Depressive symptoms and the associations with individual, psychosocial, and structural determinants in Swedish adolescents

Abstract

Depressive symptoms in adolescents are an increasing public health issue in Sweden and in most Western countries. Aim: To explore how individual, psychosocial, and structural determinants are associated with depressive symptoms in Swedish adolescents. Methods: A webbased questionnaire was answered by 1193 13-to 16-year-old boys (n = 566) and girls (n = 627). Stepwise logistic regressions were employed to analyse the association between depressive symptoms and various determinants at the individual level (self-efficacy), the psychosocial level (parental, peer, and teacher support, school demands, sexual harassment, and bullying) and the structural level (family affluence, having less money than friends, and parental foreign background). Results: Determinants at the individual, psychosocial, and structural levels were independently associated with high levels of depressive symptoms in both boys and girls. The full model explained a high proportion of the variance in depressive symptoms in both genders; 34.1% in boys and 36.8% in girls. The psychosocial level contributed the most to explaining the variance in depressive symptoms in boys. In girls, when harassment variables were separated from psychosocial variables, the harassment variables contributed as much to the full model as the rest of the psychosocial variables combined. Conclusions: Addressing psychosocial determinants provides the greatest benefits for preventing depressive symptoms in adolescents. Acknowledging the association between sexual harassment and depressive symptoms for girls and having less money than their friends for boys and girls are particularly important.

Participation and support – associations with Swedish pupils’ positive health

“…[24]. Inspired by the Ottawa Charters [25] definition of health, the PHS scale was designed based on the Salutogenic theory to identify resources that can be used to strengthen an individual and improve health. The PHS measures mental and cognitive aspects of health using positive worded questions [24].…”

“…The answer alternatives: “always” and “often” were categorised as having high personal affluence, while the response alternatives: “sometimes”, “rarely” and “never” had low personal relative affluence. It is important to note that absolute SES of a student is not determined by this variable; however, it is shown to be a stable indicator of relative economic affluence, which has been correlated in another study to mental health [25]. …”

Peer integration, teacher-student relationships and the associations with depressive symptoms in secondary school students with and without special needs

“…schools are of high importance because they have an impact on students´academic, social, emotional and mental health development (Kidger et al 2012;Låftman and Östberg 2006). Several studies indicated that poor peer integration and poor teacherstudent relationships were associated with high levels of depressive symptoms in students (Gooren et al 2011;Raufelder 2014;Zetterström Dahlqvist, Landstedt, and Gillander Gådin 2012;Zimmer-Gembeck, Hunter, and Pronk 2007). Longitudinal research has identified problems in peer integration and a low quality of teacher-student relationship as predictors of depression (Landstedt, Hammarström, and Winefield 2015;Rudasill et al 2014;van Lier and Koot 2010).…”

The social gradient in stress and depressive symptoms among adolescent girls: A systematic review and narrative synthesis

“…No significant correlation between education and depressive symptoms in girls in adjusted models, only in crude model. Dahlqvist et al 2012. Depressive symptoms and the associations with individual, psychosocial, and structural determinants in Swedish adolescents.…”

“…Sweden. Design: Cross sectional, sample size 628; SES: Family Affluence Scale (FAS), "Money as friends"; Outcome: Depressive symptoms, Center for Epidemiologic Studies Depression Scale (CES-D) (34).…”