Prevalence of Depression Among Adolescents in the U.S. From 2009 to 2019: Analysis of Trends by Sex, Race/Ethnicity, and Income

Miron O., Yu K., Wilf-Miron R., Kohane I.S.

This study uses Centers for Disease Control and Prevention (CDC) data to characterize trends in suicide rates among adolescents and young adults aged 15 to 24 years in the United States and to determine if the increase in suicide rates observed in years 2000-2016 is continuing.

Keyes K.M., Gary D., O’Malley P.M., Hamilton A., Schulenberg J.

Mental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018. Data are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students (N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age–period–cohort effects estimated using the hierarchical age–period–cohort models. Among girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999–2004. Depressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.

Twenge J.M., Cooper A.B., Joiner T.E., Duffy M.E., Binau S.G.

Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends in mood disorders and suicide-related outcomes since the mid-2000s. Rates of major depressive episode in the last year increased 52% 2005–2017 (from 8.7% to 13.2%) among adolescents aged 12 to 17 and 63% 2009–2017 (from 8.1% to 13.2%) among young adults 18–25. Serious psychological distress in the last month and suicide-related outcomes (suicidal ideation, plans, attempts, and deaths by suicide) in the last year also increased among young adults 18–25 from 2008–2017 (with a 71% increase in serious psychological distress), with less consistent and weaker increases among adults ages 26 and over. Hierarchical linear modeling analyses separating the effects of age, period, and birth cohort suggest the trends among adults are primarily due to cohort, with a steady rise in mood disorder and suicide-related outcomes between cohorts born from the early 1980s (Millennials) to the late 1990s (iGen). Cultural trends contributing to an increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s, including the rise of electronic communication and digital media and declines in sleep duration, may have had a larger impact on younger people, creating a cohort effect.

Clayborne Z.M., Varin M., Colman I.

Experiencing depression in adolescence can disrupt important developmental processes, which can have longstanding effects on socioeconomic status and relationships. The objective of this article was to systematically review the evidence examining associations between adolescent depression and adult psychosocial outcomes.Five databases (MEDLINE, Embase, PsycINFO, CINAHL, and ERIC) were searched for articles published from 1980 through March 2017. Eligible articles were peer reviewed, published in English, had prospective cohort study designs, and contrasted adult psychosocial outcomes in those with versus without adolescent depression. Outcomes with sufficient data were pooled using random-effects meta-analyses, with summary measures reported as odds ratios (ORs). A protocol for this review was registered on PROSPERO (CRD42017059662).Of the 4,988 references screened for inclusion, 31 articles comprising 136 analyses were included for review. Twenty-four cohorts were represented. Seventy-seven analyses across 10 outcomes were meta-analyzed, with remaining analyses summarized narratively. Meta-analyses suggested that adolescent depression was associated with outcomes including, but not limited to, failure to complete secondary school (OR 1.76, 95% CI 1.29-2.39), unemployment (OR 1.66, 95% CI 1.29-2.14), and pregnancy/parenthood (OR 1.38, 95% CI 1.06-1.81).This review demonstrates that adolescent depression is associated with a myriad of adult psychosocial outcomes. Many are linked and can lead to the propagation of difficulties across the lifespan. These findings can have important implications for encouraging the provision of targeted mental health care early in development to improve life chances.

Johnson D., Dupuis G., Piche J., Clayborne Z., Colman I.

