Determinants of adolescents' depression, anxiety, and somatic symptoms in Northwest Ethiopia: A non-recursive structural equation modeling

Abstract

Introduction In low and middle-income countries, adolescent mental health is not only a major public health challenge but also a development concern. Depression and anxiety are the most common mental health disorders and somatic symptoms often co-exist with them. Adolescents with common mental health problems are associated with an increased risk of suicide, future unemployment, and poor quality of life. However, little is known about the mental health of adolescents in Ethiopia. Thus, this study aimed to assess the determinants of depression, anxiety, and somatic symptoms among adolescents in Northwest Ethiopia, in 2022. Methods An institution-based cross-sectional study was conducted from June 8 to 24, 2022. Twostage stratified random sampling was used to select 1407 adolescents in Northwest Ethiopia. Structured and standardized self-administered questionnaires were used to collect the data. Non-recursive structural equation modeling was employed to assess the direct, indirect, and total effects of predictors. Adjusted regression coefficients and corresponding 95% confidence intervals were used to interpret the strength of the association. Results The prevalence of depression, anxiety, and somatic symptoms were 28.21% (95% CI: 25.8, 31%), 25.05% (95%CI: 22.8, 27.5), and 25.24(95% CI: 23, 27.6%) respectively. Alcohol use had a significant positive effect on depression [β = 0.14, 95% CI: 0.073, 0.201], anxiety [β = 0.11, 95% CI: 0.041, 0.188], and somatic symptoms [β = 0.12, 95% CI: 0.062, 0.211]. Stress had a significant positive effect on depression [β = 0.76, 95% CI: 0.642, 0.900], anxiety [β = 1.10, 95% CI: 0.955, 1.264], and somatic symptoms [β = 086, 95% C: 0.700, 1.025]. Depression had a direct positive effect on anxiety [β = 0.74, 95% CI: 0.508, 1.010]. Conclusion In this study, the prevalence of depression, anxiety, and somatic symptoms was moderate. Alcohol use and stress were significantly related to depression, anxiety, and somatic symptoms. The bidirectional relationship between anxiety and depression was significant. Therefore, public health interventions should focus on the bidirectional relationship between depression and anxiety, as well as on identified factors to reduce the burden of mental illness in adolescents.