Abstract
BACKGROUND: Research on mental health problems among Muslim adolescents living in ongoing long-term civil conflict areas of Thailand is scarce. Thus, this study aims to measure the prevalence of depression and examine its influencing factors among adolescents in this type of area, Thailand’s three southernmost provinces. METHODS: This study employed 2021 household survey data collected in Thailand’s three southernmost provinces —Yala, Pattani, and Narathiwat. The studied samples included adolescents aged 13–17; 179 were males, and 208 were females. Depression was measured using the Center for Epidemiologic Studies of Depression Scale (CES-D), Thai Version, a 20-item and 4-point scale (0–3). The cut-off score for the risk of depression was 22. The binary logistic models were used to examine the effects of family- and mental health-related and other potential covariate factors on depression. RESULTS: The CES-D scores ranged from 0 to 41 in this study. The mean score was 10.05 with a standard deviation (SD) of 6.26, and 7.2% of the samples were at risk of depression. The adjusted binary logistic regression revealed that there were two factors significantly associated with depression. Adolescents living in dysfunctional families were 3.2 times more likely to be depressed than those who were in functional families (AOR 3.20, 95% CI 1.18–8.15, p-value 0.023). Adolescents experiencing post-traumatic stress disorder (PTSD) were 32.7 times more likely to be depressed than their counterparts (AOR 32.74, 95% CI 4.08–267.76, p-value 0.001). Other family- and mental health-related factors did not show a significant association. CONCLUSION: These findings emphasized the influence of family function and PTSD on adolescents’ depression. Programs that promote positive family communication, parental support, and early screening for trauma-related symptoms are essential for people in these areas. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27071-3.