Adolescent depression may increase risk for poor mental health outcomes in adulthood. The objective of this study was to systematically review the literature on the association between adolescent depression and adult anxiety and depressive disorders as well as suicidality.EMBASE, MEDLINE, and PSYCinfo databases were searched and longitudinal cohort studies in which depression was measured in adolescence (age 10-19) and outcomes of depressive disorders, anxiety disorders, or suicidality were measured in adulthood (age 21+), were selected. Meta-analysis using inverse variance and random effects modeling, along with sensitivity analyses, were used to synthesize article estimates.Twenty articles were identified, representing 15 unique cohorts. Seventeen of 18 articles showed adolescent depression increased risk for adult depression; eleven pooled cohorts estimated that adolescents with depression had 2.78 (1.97, 3.93) times increased odds of depression in adulthood. Seven of eight articles that investigated the association between adolescent depression and any adult anxiety found a significant association. Three of five articles showed a significant association between adolescent depression and adult suicidality.This review shows that adolescent depression increases the risk for subsequent depression later in life. Articles consistently found that adolescent depression increases the risk for anxiety disorders in adulthood, but evidence was mixed on whether or not a significant association existed between adolescent depression and suicidality in adulthood. Early intervention in adolescent depression may reduce long-term burden of disease.

Ribeiro J.D., Huang X., Fox K.R., Franklin J.C.

BackgroundMany studies have documented robust relationships between depression and hopelessness and subsequent suicidal thoughts and behaviours; however, much weaker and non-significant effects have also been reported. These inconsistencies raise questions about whether and to what degree these factors confer risk for suicidal thoughts and behaviours.AimsThis study aimed to evaluate the magnitude and clinical utility of depression and hopelessness as risk factors for suicide ideation, attempts and death.MethodWe conducted a meta-analysis of published studies from 1971 to 31 December 2014 that included at least one longitudinal analysis predicting suicide ideation, attempt or death using any depression or hopelessness variable.ResultsOverall prediction was weaker than anticipated, with weighted mean odds ratios of 1.96 (1.81–2.13) for ideation, 1.63 (1.55–1.72) for attempt and 1.33 (1.18–1.49) for death. Adjusting for publication bias further reduced estimates. Effects generally persisted regardless of sample severity, sample age or follow-up length.ConclusionsSeveral methodological constraints were prominent across studies; addressing these issues would likely be fruitful moving forward.Declaration of interestNone.

Pontes N.M., Ayres C.G., Lewandowski C., Pontes M.C.

This research used four consecutive waves of data from the National Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control (CDC), to estimate linear time trends by gender in the prevalence of school and electronic bullying victimization among U.S. high school students (N = 61,042). Dependent variables were student self-reported school bullying victimization and electronic bullying victimization during the previous 12 months. Independent variables used to estimate multiple logistic regression models by gender were survey year, race/ethnicity, and grade level. Results showed the prevalence of school bullying increased significantly among females from 2009 (21.2%) to 2015 (24.8%), linear trend OR = 1.08 [1.04, 1.12]; and decreased significantly among males from 2009 (18.7%) to 2015 (15.8%), linear trend OR = 0.93 [0.89, 0.98]. Prevalence of electronic bullying was unchanged between 2011 to 2015 among both male and female students. Asian race, relative to White race, was associated with significantly lower rates of both school and electronic bullying victimization among females, but not males. The incidence of school and electronic bullying victimization was significantly lower among Black and Hispanic students, but not among multiple-race students, regardless of student gender. Healthy People 2020 set a goal to reduce school bullying victimization 10% by 2019. As of 2015, school bullying victimization decreased significantly among males (16% decrease); it significantly increased among females (17% increase). Future research should explore underlying factors related to these divergent trends, and develop effective strategies to reverse the alarming rise in female school bullying victimization.

Twenge J.M., Krizan Z., Hisler G.

Insufficient sleep among adolescents carries significant health risks, making it important to determine social factors that change sleep duration. We sought to determine whether the self-reported sleep duration of U.S. adolescents changed between 2009 and 2015 and examine whether new media screen time (relative to other factors) might be responsible for changes in sleep.We drew from yearly, nationally representative surveys of sleep duration and time use among adolescents conducted since 1991 (Monitoring the Future) and 2007 (Youth Risk Behavior Surveillance System of the Centers for Disease Control; total N = 369,595).Compared to 2009, adolescents in 2015 were 16%-17% more likely to report sleeping less than 7 h a night on most nights, with an increase in short sleep duration after 2011-2013. New media screen time (electronic device use, social media, and reading news online) increased over this time period and was associated with increased odds of short sleep duration, with a clear exposure-response relationship for electronic devices after 2 or more hours of use per day. Other activities associated with short sleep duration, such as homework time, working for pay, and TV watching, were relatively stable or reduced over this time period, making it unlikely that these activities caused the sudden increase in short sleep duration.Increased new media screen time may be involved in the recent increases (from 35% to 41% and from 37% to 43%) in short sleep among adolescents. Public health interventions should consider electronic device use as a target of intervention to improve adolescent health.

