Exploring protective factors in a high-risk subsample: the pivotal role of paternal support in preventing depression in a cohort of young adults

Abstract Objective: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. It is crucial to identify protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socioeconomic vulnerabilities. Methods: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [standard deviation {SD} = 2.18]) across three waves, using multiple regression models to analyze higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in waves 1 and 2 and their association with MDD resilience at wave 3. Results: In the high-risk group, MDD incidence was 13.7% (n = 24). Paternal support had a protective effect on MDD incidence (odds ratio [OR] = 0.366; 95% confidence interval [95%CI] 0.137 to 0.955; p = 0.040) and suicide attempt risk (OR = 0.380; 95%CI 0.150 to 0.956; p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95%CI 0.953 to 0.997; p = 0.030), correlating with reduced Beck Depression Inventory (BDI) (r = 0.0484; B = −0.2202; 95%CI −0.3572 to −0.0738; p = 0.003) and Montgomery-Åsberg Depression Rating Scale (MADRS) scores (r = 0.0485; B = −0.2204; 95%CI −0.3574 to −0.0741; p = 0.003). Conclusion: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights the crucial role of fathers in family-based interventions and in promoting resilience in high-risk populations.