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Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018
Open accessAbstract
Background 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.Methods 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.Results 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.Conclusions 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.
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“These findings are consistent with recent increases in depression and suicidal ideation and behaviors among US adolescents [39–42].”
From Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement (2021) · cites this paper as [40]
Experimental — accuracy not yet measuredIn the citing paper
“Layered atop these well-known developmental trajectories, a series of new findings indicate that rates of these adolescent-emergent mental health problems (depressive and anxiety disorders, NSSI, and suicidal thoughts and behaviors) have been increasing worldwide -- especially over the past decade, and most notably amongst girls.(2,20–23)”
From Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence (2021) · cites this paper as [21]
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Self-citationNature-based interventions for vulnerable youth: a scoping review
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“…about high levels of adolescents and young adults struggling with mental health problems, adjustment difficulties, problem behavior, disengagement, or disaffection (e.g. Olfson et al. 2015; Coley et al. 2018; Keyes et al. 2019; Murray et al. 2019; Mojtabai and Olfson 2020; Cybulski et al. 2021).”
BackgroundCurran, T., Ito‐Jaeger, S., Vallejos, E. P., & Crawford, P. (2023) · Journal of Mental Health · doi:10.1080/09638237.2023.2182412 · Cited by 40
“In the United States, cohort studies of young people between 1976 and 2017 show marked increases in loneliness after 2011 (Twenge et al., 2019), anxiety (Duffy et al., 2019), depressed mood (Keyes et al., 2019), self-harm (Mercado et al., 2017), and suicidal ideation (J. M. Twenge et al., 2019).”
BackgroundGlobal Well-Being and Mental Health in the Internet Age
Vuorre, M., & Przybylski, A. K. (2023) · Clinical Psychological Science · doi:10.1177/21677026231207791 · Cited by 39
“These results align with other results that tend to be mixed or find few changes over time (Bor et al., 2014; Collishaw, 2015; Cosma et al., 2020; Keyes et al., 2019).”
McAllister, C., Hisler, G. C., Blake, A. B., Twenge, J. M., Farley, E., & Hamilton, J. L. (2021) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-021-00832-x · Cited by 38
Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds
Roberston, L., Twenge, J. M., Joiner, T. E., & Cummins, K. M. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.05.071 · Cited by 41
Beller, J. (2022) · European Journal of Ageing · doi:10.1007/s10433-022-00732-z · Cited by 40
Barker, K. M., Dunn, E. C., Richmond, T. K., Ahmed, S., Hawrilenko, M. J., & Evans, C. R. (2020) · SSM - Population Health · doi:10.1016/j.ssmph.2020.100661 · Cited by 36
Assessing adult ADHD: New research and perspectives
Lovett, B. J., & Harrison, A. G. (2021) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2021.1950640 · Cited by 35
Martínez‐Alés, G., & Keyes, K. M. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1080-6 · Cited by 38
Self-citationSubstance Use, Suicidal Thoughts, and Psychiatric Comorbidities Among High School Students
Tervo‐Clemmens, B., Gilman, J. M., Evins, A. E., Bentley, K. H., Nock, M. K., Smoller, J. W., & Schuster, R. M. (2024) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2023.6263 · Cited by 35
Lifestyle habits and depressive symptoms in Norwegian adolescents: a national cross-sectional study
Kleppang, A. L., Haugland, S. H., Bakken, A., & Stea, T. H. (2021) · BMC Public Health · doi:10.1186/s12889-021-10846-1 · Cited by 35
Fleming, T. M., Ball, J., Bavin, L. M., Rodriguez, C. R., Peiris-John, R. J., Crengle, S. M., Sutcliffe, K., Lewycka, S. O., Archer, D. J., & Clark, T. C. (2022) · Journal of the Royal Society of New Zealand · doi:10.1080/03036758.2022.2072349 · Cited by 43
Opie, J. E., Vuong, A. T., Welsh, E. T., Gray, R. J., Pearce, N., Marchionda, S., Mutch, R., & Khalil, H. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00469-4 · Cited by 42
