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

Aim: Socioeconomic inequality is found to negatively influence mental health, but studies investigating the relationship between socioeconomic status (SES) and specific common mental health problems such as stress and depressive symptoms in the general adolescent population are needed. Moreover, gender gaps in mental health among adolescents are evident, but there is a lack of studies that investigate socioeconomic differences in mental health within genders. As girls report consistently more depressive symptoms than do boys, this systematic review specifically investigates whether socioeconomic status is associated with stress and depressive symptoms among adolescent girls in the general population. Methods: Eligible studies according to predefined inclusion criteria were identified from Medline, PsycINFO, ISI Web of Science, Svemed+ and Idunn. Eight studies were identified, whereby only two measured stress; hence, the evidence base for stress was too limited to perform an analysis. A narrative synthesis was conducted of the six studies that measured depressive symptoms. Results: A significant inverse social gradient in depressive symptoms among adolescent girls was revealed in all studies that applied parental employment status and perceived financial difficulties as SES measures, while parental educational level and Family Affluence Scale (FAS) gave inconsistent results. The relatively low number of studies may limit interpretation. Conclusions: Depressive symptoms were more common among adolescent girls with low SES compared to girls with higher SES. SES measures should be applied with care in studies of populations of adolescent girls, as the results can vary based on the chosen indicator. Actions to reduce depressive symptoms among adolescent girls in the general population should include targeting socioeconomic inequalities