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

Depressive symptoms in adolescents are an in-creasing public health issue in Sweden and in most Western countries. Aim: To explore how individual, psychosocial, and structural deter-minants are associated with depressive symp-toms in Swedish adolescents. Methods: A web- based 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 sym- ptoms and various determinants at the individ-ual level (self-efficacy), the psychosocial level (parental, peer, and teacher support, school de-mands, sexual harassment, and bullying) and the structural level (family affluence, having less money than friends, and parental foreign back-ground). Results: Determinants at the individual, psychosocial, and structural levels were inde-pendently associated with high levels of depres-sive symptoms in both boys and girls. The full model explained a high proportion of the vari-ance in depressive symptoms in both genders; 34.1% in boys and 36.8% in girls. The psycho-social 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 var- iables contributed as much to the full model as the rest of the psychosocial variables combined. Conclusions: Addressing psychosocial determi-nants provides the greatest benefits for prevent-ing depressive symptoms in adolescents. Ac-knowledging the association between sexual harassment and depressive symptoms for girls and having less money than their friends for boys and girls are particularly important