| Cross-sectional studies |
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| Zhang et al.,13 2020, China |
To assess the prevalence of prenatal depression and explore its associated factors |
605 pregnant women from three hospitals in two provincial capitals (Shenyang and Zhengzhou) and one municipality (Chongqing) were included. The maximum age was 35. 433 women had no prenatal depression. 172 had prenatal depression. |
A smartphone CES-D questionnaire was used to assess prenatal depression. Resilience was measured using the 14-item Ego RS. |
N/A |
Individuals with prenatal depression had a higher likelihood (75%) of being in the group with lower resilience scores (80 or less) compared to individuals without prenatal depression (40.9%, p < 0.001). |
6/7 |
Yes |
| Elmore et al.,14 2020, United States |
To examine the associations between exposure to adverse childhood experiences and positive childhood experiences and depression |
Non-institutionalized households with at least one child between 0 and 17 in the United States were randomly selected for the survey. If the parent or caregiver had more than one child, the interviewer randomly chose a single child for the interview. These children were 8 years or older. The final sample was 40,302 children. The sample was divided between currently depressed (n = 2,174) and not currently depressed (38,128). |
Resilience and depression were measured using the NSCH survey. Depression was self-reported. In order to be a part of the depression group, parents had to answer yes to the following questions: “Has a doctor ever told you this child has...” for 26 independent health conditions. If they answered yes, a secondary question, “If yes, does this child CURRENTLY have this condition?” was answered. |
Race, age, relation to the child, insurance, adult education, special healthcare needs, and caregiver mental health. |
Children who were currently depressed were less likely to report child resilience. The presence of child resilience reduced the odds of depression fourfold. Unadjusted OR: 8.17 (manually calculated using data from Table 2); adjusted OR (95%CI); 3.74 (2.88-4.84). |
5/7 |
Yes |
| Seok et al.,15 2012, South Korea |
To assess the relationships between depressive symptoms, early-life stress, and resilience in MDD |
26 patients with MDD (seven males and 19 females; mean age of 31.9 ± 1.8 years) were recruited by hospital staff psychiatrists. 26 age and gender-matched healthy controls (mean age of 32.3 ± 1.7 years) were recruited from the community. |
Diagnosis of MDD was confirmed using the Korean version of the SCID for DSM-IV. Resilience was measured using the CD-RISC. Resilience was split into five factors. |
The control group and the group with MDD were matched based on gender and age. |
Controls had higher resilience scores than individuals with MDD. Resilience was divided into the factors below: Self-efficacy MDD: 12.8 ± 1.4 Control: 17.1 ± 1.1 T-score: -2.358 p-value: 0.022 Self-confidence MDD: 11.8 ± 1.3 Control: 20.0 ± 0.8 T-score: -5.258 P-value: < 0.001 Optimism MDD: 8.2 ± 0.7 Control: 10.9 ± 0.6 T-score: -2.860 p-value: 0.006 Self-control MDD: 5.6 ± 0.7 Control: 9.7 ± 0.5 T-score: -4.502 p-value: < 0.001 Spirituality/autonomy MDD: 5.5 ± 0.7 Control: 7.2 ± 0.5 T-score: -2.506 p-value: 0.041 |
7/7 |
Yes |
| Cha et al.,16 2014, South Korea |
To investigate the demographic and clinical factors related to resilience in euthymic patients with BD. The association between impulsivity and resilience was also investigated. |
A total of 62 outpatients with BD type I, II, and NOS who were in remission were recruited along with 62 healthy individuals matched to the BD group for age and sex. |
Cases were diagnosed in accordance with the DSM-IV-TR criteria. Resilience was measured using the CD-RISC. |
Length of education and employment status. The control group and the group with BD were matched for age and sex. |
The resilience scores were higher in controls (72.77 ± 10.14) than in individuals with BD (60.58 ± 18.89, p < 0.001). The results remained significant after adjusting for confounders. |
7/7 |
Yes |
| Ozawa et al.,17 2017, Japan |
To address the degree and quality of resilience in patients with depression in the context of remission status, spirituality/religiosity, and family members’ resilience levels |
The sample was collected from ten psychiatric hospitals and clinics in Tokyo and Saitama, Japan. The sample comprised outpatients 18 years and older. The control group were family members with no depression. There were 36 people in the control group. 100 outpatients with depression were examined. |
Depression was diagnosed with ICD-10. Resilience was measured using the 25-item RS. |
There were no significant differences between the control group and the group with depression in terms of years of education. |
