Cited by 1,511Mental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional DevelopmentTreatment of Major Depression

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Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and meta-analysis

Shorey, Shefaly, Ng, Esperanza Debby, Wong, Celine H. J.·2022·British Journal of Clinical Psychology

DOI 10.1111/bjc.12333

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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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“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].”
Method
Blood cytokines in major depressive disorder in drug-naïve adolescents: A systematic review and meta-analysis
Jadhav, K. K., Daouk, J., Kurkinen, K., Kraav, S., Eriksson, P., Tolmunen, T., & Kanninen, K. M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.11.071 · Cited by 33
The Relationship Between College Students’ Interpersonal Relationship and Mental Health: Multiple Mediating Effect of Safety Awareness and College Planning
Sun, Y. (2023) · Psychology Research and Behavior Management · doi:10.2147/prbm.s396301 · Cited by 28
Effect of psychosocial interventions for depression in adults with chronic kidney disease: a systematic review and meta-analysis
Yang, H., Li, Q., & Pei, D. (2024) · BMC Nephrology · doi:10.1186/s12882-023-03447-0 · Cited by 28
“…techniques, exercise, education, or individual social support including by telephone, are defined as interventions that can provide psychological, emotional, or social support without using pharmacological substances and have been demonstrated to be effective for people with depression [52].”
Background
The Burden of adolescent depression and the impact of COVID-19 across 204 countries and regions from 1990 to 2021: results from the 2021 global burden of disease study
Zhu, F., Yang, Y. X., Yin, T., Pan, M., Xu, J., Chen, R., Zheng, W., & Gu, F. (2025) · Scientific Reports · doi:10.1038/s41598-024-84843-w · Cited by 34
Internet gaming disorder and depression mediated by impaired resilience and sleep distress: a three-wave longitudinal study among Chinese adolescents
Peng, P., Chen, Z., Ren, S., Hé, Y., Li, J. G., Liao, A., Zhao, L. L., Shao, X., Chen, S. S., He, R., et al. (2025) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796025000046 · Cited by 28
Adolescent Social Media Use: Pitfalls and Promises in Relation to Cybervictimization, Friend Support, and Depressive Symptoms
Fredrick, S. S., Nickerson, A. B., & Livingston, J. A. (2022) · Journal of Youth and Adolescence · doi:10.1007/s10964-021-01561-6 · Cited by 28
The Role of Emotional Skills (Competence) and Coping Strategies in Adolescent Depression
Vučenović, D., Sipek, G., & Jelić, K. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13030041 · Cited by 37
“The global prevalence rate of self-reported depressive symptoms among adolescents increased from 24% to 37% in 2001-2010 [33], and recent data suggest another decline in their general resilience and coping abilities.”
Background
Borderline Personality as a Factor in Late, Missed, and Mis-Diagnosis in Autistic Girls and Women: A Conceptual Analysis
McQuaid, G. A., Strang, J. F., & Jack, A. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0034 · Cited by 38
Cross-sectional and longitudinal associations of adherence to the 24-hour movement guidelines with mental health problems among Chinese adolescents
Zhang, Y., Pan, Y., Ma, Z., Wang, D., Zou, R., & Fan, F. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111352 · Cited by 29
Multicenter Study of Utility and Acceptability of Depression and Anxiety Screening in Adolescents and Young Adults With Childhood‐Onset Systemic Lupus
Rubinstein, T. B., Dionizovik-Dimanovski, M., Davis, A. M., Smith, C. A., Faust, L., Rutstein, B. H., Mitchell, M., Jones, J. T., Harris, J. G., Rodriguez, M. M., et al. (2021) · Arthritis Care & Research · doi:10.1002/acr.24825 · Cited by 26
“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…”
Background
Global, regional, and national trends in incidence of depression among women, 1990-2019: An analysis of the global burden of disease study
Gao, P., Cao, G., Liu, J., Yang, F., & Liu, M. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115668 · Cited by 27
Problematic social media use mediates the effect of cyberbullying victimisation on psychosomatic complaints in adolescents
Peprah, P., Oduro, M. S., Atta-Osei, G., Addo, I. Y., Morgan, A. K., & Gyasi, R. M. (2024) · Scientific Reports · doi:10.1038/s41598-024-59509-2 · Cited by 26
Assessing the impact of physical activity on reducing depressive symptoms: a rapid review
Samsudin, N., Bailey, R. P., Ríes, F., Hashim, S. N. A., & Fernandez, J. A. (2024) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-024-00895-5 · Cited by 26
“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].”
Result
Prevalence and Determinants of Depressive Symptoms among Young Adolescents in Malaysia: A Cross-Sectional Study
