Depression a Growing, Deadly Threat for Teens, Young Adults

Megan Brooks

November 15, 2016

The prevalence of major depression among US adolescents and young adults has increased substantially in recent years, and female adolescents appear most vulnerable, new research indicates.

Coupled with "little change" in mental health treatments, these trends mean that a growing number of young people have untreated depression, Ramin Mojtabai, MD, from the Bloomberg School of Public Health, Johns Hopkins University, in Baltimore, Maryland, and colleagues write.

The study was published online November 14 in Pediatrics.

Need for Action

The findings are based on data from more than 172,000 adolescents and close to 179,000 young adults who responded to the National Surveys on Drug Use and Health, annual cross-sectional surveys of the US population.

Among those aged 12 to 17 years, the 12-month prevalence of major depressive episodes (MDEs) jumped 37% from 8.7% in 2005 to 11.3% in 2014.

This translates into an increase of more than a half million adolescents with 12-month MDE between 2005 (roughly 2,200,000) and 2014 (roughly 2,700,000).

Among teenage girls, the prevalence of 12-month MDE rose from 13.1% in 2004 to 17.3% in 2014, whereas among boys, the prevalence rose from 4.5% to 5.7%.

"This aligns with past studies that also found a larger increase in depressive symptoms in girls than boys in more recent years, and recent data on trends in suicide in the United States that identified a greater increase among adolescent girls and young women," Dr Mojtabai and colleagues say.

The increase in the prevalence of MDE was more modest among young adults aged 18 to 25 years, rising from 8.8% in 2005 to 9.6% in 2014.

Demographic data show that among 12- to 17-year-olds, those with MDE are more apt to be older, not in school, and living in single-parent homes and to have substance use disorders in comparison with their peers without MDE. Among young adults aged 18 to 25 years, those with MDE are more likely to be female, black, and have a substance use disorder. The trends remained significant after adjustment for substance use disorders and sociodemographic factors.

As for treatment, the proportion of adolescents with MDE who received mental health counseling or treatment in the past 12 months for their depression from any type of healthcare provider did not change significantly between 2005 and 2014, the researchers report.

However, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents.

Nonetheless, the researchers note that the "growing number of depressed adolescents and young adults who do not receive any mental health treatment for their MDE calls for renewed outreach efforts, especially in school and college health and counseling services and pediatric practices where many of the untreated adolescents and young adults with depression may be detected and managed."

Deadly Threat

The authors of a linked commentary agree.

"Depression is a sizeable and growing deadly threat to our US adolescent population. The prioritization of youth depression treatment of our US population health is imperative," write Anne Glowinski, MD, and Giuseppe D'Amelio, of Washington University in St. Louis, Missouri.

They add that the causes behind the rise in adolescent depression should be investigated scientifically.

They also note that despite the "disturbing" rise in depression among adolescents, the percentage of young people with a history of past-year MDE seen in primary care for depression is only about 10% "and has not appreciably budged in the past decade."

Since 2007, the American Academy of Pediatrics has recommended that clinicians routinely screen youth aged 11 to 21 for depression. "Sadly, even if this important update influences primary care providers to screen more youth, there will never be enough qualified mental health specialists to take care of the 2.8 million or more adolescents per year, who, if screened and identified, will need treatment and monitoring for depression," Dr Glowinski and D'Amelio note.

The study received no funding. The authors and editorialists have disclosed no relevant financial relationships.

Pediatrics. Published online November 14, 2016. Abstract, Commentary

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