Study Finds Nearly 75% of Adolescents Experience Depression, Anxiety

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According to a new study, almost 3 quarters of adolescents experience clinically significant depression or anxiety symptoms, of which, most are chronic. Additionally, girls were at an increased risk of anxiety and depression symptoms compared with boys.^1,2

The Child to Adult Transition Study (CATS) was established in 2012 to form a representative cohort of adolescents in Melbourne, Victoria, Australia. A total of 43 schools were recruited using a stratified sampling approach, and all 2289 students who were aged 8 to 9 years were invited to participate in the study.^2,3

The study’s primary focus is on health and emotional development in the middle years of school, specifically looking at the experiences of children and their families, the changing social context as they go through their schooling, the consequences this may have on academic outcomes and their reactions to biological changes of puberty. Further, CATS aims to improve the understanding of the influences on both health and emotional adjustments of children as they journey through adolescence and into young adulthood. According to the experts, information collected as part of the study will help to identify when and how to promote the best health and emotional adjustment within children and adolescents.³

For this study, 1239 (54.1%) of the total 2289 students were enrolled and followed up annually from 2012 to 2019 for a total of 10 waves. Data from waves 3 through 10 (ages 10 to 18 years) were used for the current study and analyzed common mental disorders (CMDs), such as depression and anxiety, to describe the course of CMD-related symptoms across adolescence. The primary measures of interest were described as the following: clinically relevant depressive symptoms, clinically relevant anxiety symptoms, and any CMD (clinically relevant depressive or anxiety symptoms) during waves 3 through 10. Secondary measures of interest were comorbid CMDs (concurrent reporting of clinically significant anxiety and depressive symptoms) during waves 3 through 10.²

Of the 1239 adolescents who participated in the study, most were female (n = 667; 53.8%) and classified as socioeconomically advantaged (n = 769; 62.1%). Additionally, from the available data, 675 (66.4%) of the available 1016 patients had a mother whose highest level of education was vocational or tertiary, and 579 (70.7%) of the 819 participants with ethnicity data identified as either Anglo-Celtic or European.²

Overall, the findings showed that the incidence of any clinically significant CMD symptoms during adolescence was approximately 74% (95% CI 70–77). Specifically, female adolescents were more likely to experience and report symptoms (84% [95% CI 81–88]) compared with their male counterparts (61% [95% CI 55–66]).²

“These are striking findings, particularly given how many young people experienced symptoms over multiple years of the study and how much depression and anxiety symptoms can affect young people’s functioning and can have long-lasting negative health outcomes,” Ellie May Robson, PhD, research officer at the Murdoch Children’s Research Institute (MCRI), said in a news release.¹

Additionally, incidences of clinically significant depressive symptoms and anxiety symptoms were about 65% (95% CI 62–68) and 58% (95% CI 55–62), respectively. The frequency of comorbid CMD was about 48% (95% CI 45–52). The estimated mean ages of first report in adolescence for both sexes were 14.1 years (95% CI 13.9–14.4) and 13.6 years (3.3–13.9) for depressive and anxiety symptoms, respectively. Among those who reached the threshold score for any CMD between the ages 10 and 18 years, over half had a chronic course that lasted 3 or more waves (depression: 54% [95% CI 49–60]; anxiety: 52% [95% CI 47–58]). About a third of patients met criteria for full remission at any subsequent wave (depression: 30% [95% CI 25–35]; anxiety 33% [95% CI 27–39]).²

The authors also observed that female adolescents were consistently estimated to have a worse course of adolescent CMDs compared with their male counterparts. For example, the investigators found that about 64% (95% CI 58–70) of females had a chronic course of depressive symptoms compared with about 37% [95% CI 26–48] of males).²

“To our knowledge, this longitudinal study shows the highest cumulative incidence of clinically significant symptoms of common mental disorders that has ever been reported across adolescence from any country,” Susan Sawyer, MBBS, MD, FRACP, professor at MCRI, said in the news release. “This high incidence of common mental health problems suggests that even the most well-resourced country would struggle to provide adequate treatment if every young person sought help. Beyond clinical care, we urgently need to fund, develop and evaluate preventive strategies that aim to reduce the onset and chronicity of depression and anxiety.”¹

The authors note that the onset of anxiety and depression symptoms increased at times that concurred with educational stress, such as transitioning from primary to secondary school, exam periods, and the end of compulsory education. They also noted that the 75% of participants who struggled with mental health problems during the COVID-19 years already had symptoms, highlighting factors beyond the pandemic stressors.^1,2

“Adolescents today are growing up in a distinctly different psychosocial landscape than earlier generations, one that is characterized by greater mental health literacy, reduced stigma, and at times the glamorization of mental health problems,” said Robson. “Given this context, our next step will be to explore what impact these reported symptoms have on the functioning and health outcomes of contemporary adolescents.”¹

REFERENCES

1. Almost three quarters of adolescents experience depression or anxiety. News release. Murdoch Children’s Research Institute. December 17, 2024. Accessed December 19, 2024. https://www.eurekalert.org/news-releases/1068330

2. Robson EM, Mbiostat HMH, Dashti SG, et al. Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population-based cohort study in Australia. Lancet Psychiatry. 2024;12(1):44-53.

3. Murdoch Children’s Research Institute. Child to Adult Transition Study (CATS). Accessed December 19, 2024. https://www.mcri.edu.au/research/projects/child-adult-transition-study-cats