Adolescent major depression in the National Comorbidity Survey

A recent study published in the January 2015 issue of the Journal of the American Academy of Child and Adolescent Psychiatry underscores the important public health significance of depression among U.S. adolescents.

Mental disorders are the leading cause of years lived with disability worldwide with 40.5% of this burden attributable to major depression. In adolescence, rates of depression increase substantially between 13 and 18 years of age, and the estimated cumulative incidence in this population approximates the adult lifetime prevalence rate.

Using data from a nationally representative sample of adolescents who participated in the National Comorbidity Survey - Adolescent Supplement (NCS-A), a group of researchers led by Dr. Kathleen Merikangas of the National Institute of Mental Health's Intramural Research Program, evaluated symptoms of DSM-IV major depressive disorder (MDD), mild/moderate MDD, and severe MDD in 10,123 adolescents. Data was collected from adolescents 13 to 18 years old, representing the critical developmental period for the onset of depression.

MDD was highly prevalent in adolescents, whether measured over lifetime (11%) or past year (7.5%). Prevalence rates of MDD increased across adolescence, and females had 2-3-fold greater rates than males. The majority of adolescents with MDD demonstrated severe role impairment and substantial comorbidity with other mental conditions. Although treatment in any form was received by the majority of adolescents with MDD (60.4%), a much lower percentage received disorder-specific treatment (33.9%) or received treatment from the mental health sector (34.9%).

"One of the major concerns raised by these findings was the substantial proportion of those with severe major depression who reported a history of suicide attempts, yet many had not received care in either the medical or mental health sectors," said Dr. Shelli Avenevoli, the lead author, who was involved in the development of the NCS-A.

These findings extend the growing evidence regarding the significance of adolescent depression from regional community studies, and national surveys that focused on current depressive episodes in adolescents.The study highlights the clinical and public health need for screening, early identification, early intervention and treatment of MDD during adolescence.