Depressive Symptoms and Associated Factors among School Adolescents in Sousse-Medina: A Cross-Sectional Study

Abstract

Adolescent depression is a major public health problem and remains insufficiently detected within school environments, despite its impact on social relationships, family functioning, and academic performance. This cross sectional analytic study aimed to estimate the prevalence of depressive symptoms among school-attending adolescents in Sousse-Medina and identify factors associated with depressive symp- toms. Between November 2024 and January 2025, 390 students aged 12 to 18 years from three public schools completed an anonymous self-administered questionnaire. Depressive symptoms were measured using the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), and statistical com- parisons were performed using a 5% significance threshold. A probable depressive state (HADS-D ≥ 11) was found in 50.3% of participants, while 38.2% had borderline scores. Higher depressive levels were observed among adolescents from non-married parental settings (p = 0.001), those reporting sleep disturbances (p = 0.001), suicidal thoughts (p = 0.001), and exposure to physical aggression (p = 0.024). No significant differences were noted regarding age, sex, school performance, or substance use. The marked prevalence of depressive symptoms indicates the potential need for routine mental-health screening in schools and for strengthening psychological support services targeted toward vulnerable students.