorders and their development in children and adolescents.


Risk factors Protective factors Mental health Depression Children and adolescents BELLA study 



The authors thank all children, adolescents, their parents and young adults who participated in this research for their time and involvement. Further, we would like to thank the Robert Koch Institute for their ongoing support and co-operation. The BELLA study has been financially supported by various grants: Baseline, 1-year follow-up and 2-year follow-up of the BELLA study were financed by the German Science Foundation. The 6-year follow-up was funded by the German Federal Ministry of Health (BMG).

Conflict of interest

None of the authors has a conflict of interest to disclose.

Supplementary material

787_2014_637_MOESM1_ESM.docx (63 kb)
Supplementary material 1 (DOCX 64 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Fionna Klasen
    • 1
  • Christiane Otto
    • 1
  • Levente Kriston
    • 1
    • 2
  • Praveetha Patalay
    • 3
  • Robert Schlack
    • 4
  • Ulrike Ravens-Sieberer
    • 1
  • The BELLA study group
  1. 1.Department of Child and Adolescent Psychiatry, Psychotherapy, and PsychosomaticsUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Medical PsychologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Evidence Based Practice UnitUniversity College London and Anna Freud CentreLondonUK
  4. 4.Robert Koch InstituteBerlinGermany

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