Factors associated with symptoms of major depression in Salvadoran adolescents

Abstract

Introduction. Depression is a major cause of disability, affecting 350 million people worldwide. The 2022 National Mental Health Survey reported that four out of ten Salvadoran adolescents have symptoms of major depressive disorder. Objective. Analyze the factors associated with symptoms of major depression in Salvadoran adolescents. Methodology. A cross-sectional analytical study was conducted using data from the 2022 National Mental Health Survey. The major depression variable was analyzed using two models: binomial logistic regression and random forests, with 80 % training and 20 % test sets. Results. A total of 1209 adolescents were studied; 33.5 % exhibited symptoms of major depression. The main associated factors were behavioral problems (OR 2.22; p < 0.05), low emotional expression within the family (OR 2.124; p < 0.05), as well as the presence of adult post-traumatic stress in the household (OR 2.91; p < 0.05), the level of COVID-19-related stress (OR 2.455; p < 0.05), and low adult resilience (OR 2.165; p < 0.05). Furthermore, the random forest analysis identified a history of depression in the adult and female sex as variables with the greatest predictive importance, whereas only the statistically significant variables in the logistic regression were considered associated factors. Conclusion. This study identified the following as the main factors associated with depressive symptoms consistent with major depression: the presence of post-traumatic stress disorder in an adult in the household, COVID-19-related stress, low adult resilience, borderline behavioral problems, and low emotional expression in adolescents