The RS total score was higher in controls (118.9 ± 22.0) than in individuals with depression (100.8 ± 25.9, p < 0.001). |
6/7 |
Yes |
| Deng et al.,18 2018, China |
To examine the relationship between resilience and cognitive function in patients with schizophrenia, patients with BD, and healthy controls |
81 patients with schizophrenia and 34 with BD were recruited from the inpatient and outpatient units of the Department of Psychiatry of the Second Xiangya Hospital of Central South University, Changsha, China. 52 people were in the healthy control group. |
BD was diagnosed using the SCID for DSM-IV. Resilience was measured using the CD-RISC (Chinese version). |
Years of education, gender, marital status, and employment. The control group, the group with BD, and the group with schizophrenia were matched for age |
The resilience scores were higher in controls (69.83 ± 11.70) than in individuals with BD (61.44 ± 18.1, p < 0.02). The difference between schizophrenia, BD, and controls remained significant after adjusting for confounders. |
7/7 |
Yes |
| Bozikas et al.,19 2018, Greece |
To examine the association between resilience and social functioning in patients with BD |
40 clinically stable patients with BD type I and BD type II were included. 40 healthy controls matched for age, sex, and educational background were also included. |
BD diagnosis was completed using the DSM-IV and diagnosis was confirmed using the Greek version of the MINI. Resilience was measured using the CD-RISC. |
The control group and the group with BD were matched for age, sex, and educational background. |
The resilience scores were higher in controls (73.25 ± 9.12) than in individuals with BD (61.98 ± 12.811, p < 0.001). |
7/7 |
Yes |
| Post et al.,20 2018, Austria |
To examine to what extent resilience, internalized stigma, and psychopathology are correlated with QoL |
60 outpatients diagnosed with BD-I and 77 healthy control subjects from the general community were included. |
BD was diagnosed in accordance with the DSM-IV criteria. Resilience was measured using the 25-item RS. |
There were no significant differences between the control group and the group with BD in terms of years of education or age. |
The resilience scores were higher in controls (150.4 ± 14) than in individuals with BD (129.8 ± 2, p < 0.001). |
7/7 |
Yes |
| Vieira et al.,8 2020, Brazil |
To assess the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample |
There were 837 individuals in the control group. There were 317 individuals in the MDD group. There were 90 individuals in the BD group. |
Mood disorders were assessed using the MINI- PLUS. The severity of depressive symptoms was assessed using the MADRS scale. Resilience was measured using the 25-item RS. |
N/A |
The resilience scores were higher in controls (139.61 ± 17.60) than in individuals with MDD (129.95 ± 22.72) and BD (122.30 ± 24.77, p < 0.001). |
5/7 |
Yes |
| Uygun et al.,21 2020, Turkey |
To examine the relationship between perceived social support and resilience in individuals with BD |
90 euthymic individuals with BD and 30 controls were included. Age ranged from 18-65 years. |
Patients had already been diagnosed with BD prior to the study. Resilience was measured using the Psychological RSA. |
The control group and the group with BD were matched for age, gender, marital status, and educational level. |
The resilience scores were higher in controls (111.2 ± 4.43) than in individuals with BD (98.91 ± 17.89, p = 0.0001). |
7/7 |
Yes |
| Aroian et al.,22 2000, Russia |
To assess the relationships between resilience, demographic characteristics, immigration demands, and depression in a sample of 450 adult Russian immigrants to Israel |
450 Russian immigrants who emigrated from the former Soviet Union to Northern Israel between 1990 and 1995. 241 people had depression. 209 did not have depression. |
Depression was measured using the 13-item Depression Scale of the SCL-90-R (Russian Version). Resilience was measured using the RS developed by Wagnild and Youngís (1993). |
N/A |
The odds of not being depressed given an increase in resilience were increased about twofold (p = 0.0001). |
6/7 |
Yes |
| Hsieh et al.,23 2016, Taiwan |
To examine the relationships among recent workplace violence, depressive tendency, social support, and resilience in victimized nurses |
The sample was recruited from two hospitals in Taiwan. 159 nurses met the inclusion criteria and were divided between a group with a depressive tendency (n = 74) and a group without depressive tendencies (n = 85). |
Depressive tendency was measured using the CES-D. The cut-off used for depressive tendency was 14. Resilience was measured using the RS developed by Friborget al. (2006). |
