Emotional and Early Maladaptive Schemas in Adolescents Diagnosed With Major Depressive Disorder

Early maladaptive schemas and dysfunctional emotional schema beliefs are implicated in adolescent major depressive disorder; however, their relationship with comorbid anxiety disorders remains unclear.

In this cross-sectional controlled cohort study, 87 adolescents diagnosed with major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and 100 healthy controls completed the Young Schema Questionnaire-Short Form 3, the Leahy Emotional Schema Scale, the Beck Depression Inventory, and the Screen for Child Anxiety Related Emotional Disorders. Hierarchical regression analyses examined predictors of depressive symptom severity.

Adolescents with major depressive disorder demonstrated significantly higher early maladaptive schema and emotional schema scores than controls. Comorbid anxiety disorders were associated with greater schema pathology. In hierarchical regression analyses, LESS-II total score emerged as the strongest independent correlate of depressive symptom severity.

Schema-related dysfunction is prominent in adolescent depression, particularly when anxiety is present.