Associations between family support, loneliness, and underlying depression among children and adolescents in the China family panel studies: A mediation analysis (Withdrawn Publication. See vol. 333, pg. 446, 2023)

Objective: This study aimed to assess the association between depression and family support among Chinese children and adolescents and to investigate whether loneliness could mediate this relationship.Methods: There were 2755 children and adolescents aged 18 and below from the China Family Panel Studies (CFPS) that participated in our study. Depression in children and adolescents was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Binary logistic regression combined with mediation analysis was used to examine the association between family support and depression and the mediating effect of loneliness on this relationship.Results: Of the 2755 children and adolescents, 848 (30.8 %) reported feeling lonely and 310 (11.3 %) reported feeling depressed. Multivariate logistic regression analysis showed that compared with children and adolescents with family support, children and adolescents without family support had a higher risk of loneliness (odds ratio (OR) = 1.668, 95 % confidence interval (CI): 1.318-2.111) and depression (odds ratio (OR) = 2.252, 95 % confidence interval (CI) 1.669-3.039). Mediation analysis revealed that loneliness played a partial mediating role in the association between family support and depression (beta = -0.109, P < 0.001), and the mediation proportion was 38.11 %.Conclusion: Family support affects depression directly and indirectly through loneliness. The results suggest that parents should provide more support to children and adolescents to reduce the risk of loneliness and underlying depression during the COVID-19 pandemic.