Weinberger A.H., Gbedemah M., Martinez A.M., Nash D., Galea S., Goodwin R.D.

AbstractBackgroundMajor depression is associated with significant disability, morbidity, and mortality. The current study estimated trends in the prevalence of major depression in the US population from 2005 to 2015 overall and by demographic subgroups.MethodsData were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons ages 12 and over (total analytic sample N = 607 520). Past-year depression prevalence was examined annually among respondents from 2005 to 2015. Time trends in depression prevalence stratified by survey year were tested using logistic regression. Data were re-analyzed stratified by age, gender, race/ethnicity, income, and education.ResultsDepression prevalence increased significantly in the USA from 2005 to 2015, before and after controlling for demographics. Increases in depression were significant for the youngest and oldest age groups, men, and women, Non-Hispanic White persons, the lowest income group, and the highest education and income groups. A significant year × demographic interaction was found for age. The rate of increase in depression was significantly more rapid among youth relative to all older age groups.ConclusionsThe prevalence of depression increased significantly in the USA from 2005 to 2015. The rate of increase in depression among youth was significantly more rapid relative to older groups. Further research into understanding the macro level, micro level, and individual factors that are contributing to the increase in depression, including factors specific to demographic subgroups, would help to direct public health prevention and intervention efforts.

Das J.K., Salam R.A., Lassi Z.S., Khan M.N., Mahmood W., Patel V., Bhutta Z.A.

Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n = 8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]: -.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing depression score (SMD: -.66; 95% CI: -1.25 to -.08) with no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31-11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms. The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups, socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors.

Fink E., Patalay P., Sharpe H., Holley S., Deighton J., Wolpert M.

To examine the changes in mental health difficulties in early adolescence between 2009 and 2014 in England.Analysis reports on data from two cross-sectional samples of adolescents (aged 11-13 years) collected 5 years apart in 2009 and 2014 in secondary schools across England. Samples were matched using propensity scoring, resulting in a total pooled sample of 3,366 adolescents. Mental health difficulties were reported by participants using the Strengths and Difficulties Questionnaire.Overall, there were similar levels of mental health difficulties experienced by adolescents in 2009 and 2014. Notable exceptions were a significant increase in emotional problems in girls and a decrease in total difficulties in boys in 2014 compared to 2009.The increased prevalence of emotional problems in girls mirrors a trend found in other similar studies, and the results are discussed in the context of recent economic and societal changes. The small decrease in total difficulties in boys, although promising, clearly warrants further research.

Bor W., Dean A.J., Najman J., Hayatbakhsh R.

Objective: Up to one in five children experience mental health problems. Social and cultural factors may influence emergence of mental health problems. The 21st century has led to changes in many of these factors, but it is unclear whether rates of internalizing and externalizing problems have also changed in recent cohorts of young people. Methods: A comprehensive literature search was undertaken to locate cohort or population studies that examined changes in mental health of children over time, where participants were aged 18 years and under, and the time frame for change was at least 10 years, with data for at least one time point in the 21st century being statistically compared to at least one time point in the 20th century. Studies were reviewed for quality and outcome. Results: Nineteen studies met criteria for review. These included studies of toddlers, children, and adolescents. Seventeen studies examined internalizing problems, and 11 studies examined externalizing problems. For both children and toddlers, recent cohorts did not exhibit worsening of mental health symptoms. In adolescents, the burden of externalizing problems appear to be stable. However, the majority of studies report an increase in internalizing problems in adolescent girls. The findings for internalizing problems in boys were mixed. Conclusions: These findings suggest that recent cohorts of adolescent girls are experiencing increases in internalizing symptoms compared to previous cohorts. Approaches for prevention and early intervention should be explored.

