Tree-drawing test characteristics as potential predictors of adolescent depressive disorders

This study examined the relationship between adolescent depressive disorders and drawing characteristics identified in the Tree-Drawing Test (TDT) and developed a predictive model based on TDT features. Participants included 48 adolescents diagnosed with depressive disorders and 32 healthy controls. All participants completed the TDT and the Self-Rating Depression Scale (SDS). Group differences in drawing characteristics were analyzed using chi-square tests. Binary logistic regression analysis was conducted with depressive disorder status (presence vs. absence) as the dependent variable and selected drawing characteristics as independent variables to identify significant predictors. Significant differences between the depression and control groups were found across 10 drawing characteristics. Logistic regression analyses indicated that tree shading or darkened areas (odds ratio [OR] = 4.155, p = 0.045), overly detailed depiction of the tree (OR = 7.094, p = 0.007), and disorganized crown lines (OR = 7.828, p = 0.003) were potential independent predictors of adolescent depressive disorders. A logistic model incorporating these three characteristics achieved an overall classification accuracy of 83.8% and an area under the receiver operating characteristic curve (AUC) of 0.900. These findings provide preliminary evidence that the TDT may serve as a useful supplementary tool for the assessment of depressive disorder in adolescents. Further validation in larger and independent samples is required.