The Social Determinants of Depression among Adolescents in Low- and Middle-Income Countries: A Scoping Review

In Low and Middle Income Countries (LMICs), adolescent depression is one of the leading mental health problems with serious implications, posing a significant public health concern. A comprehensive understanding of adolescent depression and the development of effective intervention strategies require not only an examination of its biological and psychological determinants but also a critical analysis of the social factors influencing its prevalence and impact. This scoping review, guided by Arksey and OMalleys framework, examined the social factors influencing adolescent depression. A total of 48 primary studies were included, identified through a systematic search across five databases and manual exploration of relevant literature from various LMICs. This review identified structural factors including gender, socioeconomic status, ethnicity, and family structure alongside stressors in family, school, and neighborhood settings, such as conflict, harsh parenting, maltreatment, academic pressure, peer rejection, bullying, and neighborhood violence, as key contributors to adolescent depression. Conversely, social support from family, peers and teachers was found to be a protective factor against depression. However, these studies are primarily cross-sectional, with a predominant focus on Asia and limited attention to neighborhood-level factors, often concentrating on school-going adolescents. Furthermore, the studies are largely descriptive and atomized, inadequately exploring the domains and their interplay with social structures in shaping adolescent depression.