Prevalence and Predictors of Depressive Symptoms among School-Going Adolescents in Kenya

Introduction Depression is a growing concern among adolescents, particularly in low- and middle-income countries (LMICs), such as Kenya, where mental health issues often remain unaddressed. This study aimed to assess the prevalence and factors associated with depressive symptoms among adolescents in selected public secondary schools in rural and semirural Kenya during the post-COVID-19 era. Methods This cross-sectional study was conducted among adolescents selected from 30 public secondary schools in Western Kenya via a two-stage cluster sampling method. The calculated sample was distributed proportionally across schools by type, gender, and grade to ensure representative coverage. Written informed consent and assent were obtained from all the respondents. The Patient Health Questionnaire for Adolescents (PHQ-A) was used to assess depression, whereas the Car, Relax, Alone, Forget, Friends, and Trouble (CRAFFT) and Childhood Adolescent Trauma Screener (CATS) tools were used to assess substance use and trauma exposure, respectively. These assessments were conducted via electronic data capture devices in an interview format. Descriptive statistics were used for analysis of continuous and categorical variables, whereas multivariate logistic regression models were used for correlation analysis. Results A total of 1020 adolescents (467 males, 553 females) participated in this study, with a response rate of 97.1% and a median age of 17 years. The prevalence of depressive symptoms ranged from 2.9% for moderately severe depression to 36.9% for mild depression. Approximately 5% of the screened respondents had a high risk of substance abuse-related problems, whereas 17.2% exhibited probable posttraumatic stress disorder (PTSD). Age and living away from one’s parents were key predictors of probable depression. School-related pressures, conflicts at home, trauma exposure, and a history of substance use were strongly linked to probable depression. Conversely, living with parents, holding religious beliefs and having access to a trusted adult to confide were associated with a reduced risk of depressive symptoms. Conclusion The overall prevalence of depressive symptoms was significantly high among the adolescents and strongly correlated with intrapersonal, school-related and family-related factors. These findings underscore the importance of integrating routine mental health screenings into school health programs and enhancing protective factors to mitigate the risk of depression.