Biopsychosocial and Contextual Risk Factors for Adolescent Depressive Symptoms in Thailand: A Systematic Review
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Objective: This systematic review aimed to synthesize evidence on biopsychosocial and contextual factors associated with depressive symptoms among Thai adolescents.
Methods and Materials: A systematic review was conducted following PRISMA 2020 guidelines. Four electronic databases, including CINAHL, PubMed, Thai Journal Citation Index Center, and Thai Journal Online, were searched for studies published between 2015 and 2025. Eligible studies were cross-sectional studies examining factors associated with depressive symptoms among Thai adolescents aged 10–19 years using validated screening instruments. The review protocol was registered in PROSPERO (CRD420251047610). Methodological quality was assessed using the adapted Newcastle–Ottawa Scale. Due to heterogeneity in populations, instruments, and reported effect measures, findings were synthesized narratively.
Findings: From 308 identified records, 21 cross-sectional studies involving 19,119 adolescents were included. Six studies were rated as very good quality, 14 as good quality, and one as satisfactory. Depressive symptoms were assessed mainly using PHQ-9, CES-D, CDI, and TMHQ. Repeatedly reported biological factors included female sex, obesity, low health-related behaviors, and substance use. Psychological factors included stress, bullying victimization, low self-esteem, low resilience, maladaptive coping, internet or game addiction, social comparison, and interpersonal distress. Social-contextual factors included low family support, domestic violence, parental divorce or separation, childhood maltreatment, low household income, parental psychiatric history, family-related stress, peer problems, friendship or romantic stress, and limited peer support.
Conclusion: Depressive symptoms among Thai adolescents were associated with multiple interacting biological, psychological, familial, and social-contextual factors. Because all included studies were cross-sectional, causal relationships cannot be inferred.
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