Singh, S., Lai, C. H., Iderus, N. H. M., Ghazali, S. M., Ahmad, L. C. R. Q., Lim, M. C., Nadzri, M. N. M., Zulkifli, A. A., Suppiah, J., Zaki, R. A., et al. (2023) · Children · doi:10.3390/children10010141 · Cited by 35
“Furthermore, depressive symptoms are highly prevalent among adolescents residing in LMICs in the Middle East, Africa, and Asia regions [9].”
Background
Association between physical activity and depressive symptoms in adolescents: A prospective cohort study
Jiang, W., Sun, L., He, Y., Liu, W., Hua, Y., Zheng, X., Huang, C., Liu, Q., Xiong, L., & Guo, L. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115544 · Cited by 28
Analysis of the associations between moderate-to-vigorous physical activity and screen time on psychological symptoms among university students: a cross-sectional survey based on six geographic regions in China
Deng, G.-F., Wen, Y., Cheng, J., Huang, B., & Liu, N. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05945-3 · Cited by 30
“%) than male students (14.7%), a result that is lower than the global study of 34% detection rate of psychological symptoms [38].”
BackgroundInfluential
Health survey on anxiety, depression, and stress in Afghanistan: A large-scale cross-sectional study amid ongoing challenges
Neyazi, A., Mohammadi, A. Q., Razaqi, N., Rahimi, B. A., Sifat, S., Rahimy, N., Tareen, Z., Mehmood, Q., Satapathy, P., & Griffiths, M. D. (2024) · Discover Mental Health · doi:10.1007/s44192-024-00090-5 · Cited by 27
“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.”
Result
The central mediating effect of inhibitory control and negative emotion on the relationship between bullying victimization and social network site addiction in adolescents
Wang, J., Wang, N., Qi, T., Liu, Y., & Guo, Z. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1520404 · Cited by 27
Depression, Anxiety, and Suicide Among Adolescents: Sex Differences and Future Perspectives
Toro, G. V. R., Arias, P., de la Torre‐Luque, A., Singer, J. B., & Lagunas, N. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14103446 · Cited by 38
“Depressive symptoms were more prevalent among female adolescents than male adolescents [24].”
The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Mental Health in Adolescents—Cross Sectional Evidence from China
Luo, L., Zeng, X., Cao, Y., Hu, Y., Wen, S., Tang, K., Ding, L., Wang, X., & Song, N. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043167 · Cited by 25
“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].”
Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study
Urbańska-Grosz, J., Sitek, E. J., Pakalska−Korcala, A., Pietraszczyk-Kędziora, B., Skwarska, K., & Walkiewicz, M. (2024) · Children · doi:10.3390/children11010131 · Cited by 34
The relationship between socioeconomic status and depression: A systematic review and meta-analysis
ZHANG, Y., ZHANG, J., Hongxia, L. I., & JIANG, Y. (2022) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2022.02650 · Cited by 24
The dark triad and depressive symptoms among chinese adolescents: moderated mediation models of age and emotion regulation strategies
Shen, K. (2022) · Current Psychology · doi:10.1007/s12144-022-04132-5 · Cited by 29
“Yet, female adolescents often reported more symptoms of depression than males (Granrud et al., 2019 ; Shorey et al., 2021).”
Background
Neuroinflammation in the Amygdala Is Associated With Recent Depressive Symptoms
Zhang, W., Rutlin, J. R., Eisenstein, S. A., Wang, Y., Barch, D. M., Hershey, T. G., Bogdan, R., & Bijsterbosch, J. D. (2023) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2023.04.011 · Cited by 24
“https://doi.org/10.1016/j.bpsc.2023.04.011 Major depressive disorder (MDD) is a worldwide health issue with profound emotional, cognitive, and economic consequences (1,2).”
Influential
The direction of effects between parenting and adolescent affective well-being in everyday life is family specific
Boele, S., Bülow, A., Beltz, A. M., de Haan, A. D., Denissen, J. J. A., & Keijsers, L. (2023) · Scientific Reports · doi:10.1038/s41598-023-43294-5 · Cited by 23
“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.”
Background
Converged avenues: depression and Alzheimer’s disease– shared pathophysiology and novel therapeutics
Bajaj, S., & Mahesh, R. (2024) · Molecular Biology Reports · doi:10.1007/s11033-023-09170-1 · Cited by 25
Gender Differences in the Relationship Between Short-Form Video Addiction and Adolescent Depression: The Mediating Role of Attentional Bias
Wu, Y., Bai, Y., Liu, X., Xu, W., & Liu, Y. (2025) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2024.0442 · Cited by 23
Emerging strategies and clinical recommendations for the management of novel depression subtypes
Chiappini, S., Sampogna, G., Ventriglio, A., Menculini, G., Ricci, V., Pettorruso, M., Volpe, U., & Martinotti, G. (2025) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2025.2470973 · Cited by 24
“%) 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
