ArticleFrontiers in psychiatry2026
Prevalence and factors associated with depressive symptoms among adolescents in Saudi Arabia after the COVID-19 pandemic: a cross-sectional study.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives: Adolescent depression has risen globally with substantial increase during COVID-19 pandemic compared with pre-pandemic levels due to multiple reasons including quarantine and school closures. This study aimed to determine the prevalence and factors associated with depressive symptoms among adolescents in Saudi Arabia after the acute phase of the COVID-19 pandemic and its associated disruptions. Methods: A multiregional cross-sectional online survey enrolled adolescents (10-18 years) in Saudi Arabia. Depressive symptoms were assessed using Patient Health Questionnaire-Adolescent version (PHQ-A). Data from PHQ-A, demographic and psychosocial data were analyzed by univariate and multivariate regression comparing adolescents with and without depressive symptoms to identify significant factors. Results: A total of 518 adolescents with a mean age of 16.60 years participated; 355 (68.5%) had depressive symptoms (mild 27.4%, moderate 19.5%, moderately severe 13.7%, severe 7.9%) and 163 adolescents (31.5%) reported no or minimal symptoms. In multivariate regression, the significant independent factors associated with depressive symptoms, were dissatisfaction with facial appearance (AOR = 3.80, p<0.001), major life challenges (AOR = 3.39, p<0.001), excellent academic level (AOR = 3.12, p=0.001), low self-esteem (AOR = 2.41, p=0.006), being in secondary/high school (AOR = 2.24, p=0.006), and academic stress (AOR = 2.10, p=0.006). Other factors identified in univariate analysis lost significance in the multivariate model. The regression model demonstrated an overall accuracy/predictability of 80.9% with excellent discrimination between adolescents with and without depressive symptoms. Conclusions: This is one of few comprehensive assessments of recent prevalence and wide-range of factors associated with depressive symptoms among adolescents. Depressive symptoms were high among adolescents even after the COVID-19 pandemic, consistent with global patterns. Psychological/personal factors including dissatisfaction with appearance, major life challenges and academic pressure were more significantly associated with depressive symptoms than sociodemographic factors. These findings can guide targeted awareness campaigns and preventive measures in Saudi Arabia and similar global settings. There is a need for identifying adolescents with depressive symptoms to provide culturally appropriate interventions including school-based screening programs, counseling services, family/teachers' engagement and accessible mental health support with particular attention to self-image concerns and academic stress.
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