Purpose: The aim of this study was to investigate the association between interpersonal relationships and the risk of MDD in freshmen. Methods: 6,947 participants without baseline MDD (lifetime) completed the 1-year follow-up survey in 2019. Demographic information, interpersonal relationship scores measured by the Chinese version of Interpersonal Relationship Comprehensive Scale, depression severity at baseline screened with Patient Health Questionnaire-9, lifetime severe traumatic events and MDD at baseline and follow-up survey screened via the Composite International Diagnostic Interview 3.0 were collected. Logistic regression was performed to quantify the associations between interpersonal relationships and the new-onset of MDD. Results: The baseline total relationship score (9 to 14, mild relationship distress) and the dimension score of dealing with people were positively associated with MDD incidence, respectively (OR total score=1.68, 95%CI: 1.16-2.43; OR dealing with people=1.39, 95%CI: 1.10-1.75). Interpersonal relationship score was not associated with MDD in participants without baseline depressive symptoms. However, it was positively associated with MDD (OR=2.10, 95%CI: 1.40-3.15) among participants with baseline depressive symptoms. There was a statistically significant interactions between dealing with people and baseline PHQ-9 score for the risk of MDD. Conclusions: Interpersonal relationship perplex can increase the risk of MDD in college students. College students suffering from depressive symptoms without MDD yet who have interpersonal disorder deserve more attention in terms of prevention against MDD.
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