Background: Self-esteem, life satisfaction, resilience, and coping strategies are closely linked to depression; however, their interrelationships and relative contributions to depressive outcomes remain insufficiently understood. This study aimed to examine these associations in individuals with major depressive disorder (MDD) and healthy controls and to evaluate their predictive and mediating roles in depression. Methods: This analytical cross-sectional study included 311 participants (158 patients with MDD and 153 healthy controls) recruited from the Psychiatry Outpatient Clinics of Mugla Training and Research Hospital. Psychiatric diagnoses were confirmed using the Structured Clinical Interview for DSM-5 (SCID-5). Groups were balanced for age, sex, and education using propensity score matching (PSM). Participants completed the Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Brief Resilience Scale, Brief COPE Inventory, and Beck Depression Inventory. Results: Compared with healthy controls, individuals with MDD reported significantly lower life satisfaction and resilience and higher depressive symptom severity, whereas self-esteem did not differ significantly between groups. Emotion-focused coping decreased with increasing depression severity, while avoidant coping showed a modest but significant increase in severe depression. Logistic regression analyses identified life satisfaction (OR = 0.95, p = 0.004) and resilience (OR = 0.92, p = 0.002) as significant protective predictors of depression. Mediation analyses demonstrated that life satisfaction partially mediated the relationship between self-esteem and depression, whereas resilience exerted a predominantly direct effect. Conclusion: Life satisfaction and resilience emerge as key protective factors against depression. Self-esteem appears to influence depressive outcomes indirectly through life satisfaction rather than through a direct effect. These findings underscore the importance of interventions that enhance resilience and promote positive evaluations of life in individuals at risk for depression.
Selçuk et al. (Thu,) studied this question.