Main points: 1.Medication Adherence Comprehensive Analysis: Through a study involving 218 adolescents with severe depression, the current status and influencing factors of medication adherence were thoroughly investigated. 2.Emphasis on Socio-Psychological Factors: Special attention was given to the impact of socio-psychological factors such as family background on medication adherence, offering valuable insights for clinical interventions. 3.Highlighting Early Intervention Measures: The findings underscored the importance of early intervention measures to enhance medication adherence and improve treatment outcomes.