| Summary: | Objective To explore the trend and the pattern of temporal changes of depressive symptoms and the association of mental toughness and demographic characteristics with the severity of depression in military personnel serving in high-altitude regions. Methods In August of 2016, 2017 and 2018, we conducted 3 group assessments of 212 military personnel serving in high-altitude regions along the Qinghai-Tibet Supply Line by cluster sampling using a self-designed demographic data questionnaire, Center for Epidemiologic Studies Depression Scale and Mental Quality Questionnaire for Armymen. The scores for mental toughness of the subjects in the 2016 assessment and the demographic data collected in 2017 were used to predict the scores of depressive symptoms of the subjects in 2018. Results In the years of 2016, 2017, and 2018, the military personnel had mean depression symptom scores of 13.61±7.62, 13.65±6.36 and 21.87±10.61, respectively, significantly higher than the national norms for Chinese youth (P < 0.05). The incidence of depressive symptoms was significantly higher in these military personnel than the norm in Chinese soldiers (P < 0.01), and their depressive symptoms showed a significant trend of aggravation with the extension of military service time (P < 0.01). Age and the length of military service time significantly affected the depressive symptoms (P < 0.05); age, time of military service and mental toughness showed significant negative correlations with depressive symptom scores among these individuals (r=-0.245 to -0.287, P < 0.001). Regulatory effect analysis showed that age could modulate the relationship between mental toughness and depressive symptoms (t=-1.768, P < 0.05), and explained 17.1% of the variance rate of depressive symptoms. Conclusion The military personnel serving in high-altitude regions have a high incidence of depression and severe depressive symptoms. Age, time of military service and mental toughness are important factors affecting the depressive symptoms. Age can modulate the relationship between mental toughness and depressive symptoms, and an older age is associated with a better use of mental toughness to prevent depression, suggesting that improving mental toughness can alleviate depressive symptoms in these personnel.
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