Abstract
ObjectiveMajor depressive disorder is a debilitating mental health issue that frequently emerges during childhood or adolescence. Although prior research has established the burden of depressive symptoms in young people, less is known about how depression affects quality of life (QoL), a multidimensional construct encompassing emotional, physical and social functioning. This systematic review aimed to systematically evaluate the association between depression and QoL in children and adolescents, with particular attention to domain-specific and informant effects.MethodFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE, Embase and PsycINFO were searched from inception to July 31, 2025, and reference lists of included studies were searched. Eligible studies included English-language, peer-reviewed, observational studies assessing depression and QoL using validated measures in children and adolescents (defined as samples with all participants <18 years or with a mean age <18). Studies focused on general well-being and samples with comorbidities were excluded. Risk of bias was assessed using the appropriate Joanna Briggs Institute Critical Appraisal Checklists. A structured narrative synthesis was conducted, grouping studies by comparison type (e.g., depressed vs. nondepressed groups, severity-QoL associations, domain-specific outcomes and informant differences).ResultsTwenty-seven studies (N = 28,738) met inclusion criteria. Across clinical and community samples, depression was consistently associated with lower QoL, particularly within emotional domains. Several studies also highlighted discrepancies between child and parent QoL assessments.ConclusionsEvidence was limited by heterogeneity in measurement tools, inconsistent adjustment for confounders, item overlap between constructs and a scarcity of longitudinal designs. Nonetheless, findings underscore the significant impact of depression on children's and adolescents' lives beyond symptom severity alone. This systematic review highlights the importance of assessing QoL alongside depression symptoms to inform comprehensive, person-centred approaches to child and adolescent mental health care. Future research should prioritize longitudinal designs and the examination of mediators and moderators that shape the depression-QoL relationship.