Abstract
Objective
Major depressive disorder is a debilitating mental health issue that frequently emerges during childhood or adolescence. Although prior research has established the burden of depressive symptoms in young people, less is known about how depression affects quality of life (QoL), a multidimensional construct encompassing emotional, physical and social functioning. This systematic review aimed to systematically evaluate the association between depression and QoL in children and adolescents, with particular attention to domain-specific and informant effects.
Method
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE, Embase and PsycINFO were searched from inception to July 31, 2025, and reference lists of included studies were searched. Eligible studies included English-language, peer-reviewed, observational studies assessing depression and QoL using validated measures in children and adolescents (defined as samples with all participants <18 years or with a mean age <18). Studies focused on general well-being and samples with comorbidities were excluded. Risk of bias was assessed using the appropriate Joanna Briggs Institute Critical Appraisal Checklists. A structured narrative synthesis was conducted, grouping studies by comparison type (e.g., depressed vs. nondepressed groups, severity–QoL associations, domain-specific outcomes and informant differences).
Results
Twenty-seven studies (N = 28,738) met inclusion criteria. Across clinical and community samples, depression was consistently associated with lower QoL, particularly within emotional domains. Several studies also highlighted discrepancies between child and parent QoL assessments.
Conclusions
Evidence was limited by heterogeneity in measurement tools, inconsistent adjustment for confounders, item overlap between constructs and a scarcity of longitudinal designs. Nonetheless, findings underscore the significant impact of depression on children's and adolescents’ lives beyond symptom severity alone. This systematic review highlights the importance of assessing QoL alongside depression symptoms to inform comprehensive, person-centred approaches to child and adolescent mental health care. Future research should prioritize longitudinal designs and the examination of mediators and moderators that shape the depression–QoL relationship.
Plain Language Summary Title
How Depression Affects Quality of Life in Children and Teens: A Review of the Research
Depression is one of the most common mental health problems among children and teenagers, and it can affect more than just mood. Quality of life is a concept that captures how people feel and function in their daily lives, and it includes aspects such as emotional well-being, physical health, relationships, and school life. This systematic review looked at 27 studies from around the world to understand how depression is linked to quality of life in young people. The findings were clear: children and teens with depression tend to report a lower quality of life than those without depression, whether or not they have an official diagnosis. The strongest link was between depression and emotional well-being, but other areas such as friendships, school, and even physical health were sometimes affected. However, the impact on physical health was less consistent, possibly because most young people are physically healthy. Some studies compared how young people rated their own quality of life versus how their parents rated it. These results often didn't match, especially for emotional well-being, showing that it's important to get perspectives from both the child and the parent. Overall, this review highlights that treating depression in young people should focus on more than just reducing symptoms. Improving the quality of individuals' everyday lives is just as important. Future research should explore how depression and quality of life influence each other over time, and what factors help some young people maintain a good quality of life despite having depression. This information can help design better treatments that address both the emotional and practical challenges young people face.
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