Depressive symptoms and suicidal ideation among Mexican adults in a syndemic analysis of chronic comorbidities and social conditions

Objective To estimate the prevalence and determinants of depressive symptoms, suicidal ideation, and their coexistence with chronic diseases in Mexican adults living in social vulnerability. Methods We analysed data from 32,087 adults (≥ 20 years) from ENSANUT Continuous 2021–2023. We built a four-category multinomial outcome aligned with the study objective. We then used multinomial logistic regression to examine associations between outcomes and sociodemographic characteristics, lifestyles, chronic comorbidities, and potential interactions. Results In this population, 15.4% reported depressive symptoms, 4.3% reported suicidal ideation, and 3.5% reported both. Women and older adults showed higher prevalence. We identified a significant interaction between diabetes, hypertension and obesity. The coexistence of chronic kidney disease and cardiovascular disease correlated with higher probability of simultaneous depressive symptoms and ideation. Social gradients heightened vulnerability, with greater probability among people in lower socioeconomic strata and in urban settings. Conclusions Depressive symptoms and suicidal ideation in Mexico operate within a syndemic framework, amplified by cardiometabolic and cardio-renal multimorbidity and by social inequalities. Integrating care for depressive symptoms and suicidal ideation within chronic disease programmes should be a public health priority.