Recovery from mental distress in youths in low-income urban areas in South America.

PURPOSE: Improving youth mental health is a major societal challenge. In low-income urban areas in South America, this cohort study explored rates and predictors of recovery among young people with depression and/or anxiety symptoms over two years. METHODS: Adolescents (15-16 years old) and young adults (20-24 years old) with depression and/or anxiety symptoms (≥ 10 on Patient Health Questionnaire-8 and/or Generalised Anxiety Disorder-7) from low-income areas in Bogotá, Buenos Aires and Lima, were recruited from community organisations and educational institutions between April 2021 and November 2022 and reassessed after 6, 12 and 24 months. Sociodemographic characteristics, substance use, stressful life events, resilience, coping strategies, social capital, perceived social support, sports and arts activities, and social media engagement were explored as predictors of recovery. RESULTS: We recruited 1437 young people. Overall recovery rates were 30.3% after 6 months, 32.6% after one year and 37.3% after two years. In a multivariable model, female gender, younger age group, more severe initial depression and anxiety symptoms, more stressful life events in the last year and before that, lower resilience levels and higher social media engagement all predicted lower recovery rates. Interaction analyses showed a decreasing effect of baseline depression symptoms over time and a poorer recovery in female adolescents, but not young adults. CONCLUSIONS: Most young people with mental distress in low-income urban areas in South America do not recover over a two-year period. Programmes to strengthen resilience and reduce social media engagement should be developed to improve outcomes of mental distress in young people.