Aims <p>This study aims to analyze the clustering characteristics of health risk behaviors in adolescents with depression, and explore the mechanism of psychological resilience and depression in childhood abuse and different health risk behavior clusters.</p> Methods <p>From July 2021 to September 2022, 413 depression adolescents were collected by convenience sampling method and reported their health risk behavior, childhood abuse, psychological resilience and depression by questionnaires. Mplus7.4 was used for latent profile analysis to identify the potential categories of health risk behaviors of adolescents with depression, and SPSS26.0 was used to analyze the chain mediating effect of resilience and depression between childhood abuse and different health risk behavior clusters.</p> Results <p>The latent profile analysis identified two potential categories of health risk behaviors in adolescents with depression: high risk behavior clusters and unhealthy lifestyle clusters. Resilience and depression played a chain mediating role between childhood abuse and high risk behavior clusters and resilience played an independent mediating role between childhood abuse and unhealthy lifestyle clusters.</p> Conclusions <p>There are two potential categories of health risk behaviors in adolescents with depression and attention should be paid to the high risk behavior clusters and focus on the role of resilience in relieving the negative effect of childhood abuse and depression on risk behaviors.</p> Clinical trial number <p>Not applicable.</p>