Examining the effects of school-vacation transitions on depression and anxiety in adolescents: network analysis.

Background: The school-vacation cycle may have impacts on the psychological states of adolescents. However, little evidence illustrates how transition from school to vacation impacts students' psychological states (e.g. depression and anxiety).

Aims: To explore the changing patterns of depression and anxiety symptoms among adolescent students within a school-vacation transition and to provide insights for prevention or intervention targets.

Method: Social demographic data and depression and anxiety symptoms were measured from 1380 adolescent students during the school year (age: 13.8 ± 0.88) and 1100 students during the summer vacation (age: 14.2 ± 0.93) in China. Multilevel mixed-effect models were used to examine the changes in depression and anxiety levels and the associated influencing factors. Network analysis was used to explore the symptom network structures of depression and anxiety during school and vacation.

Results: Depression and anxiety symptoms significantly decreased during the vacation compared to the school period. Being female, higher age and with lower mother's educational level were identified as longitudinal risk factors. Interaction effects were found between group (school versus vacation) and the father's educational level as well as grade. Network analyses demonstrated that the anxiety symptoms, including 'Nervous', 'Control worry' and 'Relax' were the most central symptoms at both times. Psychomotor disturbance, including 'Restless', 'Nervous' and 'Motor', bridged depression and anxiety symptoms. The central and bridge symptoms showed variation across the school vacation.

Conclusions: The school-vacation transition had an impact on students' depression and anxiety symptoms. Prevention and intervention strategies for adolescents' depression and anxiety during school and vacation periods should be differentially developed.