Abstract

Background/Objectives: Femicide-related orphanhood exposes children and adolescents to psychological distress and may disrupt their health-related quality of life (HRQoL). This study examined the relationships between anxiety, depression, and HRQoL among children and adolescents orphaned by femicide and tested whether depressive symptoms mediate the association between anxiety and HRQoL. Methods: A cross-sectional study was conducted with 57 children and adolescents aged 8 to 18 years who had been orphaned by femicide and were residing in the Federal District of Brazil. Participants completed the Revised Child Anxiety and Depression Scale (RCADS-25) to assess anxiety and depressive symptoms and the KIDSCREEN-27 to evaluate HRQoL. Data were analyzed using Spearman correlation coefficients, linear regression models with bootstrap procedures, and mediation analyses to explore direct and indirect relationships among variables. Results: Depressive symptoms were negatively associated with HRQoL, while anxiety symptoms showed a weaker negative association with HRQoL. In the regression analysis, depression emerged as the only significant predictor of HRQoL. Mediation analysis indicated that the relationship between anxiety and HRQoL was largely explained by depressive symptoms, suggesting a partial indirect effect of anxiety through depression. Conclusions: The findings indicate that depressive symptoms may play a central role in the relationship between anxiety and perceived quality of life among children and adolescents orphaned by femicide. These results highlight the importance of assessing both anxiety and depression in this population and suggest that interventions addressing depressive symptomatology may contribute to improving psychosocial well-being and HRQoL following exposure to severe family violence.

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