Merikangas K.R., He J., Burstein M., Swanson S.A., Avenevoli S., Cui L., Benjet C., Georgiades K., Swendsen J.

To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates.The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2% (11.2% with mood disorders, 8.3% with anxiety disorders, and 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for substance use disorders.These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every four to five youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention.

Kessler R.C., Üstün T.B.

This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection. Copyright © 2004 Whurr Publishers Ltd.

Simon G.E.

Social and economic effects of mood disorders include functional impairment, disability or lost work productivity, and increased use of health services. Evidence for these impacts includes cross-sectional studies, longitudinal studies, and true experiments (randomized trials of specific treatments or treatment programs). With respect to unipolar depression, strong evidence demonstrates that depression is associated with significant functional impairment and that effective treatment helps to restore function. Studies of the effect of depression on work disability and health care costs show strong cross-sectional associations (i.e., greater disability and higher costs among those with depression) and longitudinal associations (i.e., improvement in depression is associated with reduced disability and lower costs). All of these findings regarding unipolar depression seem as consistent in the subgroup of patients with comorbid chronic medical illness as in the total population with depressive disorders. Fewer data are available regarding social and economic burden of bipolar disorder, but available data show cross-sectional associations between mood symptoms and functional impairment, disability, and health care costs. Taken together, these data describe the substantial social and economic burden of mood disorders and the potential benefits of more effective treatment. We must recall, however, that economic benefits of treatment for mood disorders are secondary to the principal objective of relieving human suffering.

Winston-Lindeboom P., Watkins N., Roeske M., Ruan-Iu L., Weissinger G., Diamond G.

Zeng Y., Jia X., Li H., Zhou N., Liang X., Liu K., Yang B., Xiang B.

Chen Q., Pan C., Shen Y., Pan Q., Zhang Q., Wang J., Hu Y., Xu H., Gong M., Jia K.

Dover G.M., Wright N.M., Wellen B.C., Moyer D.N., Riley A.R.

Objective: We aimed to compare transgender and gender diverse (TGD) youth and cisgender peers regarding universal depression and suicide screening outcomes in primary care and utilization of follow-up healthcare services after screening. Methods: We conducted a retrospective chart review at two pediatric primary care practices including 782 youth aged 10–18 years who were screened using the Ask Suicide Screening Questions (ASQ) and the nine-item Patient Health Questionnaire (PHQ-9). We compared the TGD group to their cisgender peers on demographic factors, screening outcomes, and use of follow-up services, including the emergency department, integrated behavioral health (IBH) contacts, and primary care clinician encounters. Results: Ninety-two (12%) patients were identified as TGD. TGD youth were significantly more likely than their cisgender peers to screen positive for acute and non-acute suicide risk, screen positive for depression, and to receive IBH services regardless of screening outcomes. There were no significant differences in healthcare utilization following positive screens, except TGD youth were less likely to see a primary care clinician within one month of positive depression screening. However, this effect was only significant for youth who did not receive an IBH consult at the time of screening. Conclusions: The results indicate that mental health screenings in pediatric primary care are effective for TGD populations, and that IBH at the time of screening may reduce inequities in follow-up care.

Bernhard A., Fann N., Chiocchetti A.G., Ackermann K., Martinelli A., Freitag C.M.

