Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and meta-analysis
Abstract
OBJECTIVE: Adolescence is a formative and turbulent phase where physiological, psychosocial, and cognitive changes leave adolescents vulnerable to psychological disorders. Given the lack of reviews that consolidate and compare worldwide prevalence of depression among adolescents, this review aims to examine the global prevalence of major depressive disorders, dysthymia, and elevated depressive symptoms among adolescents. METHODS: A systematic review and meta-analysis was conducted. Six databases were searched for studies published from 2001 to December 2020. Seventy-two studies were included. Subgroup analysis were performed for year of publication, geographical region, gender, and assessment tools used. RESULTS: The global point prevalence rate of elevated self-reported depressive symptoms from 2001 to 2020 was 34% (95% CI: 0.30-0.38). Point prevalence for major depressive disorder (MDD) and dysthymia was 8% (95% CI: 0.02-0.13) and 4% (95% CI: 0.01-0.07), respectively. The pooled one-year prevalence and lifetime prevalence for MDD were 8% (95% CI: 0.05-0.12) and 19% (95% CI: 0.12-0.26). Point prevalence of elevated depressive symptoms among adolescents increased from 24% (95% CI: 0.19-0.28) between 2001 and 2010 to 37% (95% CI: 0.32-0.42) between 2011 and 2020. The Middle East, Africa, and Asia have the highest prevalence of elevated depressive symptoms, and female adolescents were reported to have a higher prevalence of elevated depressive symptoms than male adolescents. CONCLUSION: Besides targeting those with existing clinical depression, research and policies should also focus on educational and supportive mitigation efforts to curb depressive symptoms among adolescents before escalation. The findings encourage future research to develop more gender-specific and culturally relevant intervention programmes. PRACTITIONER POINTS: 34% of adolescents globally, aged 10-19 years, are at risk of developing clinical depression, which exceeds the reported estimates of individuals aged 18 to 25 years. Practitioners are highly encouraged to prioritize depression screening and intervention implementation for individuals in this age group. Female adolescents and adolescents from Middle East, Africa, and Asia have the highest risk of developing depression. This urges practitioners and researchers to develop more gender-specific and culturally relevant intervention programmes.
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Women have higher prevalence rates of both depression and anxiety problems.
“women have higher prevalence rates of both depression and anxiety problems (Deng et al., 2023; Shorey et al., 2022)”
From Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. (2025) · cites this paper as Shorey et al., 2022
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“0% (Shorey et al., 2022), and the prevalence among Chinese adolescents is 24.”
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“Among adolescents, the point prevalence of elevated depressive symptoms increased from 24% (between 2001 and 2010) to 37% (between 2011 and 2020) (Shorey et al., 2022).”
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“In addition, the lifetime prevalence rate of MDD in the sample is similar to that in previous surveys among college students in China [16, 91].”
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“The JBI Critical Appraisal Tool is commonly utilized for evaluating the quality of prevalence studies [34, 35], and its use has been recently recommended following a systematic review of quality assessment tools [36].”
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“Age, median (IQR) years 17 (15–19) Sex Female 94 (89) Male 12 (11) Race and ethnicity Black, non-Hispanic 40 (38) Hispanic 32 (30) White, non-Hispanic 24 (23) Asian 10 (9) Annual household income <$15,000 16 (15) $15,000–50,000 14 (13) $50,000–100,000 15 (14) >$100,000 12 (11) Deferred or unknown 49 (46) Median househ…”
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“These findings align with other research conducted on adolescents in the Middle East, Africa, and Asia, suggesting the presence of a potential crisis in adolescent mental health [13].”
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“Furthermore, depressive symptoms are highly prevalent among adolescents residing in LMICs in the Middle East, Africa, and Asia regions [9].”
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“%) than male students (14.7%), a result that is lower than the global study of 34% detection rate of psychological symptoms [38].”
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“Importantly, extant literature has consistently corroborated the significant impact of depression on these specific demographic factors, as evidenced by prior studies [48–51], further affirming the robustness of the present study’s findings.”
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“Thus, adolescents who have adequate physical activity time, less screen time and adequate sleep time may have better mental health and be less likely to experience anxiety and depressive symptoms [12].”
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“Yet, female adolescents often reported more symptoms of depression than males (Granrud et al., 2019 ; Shorey et al., 2021).”
BackgroundNeuroinflammation in the Amygdala Is Associated With Recent Depressive Symptoms
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“Thus, to promote the well-being of adolescents 25 , there is an urgent need to gain empirical insights into how parents and adolescents impact each other within individual families.”
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“%) among adolescents is rising, with depressive symptoms increasing from 24% (2001–2010) to 37% (2011–2020), reaching 45% in 2021 [17], exacerbated by the COVID-19 pandemic ([14,15,18].”
Social jetlag and depressive symptoms among young people: a systematic review and meta-analysis
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“Low and middle-income countries (LMICs), such as those in the Middle East and Africa, have the highest prevalence of clinical depression, and females are more likely to be affected than males [2].”
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Sleep duration is associated with depressive symptoms in Chinese adolescents
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“This leaves the possibility that conditions which do not indicate use of pain medication that seem to be increasing in younger age groups, such as chronic pain or psychological distress, may have contributed to higher use of prescription analgesics [24, 27, 41].”
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- Authors
- Shorey, S., Ng, E. D., & Wong, C. H. J.
- Affiliations
- National University of Singapore (SG)
- National University Hospital (SG)
- Corresponding author
- Shorey, Shefaly
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2021-09-26
- Volume
- 61
- Issue
- 2
- Pages
- 287-305
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W3203726726
- Cited by
- 1,511
- References
- 62
- Citations by year
- 2026: 389 · 2025: 530 · 2024: 370 · 2023: 178 · 2022: 42 · 2021: 1 · 2012: 1
- FWCI
- 23.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- adolescent depression, major depressive disorder, dysthymia, global prevalence, lifetime prevalence, point prevalence, gender differences, regional variation, temporal trends, depression screening, culturally sensitive interventions, mental health policy, adolescent mental health services, school-based mental health services, community mental health services
- MeSH terms
- Adolescent, Depression, Major Depressive Disorder, Female, Humans, Male, Prevalence
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