Yanyue Ye,1,* Zheng Zhang,1,* Zhen Tao,3 Cui Liping,2 Yuxin Wang,1 Hui Chen,1 Sihong Li,1 Xianliang Chen,1 Huajia Tang,1 Jiawei Zhou,1 Jiansong Zhou1,* 

1Department of Psychiatry, the Second Xiangya Hospital of Central South University, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, Changsha, People’s Republic of China; 2Department of Psychiatry, Liuyang Brain Hospital, Liuyang, People’s Republic of China; 3Human Resources Department, Hebei Vocational University of Technology and Engineering, Hebei, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jiansong Zhou, Email zhoujs2003@csu.edu.cn

Objective: The purpose of this study was to explore how the congruence between academic pressure and psychological imbalance affects depressive symptoms in adolescents and to further explore grade-level differences in these effects among high school students.
Methods: The study population consisted of 29,975 high school students from 20 schools in Liuyang City, Hunan Province. The Mental Health Scale for Secondary School Students (MSSMHS) and Self-Depression Scale (SDS) were used to assess academic pressure, psychological imbalance and depressive symptoms. The effects of academic pressure and psychological imbalance were examined by polynomial regression and response surface analysis.
Results: The results showed that the lowest level of academic pressure (F = 35.99, p < 0.001), psychological imbalance (F = 54.50, p < 0.001), and depressive symptoms (F = 9.36, p < 0.001) was found in repeaters, while the highest level was found in twelfth graders. Academic pressure was positively associated with psychological disequilibrium, and both were positively associated with adolescent depressive symptoms. Furthermore, when academic pressure and psychological imbalance are aligned, adolescent depressive symptoms increase with the first two. In addition, adolescent depressive symptoms decreased as the difference between academic pressure and psychological imbalance increased.
Conclusion: This study elucidates the non-linear relationship between academic pressure, psychological imbalance and depressive symptoms, and that adopting appropriate strategies to reduce academic pressure and adjust psychological balance is crucial for the prevention of depression in adolescents.

Keywords: adolescents, depressive symptoms, academic pressure, psychological imbalance, polynomial regression analysis