BackgroundExposure to psychosocial stress is one of the strongest risk factors for major depressive disorder (MDD) in youth, but underlying neurobiological mechanisms are poorly understood. Previous studies on the neuroendocrine stress response in youth with MDD are scarce, limited to cortisol, and rarely considered sex differences. Due to puberty‐associated neuroendocrine transitions increasing the risk for MDD onset in adolescence, this study aimed to investigate sex‐specific stress responses of stress and sex hormones as well as of neuropeptides.MethodsIn 103 pubertal youths with MDD and 72 healthy controls (HCs; 62% females, 12–18 years), psychological stress as well as salivary cortisol, testosterone, and oxytocin reactivity to a standardized psychosocial stress test (Trier Social Stress Test, TSST) were assessed. Effects of group and sex, and their interactions were analyzed using hierarchical linear models, while controlling for potentially confounding factors (such as age and pubertal status).ResultsFemales and males with MDD showed a stronger psychological stress response than HCs. In contrast, both female and male youth with MDD showed blunted cortisol, testosterone, and oxytocin stress responses compared to HCs. In addition, baseline testosterone was elevated in MDD compared to HCs.ConclusionsResults indicate a discrepant stress reactivity in youth with MDD, with increased psychological, but decreased neuroendocrine responses to psychosocial stress. Blunted neuroendocrine stress responses in youth with MDD were found across different neuroendocrine systems and in both females and males with MDD. These novel findings point to a fundamentally changed stress response in youth with MDD irrespective of sex, which may influence successful stress regulation in the affected adolescents.

Breitenstein R.S., Gagnon S.G., Webb R.M., Choquette E., Horn I., Bollinger M., Watson M.M., Honeycutt K., Gough C.J., Kidder-Ashley P.

Transitioning from high school to college can be challenging and put young adults at risk for problematic mental health, particularly for those with bullying victimization histories. Bullying detrimentally impacts psychological well-being and mental health, both concurrently and in the future. Social support positively influences college students’ emotional, social, and academic performance. However, few studies have examined the extent to which different types of bullying, as well as different sources of social support, may interact to predict mental health symptoms. Further, few studies examine associations between bullying victimization and mental health symptoms across the transition from high school to college. We examined three sources of social support (and their composite) measured during college as moderators between high school bullying victimization (traditional, cyberbullying) and college mental health (anxiety, depressive symptoms) in a sample of young adults from the Southeast United States (n = 329). Thus, we hypothesized that social support may protect college students from the harmful effects of bullying on mental health. Multivariate linear regressions revealed that higher levels of both traditional and cyberbullying during high school predicted worse mental health during college, and higher levels of social support in college predicted better concurrent mental health. However, social support did not moderate links between either type of bullying victimization in high school and mental health in college. Our findings provide evidence for institutions and educators regarding the importance of fostering social support (e.g., developing new friendships, maintaining existing support systems with close family or friends) for young adults as they transition to college.

Muflih M., Fitriawan A.S.

Abstract Background: Compared to adult-onset depression, depression that begins in adolescence (or earlier) often has a recurrent course and is linked to more detrimental effects, such as impairment in a number of important psychosocial aspects that can last into adulthood, suggesting that adolescence serves as a critical window time period for early detection and prevention of depression. Aim: The aim of this study was to investigate the prevalence of depression among adolescents and identify the significant determinants. Methods: A cross-sectional study involving 1873 adolescents aged 14–18 years old was conducted in 16 public high schools across five provinces of Indonesia from February 2023 to January 2024. Convenience sampling was performed to recruit the participants. An Indonesian version of self-rated validated instruments was employed to assess study variables: sociodemographic profiles, rosenberg self-esteem scale (RSES), general self-efficacy scale (GSES), multidimensional scale of perceived social support (MSPSS),thethree item UCLA loneliness Scale (ULS-3), the 10-item connor–davidson resilience scale (CD-RISC-10), patient health questionnaire-9 (PHQ-9). The Chi-square test was employed as a bivariate analysis, and binary logistic regression was performed as a multivariable analysis. Results: The prevalence of adolescent depression was 37.3%. Multivariable analysis revealed that female (adjusted odds ratio [AOR] = 1.863; 95% confidence interval [CI]: 1.477–2.350), alcoholic (AOR = 6.080; 95%CI: 2.096–17.640), chronic illness (AOR = 6.845; 95%CI: 3.029–15.465), low self-esteem (AOR = 4.203; 95%CI: 3.339–5.290), low family support (AOR = 3.064; 95%CI: 2.034–4.616), low friends support (AOR = 2.029; 95%CI: 1.328–3.101), and loneliness (AOR = 3.447; 95%CI: 2.493–4.767) were significantly associated with depression (P < 0.05). Conclusions: Our findings highlight the multifaceted nature of depression among adolescents. A proactive strategy for the detection and prevention of adolescent-onset depression that targets identified key predictors should be employed on a regular basis.

