Study data published in JAMA Network Open identified perceived social support as a protective factor against mental health problems among adolescents.

In a population-based cohort study of individuals living in Canada, greater perceived social support at age 19 years was significantly associated with lower rates of depression, anxiety, and suicidal ideation at age 20 years. These associations persisted even among participants with a history of mental illness.

Investigators extracted data from the Quebec Longitudinal Study of Child Development, a population-based study of participants born between 1997 and 1998 in Quebec, Canada. Participants were followed up annually from age 5 months to age 20 years for data pertaining to developmental trajectories.

At 19 years of age, perceived social support was assessed using the 10-item Social Provision Scale (SPS-10). At 20 years of age, participants were screened for depression and anxiety symptoms using the Centre for Epidemiological Studies Depression scale (CES-D) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Participants were also asked to report if they had ever experienced suicidal ideation or attempted suicide.

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Covariates of interest included sex, family socioeconomic status, family functioning, and medical history. These covariates were extracted from surveys administered when participants were aged 15 and 17 years. Multinomial logistic regression was used to assess the relationship between social support and psychiatric symptoms. Models were adjusted for the relevant covariates.

The present analyses used data from 1174 participants, among whom 574 (48.9%) were girls and 600 (51.1%) were boys. Mean SPS-10 scores were significantly lower among boys compared with girls (26.36±4.27 vs 27.06±3.80; P =.003), suggesting lower perceived social support.

At 1 year, a total of 289 participants (24.6%) reported moderate depression symptoms and 67 (5.7%) reported severe depression symptoms. Additionally, 100 (8.5%) and 61 (5.2%) individuals reported moderate and severe anxiety symptoms, respectively.

The prevalence rates of suicidal ideation and suicide attempt were 10.3% and 2.5%, respectively. Depression and anxiety symptoms were generally more common among participants who were girls. However, no sex-based differences were observed for suicide-related outcomes.

In adjusted regression models, individuals who reported a higher level of social support at age 19 years reported fewer mental health problems 1 year later. Specifically, for each 1 standard deviation increase in social support, the odds of suicide ideation decreased by 41% (odds ratio [OR], 0.59; 95% CI, 0.50-0.70) and the odds of suicide attempt decreased by 40% (OR, 0.60; 95% CI, 0.46-0.79).

Each 1 standard deviation increase in social support also lowered the odds for severe depression (OR, 0.53; 95% CI, 0.42-0.66) and severe anxiety (OR, 0.78; 95% CI, 0.62-0.98) by 47% and 22%, respectively.

Per these data, efforts to increase social support among adolescents and young adults may be important to decreasing the prevalence of mental health problems.

The primary study limitation was the use of self-reported measures to capture social support and psychiatric symptoms rather than clinical tests or medical records. Further studies should investigate whether social support as measured from other sources is also protective against anxiety and depression.

“Emerging adulthood is a transitional life period marked by a high prevalence of [mental health problems (MHPs)],” investigators wrote. “This study provides evidence on the benefits associated with social support for MHP and suicide-related outcomes during this life-period, even in individuals who experienced MHPs in an earlier stage of development.”


Scardera S, Perret LC, Ouellet-Morin I, et al. Association of social support during adolescence with depression, anxiety, and suicidal ideation in young adults. JAMA Netw Open. 2020;3(12):e2027491. doi:10.1001/jamanetworkopen.2020.27491