Department of Epidemiology, Mailman School of Public Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, Suite 724, New York, NY, 10032, USA.
Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile.
Soc Psychiatry Psychiatr Epidemiol. 2019 Aug;54(8):987-996. doi: 10.1007/s00127-019-01697-8. Epub 2019 Mar 30.
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.
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.
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.
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.
青少年，尤其是女孩，心理健康问题和与心理健康相关的死亡率有所增加。这些趋势对病因学和预防具有影响，并表明需要关注新出现的风险因素。本研究估计了美国具有代表性的学校青少年样本中，1991 年至 2018 年期间抑郁症状的年龄、时期和队列效应。
数据来自 1991 年至 2018 年监测未来每年的 8 年级、10 年级和 12 年级学生的横断面调查（N=1,260,159）。使用四个问题衡量抑郁症状，这些问题在所有 28 年中都有一致的措辞和数据收集程序。使用分层年龄-时期-队列模型估计年龄-时期-队列效应。
在女孩中，抑郁症状从 1991 年到 2011 年下降，然后逆转，在 2018 年达到峰值；这些增加主要反映了时期效应，与所有时期的平均值相比，从 2012 年开始逐渐增加，并在 2018 年达到峰值（估计值=1.15，p<0.01）。队列效应很小，表明所有年龄组都有增加。在男孩中，趋势相似，尽管增加的程度不如女孩明显；最近出生的队列中存在下降的队列效应，表明近年来，与年龄较大的男孩相比，年轻男孩的抑郁症状增加速度较慢。种族/民族和父母教育程度的趋势基本相似，1999-2004 年出生的西班牙裔女孩有一个正的队列效应。
青少年，尤其是女孩，抑郁症状在增加，这与抑郁症和自杀率的增加一致。精神障碍症状的人口差异突出了当前精神障碍风险的环境决定因素的重要性，并提供了新兴风险因素的证据，这些因素可能正在塑造青少年心理健康的一个新的令人担忧的趋势。