MicroRNA regulation of prefrontal cortex development and psychiatric risk in adolescence
Morgunova, A., & Flores, C. (2021) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2021.04.011 · Cited by 35
Structural sexism and Women's alcohol use in the United States, 1988–2016
McKetta, S. C., Prins, S. J., Hasin, D. S., Patrick, M. E., & Keyes, K. M. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114976 · Cited by 38
Self-citationFoundational Nutrition: Implications for Human Health
Townsend, J. R., Kirby, T. O., Marshall, T. M., Church, D. D., Jajtner, A. R., & Esposito, R. (2023) · Nutrients · doi:10.3390/nu15132837 · Cited by 47
Garcia-Carachure, I., Flores‐Ramirez, F. J., Castillo, S. A., Themann, A., Arenivar, M. A., Preciado-Piña, J., Zavala, A. R., Lobo, M. K., & Iñiguez, S. D. (2020) · Neuropsychopharmacology · doi:10.1038/s41386-020-0654-7 · Cited by 32
Ren, P., Liu, B., Xiong, X., Chen, J., & Luo, F. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.048 · Cited by 35
Kulikov, V. N., Crosthwaite, P. C., Hall, S. A., Flannery, J., Strauss, G., Vierra, E., Koepsell, X., Lake, J. I., & Padmanabhan, A. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1062471 · Cited by 35
“Depression, a highly prevalent mental health disorder among adolescents, is a growing crisis within the US (1, 2).”
BackgroundMethodInfluentialOlfati, M., Samea, F., Faghihroohi, S., Balajoo, S. M., Küppers, V., Genon, S., Patil, K. R., Eickhoff, S. B., & Tahmasian, M. (2024) · EBioMedicine · doi:10.1016/j.ebiom.2024.105313 · Cited by 31
Soft Drink Consumption and Mental Health in Adolescents: A Longitudinal Examination
Mrug, S., Jones, L. C., Elliott, M. N., Tortolero, S. R., Peskin, M. F., & Schuster, M. A. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.05.034 · Cited by 31
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Freund, V. A., Schulenberg, J. E., & Maslowsky, J. (2021) · Prevention Science · doi:10.1007/s11121-020-01198-0 · Cited by 35
“Implications for prevention are especially relevant now as recent studies using the MTF dataset have found both boredom and DA to be increasing in adolescents over the past decade (Weybright et al. 2020; Keyes et al. 2019).”
BackgroundSelf-citationIs adolescent internet use a risk factor for the development of depression symptoms or vice-versa?
Fitzpatrick, C., Lemieux, A., Smith, J., West, G. L., Bohbot, V. D., & Asbridge, M. (2023) · Psychological Medicine · doi:10.1017/s0033291723000284 · Cited by 34
“Over the span of the last decade, depression and suicide rates have climbed significantly among youth, particularly for girls (Hedegaard, Curtin, & Warner, 2021; Keyes, Gary, O ’ Malley, Hamilton, & Schulenberg, 2019; Lin et al, 2016).”
BackgroundAWAKE BRUXISM PREVALENCE ACROSS POPULATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Stanisic, N., Saracutu, O. I., Colonna, A., Wu, W., Manfredini, D., & Häggman‐Henrikson, B. (2025) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2025.102171 · Cited by 30
Yosep, I., Hikmat, R., & Mardhiyah, A. (2023) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s406688 · Cited by 32
Metadata
- Authors
- Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J.
- Affiliations
- Universidad Mayor (CL)
- Columbia University (US)
- University of Michigan (US)
- Corresponding author
- Keyes, Katherine M.
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2019-03-30
- Volume
- 54
- Issue
- 8
- Pages
- 987-996
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC7015269
- OpenAlex
- W2926589548
- Cited by
- 465
- References
- 65
- Citations by year
- 2026: 39 · 2025: 78 · 2024: 90 · 2023: 79 · 2022: 69 · 2021: 64 · 2020: 39 · 2019: 7
- FWCI
- 52.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01001411)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- depressive symptoms, adolescent mental health, age-period-cohort effects, sex differences, girls, boys, cohort effects, period effects, Latino youth, race and ethnicity, parental education, suicide, environmental risk factors
- MeSH terms
- Adolescent, Cross-Sectional Studies, Depression, Ethnicity, Female, Hispanic or Latino, Humans, Male, Mental Health, Risk Factors, Students, Suicide, United States
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