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

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 13to 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.