Trends in US Youth Reported Major Depressive Episodes, 2008-2018

​Gottschlich EA, Tang SS, Larson K

Accepted for 2020 Pediatric Academic Societies Annual Meeting

Background: Adolescent suicide rates have risen dramatically over the past decade. Less is known about trends in major depressive episodes among this age group, particularly from the unique perspective of youth themselves.

Objectives: Measure the overall trend in youth reported past year major depressive episodes from 2008 to 2018, and examine trends and current rates by demographic subgroups.

Methods: The National Survey on Drug Use and Health (NSDUH) is an annual in-person interview that collects information on mental health issues from a nationally representative sample of US individuals 12 years and older. Data from the 2008 through 2018 NSDUH (N=172,087) were analyzed to examine youth report of having experienced a major depressive episode (defined as a depressed mood, loss of interest or pleasure in daily activities, and 4 of 7 other symptoms for at least 2 weeks) in the past year, based on the Diagnostic and Statistical Manual of Mental Disorders. The overall trend in the percent of youths (ages 12-17) reporting a past year major depressive episode is described for 2008 through 2018. Comparisons between 2008 and 2018 are made by demographic subgroups (age, gender, race/ethnicity, family income, father in household, and private health insurance). Statistical significance of the change from 2008 to 2018 is determined using 95% confidence intervals.

Results: Between 2008 and 2018, the portion of youths reporting a major depressive episode rose from 8.4% to 14.5%, a relative increase of 73% (Figure). Over the study period, significant increases were seen for nearly all demographic subgroups (Table). Those with a family income of $50,000-$74,999 and Hispanic youths saw relative increases greater than 100%. Notable increases also occurred among older teens (relative increases of 91% and 85% for 15-year-olds and 17-year-olds, respectively) and males (relative increase of 80%).

In 2018, females (21.4%) and older youths (17-year-olds=19.2%; 16-year-olds=18.5%; 15-year-olds=18.1%) were most likely to report a major depressive episode (Table). Some variation was also found by race/ethnicity, ranging from 15.2% (non-Hispanic white) to 11.0% (non-Hispanic black).

Conclusion: In 2008, less than 1 in 10 youths reported experiencing a major depressive episode, but in 2018 almost 15% reported a major depressive episode. Rates have increased for almost everyone over the past decade. Age and gender disparities exist, with older youths and females having the highest rates of reported major depressive episodes in 2018.