Factors Predicting Depression Among Thai Adolescents During the Transition From the COVID-19 Pandemic to the Endemic Phase.

BACKGROUND

Adolescent depression is a major public health issue in Thailand, with post-pandemic rates at 27%-37%. While perceived stress, coping, and social support are linked to depressive symptoms, their combined predictive contributions during the COVID-19 pandemic-to-endemic transition are underexplored among Southeast Asian adolescents.

PURPOSE: This study examined the effects of perceived stress, approach coping, avoidance coping, and social support on depressive symptoms among Thai adolescents during this transition.

METHODOLOGY: A predictive cross-sectional design was used with 605 Thai high school students via multistage sampling from two central Thailand schools (September 2023-March 2024). Measures included the CES-D, Perceived Stress Scale, Self-Report Coping Measure, and revised Thai Multidimensional Scale of Perceived Social Support. Hierarchical multiple regression assessed the variance explained by each predictor.

RESULTS

Depressive symptoms were found in 27.8% of participants. Perceived stress was the strongest predictor (β = 0.664, p < 0.001), accounting for 54.3% of the variance. Avoidance coping was a significant secondary predictor (β = 0.133, p < 0.001; ΔR2 = 0.012). Approach coping and social support did not reach independent significance in the final model after perceived stress and avoidance coping were accounted for.

CONCLUSIONS

Perceived stress and avoidance coping are key modifiable predictors of adolescent depression during Thailand's pandemic-to-endemic transition. School-based psychiatric nurses should integrate stress screening, adaptive coping skills training, and family-inclusive psychoeducation to address the mental health burden among Thai youth.