Sun, S., Yang, Y., Yu, F., He, Y., Luo, C., Zhang, M., Chen, H., & Tung, T. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07066-x · Cited by 27
Depression and suicidal behavior among adolescents living with HIV in Botswana: a cross-sectional study
Olashore, A. A., Paruk, S., Tshume, O., & Chiliza, B. (2022) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-022-00492-9 · Cited by 22
“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].”
BackgroundResult
Association between electronic cigarette use and depression among Thai adolescents: The Thailand National Health Examination Survey 2019–2020
Patanavanich, R., Vityananan, P., Neelapaichit, N., Chariyalertsak, S., Kessomboon, P., Assanangkornchai, S., Taneepanichskul, S., & Aekplakorn, W. (2022) · Tobacco Induced Diseases · doi:10.18332/tid/155333 · Cited by 22
Sleep duration is associated with depressive symptoms in Chinese adolescents
Lin, S., Gong, Q., Chen, J., Wang, J., Gao, H., Hong, J., Guo, Y., Zhang, Y., & Jiang, D. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.07.114 · Cited by 22
Abnormal energy metabolism, oxidative stress, and polyunsaturated fatty acid metabolism in depressed adolescents associated with childhood maltreatment: A targeted metabolite analysis
Chen, H., Wang, J., Chen, S., Chen, X., Liu, J., Tang, H., Zhou, J., Tian, Y., Wang, X., Cao, X., et al. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.115795 · Cited by 23
Childhood Physical Fitness as a Predictor of Cognition and Mental Health in Adolescence: The PANIC Study
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“Additionally, depressive symptoms are more prevalent in girls than in boys [9].”
Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019
Stangeland, H., Handal, M., Skurtveit, S. O., Aakvaag, H. F., Dyb, G., Wentzel-Larsen, T., Baumann-Larsen, M., Zwart, J. A., Storheim, K., & Stensland, S. Ø. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02066-8 · Cited by 21
“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].”
Background
Depression and HIV: a scoping review in search of neuroimmune biomarkers
Rakshasa-Loots, A. M. (2023) · Brain Communications · doi:10.1093/braincomms/fcad231 · Cited by 22
“Together with widespread stigma and marginalization, these factors contribute to the high risk for depression amongst people with HIV, especially for women with HIV and those in the Global South.4,5 However, as the brain is a key reservoir of HIV infection, it is likely that neurobiological processes also contribute t…”
Background
Virtues as protective factors for adolescent mental health
McLoughlin, S., & Kristjansson, K. R. (2024) · Journal of Research on Adolescence · doi:10.1111/jora.13004 · Cited by 34
Developmental Relations Between Bullying Victimization and Suicidal Ideation in Middle Adolescence and Emerging Adulthood: Do Internalizing Problems and Substance Use Mediate Their Links?
Zhu, X., GRIFFITHS, H. M., Eisner, M., Hepp, U., Ribeaud, D., & Murray, A. L. (2022) · Journal of Youth and Adolescence · doi:10.1007/s10964-022-01630-4 · Cited by 26
The role of only-child status in the effect of childhood trauma and parental rearing style on depressive symptoms in Shanghai adolescents
Zhong, Y., Huang, X., Chen, J., Li, Y., Li, Y., Chen, R., Cong, E., & Xu, Y. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1196569 · Cited by 21
Trajectory of depressive symptoms over adolescence in autistic and neurotypical youth
Corbett, B. A., Muscatello, R. A., McGonigle, T., Vandekar, S., Burroughs, C., & Sparks, S. (2024) · Molecular Autism · doi:10.1186/s13229-024-00600-w · Cited by 28
“While prior research suggests the transition from childhood to adolescence is associated with worsening depression symptoms for both typically developing (TD) [7, 8] and autistic youth [5, 6], it is unclear if depression symptoms in youth with ASD follow a similar trajectory to TD youth.”
Background
Is decreasing problematic mobile phone use a pathway for alleviating adolescent depression and sleep disorders? A randomized controlled trial testing the effectiveness of an eight-session mindfulness-based intervention
Liu, Q., Yang, X., Zhang, C., & Xiong, J. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00034 · Cited by 28

Authors: Shorey, S., Ng, E. D., & Wong, C. H. J.
Affiliations: National University of Singapore (SG)
National University Hospital (SG)
Corresponding author: Shorey, Shefaly
ORCID: Shorey, Shefaly
Ng, Esperanza Debby
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
DOI: 10.1111/bjc.12333
OpenAlex: W3203726726
Cited by: 1,511
References: 62
Citations by year: 2026: 389 · 2025: 530 · 2024: 370 · 2023: 178 · 2022: 42 · 2021: 1
FWCI: 23.13
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: British Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Medicine › Pharmacology (medical) › 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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Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and meta-analysis

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