The social determinants of depression among adolescents in low- and middle-income countries: A scoping review

Abstract

BACKGROUND: Adolescence (ages 10 to 19 years) is a critical developmental stage marked by biological, psychological, and social transitions that heighten vulnerability to depression. During this period, depression is often under-recognised and may persist in adulthood, negatively affecting academic performance, social relationships, and well-being. Social determinants shape vulnerability and resilience, yet research on these factors, especially in low- and middle-income countries, remains limited. OBJECTIVE: This scoping review aimed to examine the role of social factors in influencing adolescent depression in low- and middle-income countries. METHOD: Following the Arksey and O'Malley framework, empirical studies published in English between 2010 and 2023 were reviewed. Forty-seven eligible studies were identified through searches of Google Scholar, PubMed, PsychINFO, Web of Science, Sociological Abstracts, Embase, and manual sources. Data were coded and synthesised using thematic and narrative analyses. Reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. RESULTS: Socio-structural factors such as gender, socioeconomic status, ethnicity, and family structure were identified as risk factors. Stressors within the family, school, and neighbourhood, including conflict, harsh parenting, maltreatment, academic pressure, peer rejection, bullying, and neighbourhood violence, also contributed to depressive symptoms. In contrast, social support from family, peers, and teachers emerged as a protective factor. CONCLUSIONS: Most studies relied on atomisation, which overlooks how social factors contribute to cumulative stress by shaping adolescents' social settings and leading to depressive symptoms. Critical gaps remain, particularly the under-exploration of neighbourhood influences and out-of-school adolescents.