Determinants of depression among ever-married adolescent girls in Bangladesh: Evidence from the Bangladesh Adolescent Health and Wellbeing Survey 2019-2020

Common mental health disorders in early life represent a major challenge and these conditions become more complicated and substantial during the development period of adolescence. Despite the global concern over the increasing prevalence of mental health issues among adolescents, it remains largely a neglected area of research and health policy in Bangladesh, where the burden of child marriage is significantly higher. This study aimed to investigate the prevalence and factors associated with depression among married adolescent girls in Bangladesh. The study utilized the data from first-ever Bangladesh Adolescent Health and Wellbeing Survey (BAHWS), conducted in 2019-2020. A total of 1,693 married adolescent girls were included in the final analysis. Depressive symptoms were measured using the standardized Patient Health Questionnaire-9 (PHQ-9) tool. Descriptive statistics were applied to assess the prevalence of depression, while bivariate analysis was done to measure the significance of the variables. Furthermore, logistic regression was used to examine the association between any form of depression and selected covariates. The overall prevalence of mild to severe levels of depression among the participants was 53.1% (Mild: 40.3%; Moderate: 9.9%; Moderately severe: 2.3%; Severe: 0.6%). In the multivariable logistic regression model, it was found that adolescents from richest wealth quintile were 35% less likely to suffer from depression (AOR = 0.65; 95% CI = 0.45-0.92; P value = 0.02). Additionally, physical violence (AOR = 1.55; 95% CI = 1.14-2.09; P value = 0.004), sexual harassment (AOR = 1.50; 95% CI = 1.11-2.01; P value = 0.007), social bullying (AOR = 2.25; 95% CI = 1.73-2.91; P value < .001), and cyberbullying (AOR = 1.75; 95% CI = 1.10-2.77; P value = 0.01) were associated with depression. This study demonstrated that more than half of the married adolescents suffer from mild to severe levels of depression, while any form of violence and harassment significantly increases their risk of depression. Therefore, a more inclusive policy is needed, engaging with communities and local stakeholders, to lay out key actions and intervention pathways to address the issue of violence against married adolescent girls as the extent and spectrum of violence continue to evolve.