There were no significant differences between the group without a depressive tendency and the group with a depressive tendency in terms of education or age. |
The group without a depressive tendency had higher resilience scores (157.94 ± 26.30) compared to the group with a depressive tendency (135.19 ± 15.66, p < 0.001). |
4/7 |
Yes |
| Blackmon et al.,24 2017, United States |
To examine relationships between depression, psychological resilience, and other sociodemographic factors in individuals highly exposed to Hurricane Katrina in 2005 and the Deepwater Horizon Oil Spill in 2010 |
A spatially stratified random sample of 292 Mississippi Gulf Coast residents living close to the Gulf of Mexico was assessed. 61 people (21%) had depression. 231 people did not have depression. |
Depression was measured using the CES-D. A cut-off of 16 was used. Resilience was measured using the self-rated measure from the 10-item CD-RISC. |
Education (less than high school vs. bachelor’s degree or higher), health insurance, Katrina-related damages, and oil spill-related damages. There were no significant differences between the group without depression and the group with depression in terms of gender. |
Individuals without depression had higher resilience scores (33.70 ± 6.2) than individuals with depression (27.30 ± 8.08, p < 0.001). |
6/7 |
Yes |
| Simpkin et al.,25 2018, United States |
To determine how stress from uncertainty is related to resilience among pediatric residents and whether these attributes are associated with depression and burnout |
50 residents were surveyed from pediatric residency programs at four urban freestanding children’s hospitals in North America in 2015. 5 residents fulfilled the criteria for depression. 45 were not depressed. |
Depression was measured using the HANDS. Resilience was measured using the 14-item RS. |
N/A |
Individuals without depression had higher resilience scores (85.4 ± 8.0) than individuals with depression (56.6 ± 10.7, p < 0.001). |
4/7 |
Yes |
| Poudel-Tandukar et al.,26 2019, United States |
To assess the association between resilience and anxiety or depression in Bhutanese adults resettled in Western Massachusetts |
450 Bhutanese refugees aged 20-65 residing in Massachusetts were included. 54 had depression. 171 did not have depression. |
The HSC-25 was used to measure anxiety (10-items) and depression (15 items) with a cutoff mean score of ≥ 1.75 for moderate to severe symptoms. Resilience was measured using the 25-item Wagnild and Young RS. |
Age, sex, marital status, education, occupation, time living in the United States, alcohol intake, smoking, physical activity, history of any chronic disease, coping style, and social support. |
Participants in the highest tertile by resilience scores had a significantly decreased risk of depression (OR: 0.16 [95%CI 0.04-0.60], p = 0.010). |
6/7 |
Yes |
| Yörük et al.,27 2020, Turkey |
To determine the relationship between psychological resilience, burnout, stress, and sociodemographic factors and depression in nurses and midwives during the COVID-19 pandemic |
377 midwives and nurses were included (120 with depression and 257 without depression). |
Depression was measured using the BDI. The cut-off for depression was 17. Resilience was measured using the RS for adults developed by Friborg et al. |
N/A |
The group without depression had higher resilience scores (129.78 ± 17.85) than the group with depression (114.35 ± 14.95, p < 0.001). |
4/7 |
Yes |
| Barzilay et al.,28 2020, United States |
To assess the role of resilience for healthcare workers during the COVID-19 pandemic |
This was a web survey. The total sample size was 3,042 people. |
Depression was measured using the PHQ-2. Resilience was measured with a website questionnaires developed by the authors of the article. |
Age, gender, race, education, income, occupation, marital status, country of residence, number of people in the household, and date the survey was taken. |
The study concluded that with every 1 SD increase in psychological resilience scores, there was a 69.3% decrease in the possibility of depression (OR = 0.31 [95%CI 0.252-0.383], p < 0.0001). |
5/7 |
Yes |
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Author, year, country
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Aim
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Sample characteristics
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Assessments
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Confounding factors controlled
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Follow-up duration
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Main results
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Quality
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Is resilience a protective factor against mood disorders?