Lees T., Gatzke‐Kopp L.M.

ABSTRACTDepression has been postulated to relate to alterations in both anticipatory (i.e., motivation) and consummatory (i.e., hedonic pleasure) stages of reward processing. However, few studies have concurrently examined the various processes of these stages. Furthermore, little attention has been paid to whether these associations are sex‐specific, despite increasing evidence of the sex specificity of neural markers of internalizing disorders. The current study examines event‐related potentials (ERPs) of reward processing recorded during a monetary incentive delay task among a community sample of n = 309 emerging adults in relation to self‐reported symptoms of depression. Regression modeling indicated that greater depressive symptom scores were associated with reduced responsivity to reward feedback and increased responsivity to non‐reward feedback (as indexed by the Feedback‐P3) but only for participants who were identified as female at birth. Individual differences in anticipatory processes (as indexed by both the Cue‐P3 and CNV) were not associated with depressive symptoms for either sex. Results of these models suggest that depressive symptoms appear to be associated with consummatory reward processing for young women. It is possible that other dimensions of negative affect could be more poignant for male participants or may provide an additional description of the relationship between reward processing and depressive symptoms.

Gale E.L., Cecil J.E., Williams A.J.

ABSTRACTRelationships between multiple sleep outcomes, obesity and adiposity across childhood and adolescence have been previously reported. Health‐promoting interventions to improve sleep and reduce adolescent obesity could target shared determinants of sleep and obesity. The aim of this systematic review was to systematically identify and examine research that investigated the shared determinants of poor sleep and increased adiposity or obesity in adolescents. A systematic literature search covering publications up to April 2024 was conducted across 10 bibliographic databases. Search terms included objective and subjective sleep/circadian rhythm measurements, objective adiposity measurements and adolescents aged 8–18 years. Eighty studies were included in the final review. Determinants were categorised into three different domains: socioenvironmental determinants, behavioural determinants and health determinants. Shared determinants of poor sleep and increased adiposity or obesity in adolescents aged 8–18 years included: socioenvironmental determinants (gender, ethnicity, pubertal status, academic attainment), behavioural determinants (timing of moderate‐to‐vigorous physical activity (MVPA), unhealthy diet choices and timing of consumption and screen time and videogaming quantity and timing) and health determinants (wellbeing). These findings suggest that sleep hygiene and the modifiable shared behavioural determinants should be targeted in health‐promoting interventions, and statistical analyses should be adjusted for socioenvironmental determinants and wellbeing.

Qian J., Zhang H., Guo A., Fu Q., Shi J., Jin H., Yu D.

Jones B., Portillo Arias M.

Althoff R.R., Bagot K.S., Blader J., Dickstein D.P., Findling R.L., Singh M.K.

Jeong H., Luo T., Kang M., Garvey W.F., Blankenau G., Suk J., Tarzaben M., Hwang S.

Jadhav K.K., Daouk J., Kurkinen K., Kraav S., Eriksson P., Tolmunen T., Kanninen K.M.

Hurst L.E., Tengelitsch E., Bruni T., Lee J., Marcus S., Quigley J.

Youth in the United States are experiencing mental health concerns at an unprecedented level. Child Psychiatry Access Programs offer an innovative approach to close the gap between the need for care and insufficient mental health workforce. This study examined whether primary care provider consultation with a Child Psychiatry Access Program, Michigan Clinical Consultation & Care (MC3), was associated with greater access to treatment for adolescents with moderate to severe depression symptoms.