Depression and suicide constitute major public health problems, and their prevalence has been increasing among adolescents in the United States. More research is needed to understand the association between multilevel risk factors and depression and suicidal ideation in adolescents, particularly factors related to perceived social rank and environmental stress. The present study examined relationships among family mental history of mental illness, in-utero and perinatal complications, social rank factors, environmental factors, and depression and suicidal ideation in the past month in a clinical population of adolescents. A cross-sectional survey was administered in outpatient clinics to 197 adolescents ages 12–18 who were primarily Black and female. Findings from structural equation modeling showed the largest effects for the social rank factor on depression and suicidal ideation in the past month. These findings highlight the importance of preventive interventions for coping with social hierarchies to prevent depression and suicidal ideation.

抑郁症和自杀是主要的公共卫生问题，其在美国青少年中的患病率一直在上升。需要更多的研究来了解多层次风险因素与青少年抑郁和自杀意念之间的关联，特别是与感知的社会等级和环境压力相关的因素。本研究调查了临床青少年人群中过去一个月的精神疾病家族史、宫内和围产期并发症、社会等级因素、环境因素以及抑郁症和自杀意念之间的关系。在门诊对 197 名 12 至 18 岁的青少年进行了一项横断面调查，这些青少年主要是黑人和女性。结构方程模型的结果显示，过去一个月社会等级因素对抑郁和自杀意念的影响最大。这些发现强调了预防性干预措施对于应对社会等级制度以预防抑郁和自杀意念的重要性。