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Background/Aim. Attachment and emotion regulation skills are recognized as important factors in the development of depression, but their specifics have rarely been discussed in clinical adolescent population. The aim of our study was to investigate attachment and emotion regulation strategies in adolescents with depression. Methods. The sample consisted of 101 adolescents, age 16 to 24, divided into three groups: 1) 41 adolescents with the diagnosis of depressive disorder; 2) 30 adolescents with the diagnosis of anxiety disorder; 3) 30 health adolescents (without psychiatric diagnosis). The assessment was done by the following instruments: the Socio-demographic questionnaire; the Semistructured clinical interview (SCID-I) for the Diagnostic and Stratistical Manual of Mental Disorders, Fourth Edition (DSM-IV); the Beck Depression Inventory (BDI); the Inventory of Parent and Peer Attachment (IPPA) and Emotional Regulation Questionnaire (ERQ). Data were analyzed using MANCOVA and partial correlation, with gender, age and birth order as covariates. Results. The adolescents with depressive disorders had less secure attachment to mother and peers than the health adolescents and less secure attachment to father comparing to other two groups (MANCOVA F = 4.571; p = 0.000). The adolescents with anxiety disorder had less secure attachment to father and peers compared to the healthy adolescents group (p < 0.05). The depressed adolescents used the strategy of cognitive reappraisal less often than both control groups (MANCOVA F = 5.200; p = 0.001). Subjective experience of depressive symptoms was related to insecure attachments to both parents and peers (r = -0.457; -0.436; -0.349; p = 0.000), as well as to lower use of cognitive reappraisal (r = -0.446; p = 0.000). Conclusion. Our findings related the adolescent depression to insecure attachment in all domains, with the specific weakness in emotion regulation (weak cognitive reappraisal). The findings could have practical implications for preventive and therapeutic interventions.

There is an ongoing debate on the relationship between depression and anxiety, but data on similarities and differences in their predictor profiles are scarce. The aim of our study was to compare family and personality predictors of these disorders among 220 "emerging adults." As such, two clinical groups with noncomorbid depressive and anxiety disorders, and one healthy control group were assessed by sociodemographic questionnaires, Structured Clinical Interview for DSM-IV Disorders and NEO Personality Inventory, Revised. We found significant overlap in family and personality risk profiles, with increasing effect size for predictors common to anxiety and depression when the categories "no disorder-anxiety disorder-depressive disorder" were considered as existing along a continuum. Among the contributing factors we assessed, family psychiatric history, family structure and conflicts with parents were more significant than personality traits. Our study indicates that emerging adults may be more vulnerable to depression than anxiety in the presence of family and personality risk factors.

The dynamics of adolescence require adjustments in psychiatric treatment because of the challenges of this developmental stage in life. This column describes the Day Hospital for Adolescents (DHA) of the Institute of Mental Health in Belgrade, Serbia, which was established in December 2007. The DHA is a holistic program for the treatment of youths ages 15–25 with emotional disorders. The multicomponent therapeutic program includes individual treatment, several group therapeutic activities, and work with patients’ families and the school system. An evaluation of data obtained for 102 patients indicated that DHA treatment was associated with significant reductions in depression symptom severity and improved functioning. The adolescents reported a high level of treatment satisfaction. The results suggest that a multicomponent day hospital is an effective treatment modality for adolescents with emotional disorders.