Romantic relationship quality (RRQ) and break-ups (RRB) among young adults have been associated with the onset of a first major depressive episode or suicide attempts. However, the size of these associations varies across studies and the relative weight of RRB versus RRQ needs to be understood.

To investigate (1) the size of the association between adolescent RRQ/RRB and psychopathology (i.e., depression, suicide ideation, deliberate self-harm, and suicide attempt); and (2) the role of potential moderators (e.g., gender, age, and nationality).

A meta-analysis of 20 manuscripts reporting on 21 studies (n = 19623) was conducted, focusing specifically on adolescents and young adults. Studies focused on physically abusive relationships were excluded.

A model combining relationship quality and break-up yielded a highly significant association between relationship measures and depression/self-harm but the strength of this relationship was modest (r = .229). The strength of the association between depression/self-harm and RRQ (r = .279) was statistically different from RRB (r = .145) (P = .006). Location (US vs. Non-US) had no effect. Age was not significant, B = -0.005, 95% CI [-0.026, 0.016], P = .647. Gender was a weak moderator (B = .160, 95% CI [-0.021, 0.340], P = .083).

The association between psychopathology and RRQ/RRB was statistically significant but relatively small. RRQ was a stronger predictor of depression compared to RRB. This association was slightly stronger for women than for men. Implications for practice and future research will be discussed.

The authors have not supplied their declaration of competing interest.