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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]
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“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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DuPont‐Reyes, M. J., Villatoro, A. P., & Tang, L. (2025) · Journal of Medical Internet Research · doi:10.2196/64672 · Cited by 3
Amadori, A., Prestera, G., Intra, F. S., Taverna, L., Primi, C., & Brighi, A. (2025) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2025.2477126 · Cited by 3
“Moreover, the association between loneliness, psychiatric conditions, and suicidal behaviours has been demonstrated (Keyes et al., 2019; Kreski et al., 2021; Matthews et al., 2023).”
Hatfield, J. L. (2025) · Education and Information Technologies · doi:10.1007/s10639-025-13645-y · Cited by 11
Setting the Level and Annual Adjustment of Military Pay
Asch, B. J., Mattock, M. G., Smith, T. D., & Ward, J. (2020) · RAND Corporation eBooks · doi:10.7249/rra368-1 · Cited by 3
Grummitt, L. R., Bailey, S., Kelly, E. V., Birrell, L., Gardner, L. A., Halladay, J. E., Chapman, C., Andrews, J. L., Champion, K. E., Hunter, E., et al. (2024) · JMIR Pediatrics and Parenting · doi:10.2196/54637 · Cited by 3
Air Pollution’s Hidden Toll: Links Between Ozone, Particulate Matter, and Adolescent Depression
Waxman, M., & Manczak, E. M. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21121663 · Cited by 3
“…years, significant increases in the rates of depression among adolescents have been reported, with the prevalence of major depressive episodes in adolescents increasing by 7.7% between 2009 and 2019 [5], and 17% of adolescents in the US reporting at least one depressive episode in 2020 [6,7].”
InfluentialGrummitt, L. R., Rowlinson, K., Cassar, J., Conroy, C., Birrell, L., Stapinski, L. A., Barrett, E. L., Macauley, J., Teesson, M., Newton, N. C., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-21493-1 · Cited by 3
“In addition, since 2010 when this trial concluded, both student mental health concerns as well as demands on teachers have steadily increased [26, 20], raising the question of whether teacher delivery of Preventure would be feasible and acceptable and produce benefits for students as demonstrated…”
Miller, M. C., Baron, O. R., Epstein, J. N., Tamm, L., Nyquist, A. C., & Becker, S. P. (2025) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14156 · Cited by 4
Kwon, N., Lee, D., Hwang, S., Yang, S., Youn, I., Moon, H.-J., & Han, S. (2025) · Acta Psychologica · doi:10.1016/j.actpsy.2025.105432 · Cited by 4
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Perez, T. M., Mathew, J., Glue, P., Adhia, D. B., & Ridder, D. D. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.821136 · Cited by 3
“, 2009) with rates markedly increasing world-wide in recent years (Duffy et al., 2019; Keyes et al., 2019; Twenge et al., 2019; Haidt and Allen, 2020; Pfeifer and Allen, 2021).”
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Winds, K., Marka, T., Salcher, B., Rieser, N., Skrivanek, C., Hochrainer, M., Trost-Schrems, J., Rainer, L. J., Hitzl, W., Augner, C., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1310252 · Cited by 7
Takamasa, E. J., Fraser, A. M., & Rogers, A. A. (2024) · Journal of Research on Adolescence · doi:10.1111/jora.12978 · Cited by 4
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“Within a similar timeframe, studies have also documented a steady increase in mental health complaints, especially among young people (Keyes et al., 2019; Mojtabai et al., 2016).”
Depression in adolescence and the understanding of health—A phenomenographic study
Danielsson, K., Ahlborg, M. G., Mortazavi, R., Jarbin, H., & Larsson, I. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318061 · Cited by 3
“While self-reported depressive symptoms have undeniably increased among adolescents [3,4], the incidence of depression varies depending on sampling, definition and diagnostic instrument, and time frame [5].”
Exercise in Adolescent Depression: Fitness, Clinical Outcomes, and BDNF
Dopp, R. R., Miklja, Z., Jurries, E., & Mooney, A. G. (2020) · Journal of Neurology and Neurobiology · doi:10.16966/2379-7150.167 · Cited by 3
“Data from Monitoring the Future study demonstrates significant increases in reports of depressive symptoms among adolescents between 1991 and 2018, consistent with increases in depressive disorders and suicides [1].”
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Vaping Regulations and Mental Health of High School StudentsPreprint
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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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