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| Cohort studies |
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| Wu et al.,29 2017, China |
To examine the longitudinal effects of psychological resilience on childhood depression in a sample of left-behind children |
The sample consisted of 386 left-behind children. The mean age and range were 12.2 years (8-17). |
Depression was measured using the CDI. Resilience was measured using the Self-rating Scale of Psychological Resilience. |
Age, sex, and baseline depressive symptoms. |
A follow-up survey was completed a year later. |
Higher psychological resilience was a significant protective factor against developing depression among left-behind children (OR: 0.96 [95%CI 0.94-0.99], p = 0.001). |
8/10 |
Yes |
| Hiyoshi et al.,30 2017, Sweden |
To examine if physical and psychological characteristics in late adolescence, including factors previously linked with BD (BDI, asthma, and allergy), are associated with subsequent BD in adulthood |
The sample consisted of 213,693 men born between 1952 and 1956 who participated in compulsory military conscription assessments in late adolescence. These assessments happened between the ages of 17 and 20. Total cohort n = 213,693: BD: n = 1,495; depression: n = 7,106 |
BD and depression were measured using the ICD-8. Resilience was measured using a semi-structured interview with a psychologist. |
Age, sex, BMI, asthma, allergies, grip strength, cognitive ability, height, erythrocyte sedimentation rate, disease at conscription, region of residence, household crowding, and socioeconomic index in 1960. |
Follow-up started immediately after the conscription assessment and ended on the date of the first diagnosis of BD (or anxiety or depression), death, emigration, or 31 December, 2009, whichever occurred first. |
Higher stress resilience was associated with a lower risk of BD and depression |
9/10 |
Yes |
| Hoorelbekeet al.,31 2019, Belgium |
To test the role of positive affect as a central resilience factor following remission from depression |
85 patients were examined in a 7-day intervention that explored the interplay between five transdiagnostic vulnerabilities and protective factors in daily life. |
Depression was measured at baseline using the BDI-II-NL. Resilience was measured through self-report questionnaires associated with the intervention. |
N/A |
The follow-up period lasted for 7 days. |
The findings suggested a central role for positive affectivity as a key resilience factor because it positively impacted the cognitive risk and protective factors over time in RMD patients. |
3/10 |
Yes |
| Navrady et al.,32 2017, Scotland |
To examine whether increased neuroticism and reduced resilience are downstream mediators of genetic risk for depression and whether they contribute independently to risk |
Participants were sampled from the Generation Scotland: Scottish Family Health Study. At baseline, 664 individuals met the criteria for clinical MDD (16%) and 3,502 were non-MDD cases (84%). A total of 1,068 individuals in the mental health follow-up sample met the criteria for self-report MDD (26%), with 3098 classified as non-MDD cases (74%). |
Participants were screened for a clinical diagnosis of MDD at baseline using the SCID-I. During re-contact, self-report MDD was measured using the CIDI-SF. Resilience was measured using the Brief RS. |
Age at re-contact. |
The baseline screening took place between 2006 and 2011. In 2014, participants were contacted and invited to participate in a follow-up assessment |
Resilience protected against MDD. OR (SCID): 0.44, (95%CI 0.40, 0.48), p < 0.001 OR (CIDI-SF): 0.43, (95%CI 0.40, 0.47), p < 0.001. |
8/10 |
Yes |
| Interventional studies |
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| Konradt et al.,33 2018, Brazil |
To assess the effects of resilience on the severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression |
91 drug-free adults (18-29 years old) with MDD were included in this study. 68 patients completed the study and were assessed post-intervention. 61 patients were assessed at a 6-month follow-up. |
MDD diagnosis was measured using the SCID. The severity of depressive symptoms was measured using the HDRS. Resilience was measured using the 25-item RS. |
N/A |
Patients were assessed at baseline, post-intervention, and at six-month follow-up. |
The resilience scores at post-intervention (125.2 ± 24.2) and at six-month follow-up (128 ± 28.53) were significantly higher than at baseline (105.5 ± 22.47, p < 0.001). Also, higher baseline resilience indicated lower depressive symptoms later on. |
11/11 |
Yes |
| Seo et al.,34 2017, South Korea |
To examine whether basic military training can strengthen resilience in males with probable bipolar depression and probable unipolar depression |
All participants were men. PUD: n = 66 PBD: n = 66 Controls: n = 66 |
The MDQ scale was used to screen for bipolar depression. The CES-D scale was used to screen for unipolar depression. The CD-RISC was used to measure resilience. |
The control and mood disorder groups were matched for age, educational level, and BIS-11-R scores. |
Follow up after 5 weeks of basic military training |
There was no difference between the mood disorder group and the control group at baseline for resilience and the intervention did not change psychological resilience scores over 5 weeks. |
7/9 |
No |
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