Department of Family Medicine, Queen's University, 220 Bagot St., Kingston K7L 5E9, ON, Canada.
University of Calgary Dept. of Family Medicine, Calgary, Canada.
J Affect Disord. 2021 Mar 1;282:141-146. doi: 10.1016/j.jad.2020.12.178. Epub 2020 Dec 30.
Self-reported data and media suggest youth mental health is declining. To more objectively measure this, we conducted a population-wide investigation of changes in diagnosed point prevalences of anxiety/depression among children and young adults between 1997 and 2017 in Ontario, Canada.
All Ontarians (population approximately 14 million) age 5-25 in each index year were included and grouped as follows: 5-10, 11-15, 16-20, 21-25. As the Canadian medical system is public and universal, all diagnoses can be tracked via billing submissions. The outcome of interest was non-psychotic anxiety/depression diagnosed by any physician in any setting. Using regression analyses, cross-sectional administrative (billing) data for 1997, 2002, 2007, 2012 and 2017 for diagnoses of anxiety/depression were linked to indicators of sex, household income, rurality, and immigrant/refugee status.
Point prevalence of anxiety/depression diagnoses increased with age (girls 2·1 to 16·9%, boys 2·9 to 10·6%), particularly from age 11 to 20. Rates, overall, remained stable until 2012 then rose among 11-15 and 16-20 year-olds. This pattern varied by sex. An earlier inverse association with rural residency disappeared by 2017, while immigrant status aligned increasingly with absence of diagnosed anxiety/depression. Lowest household income quintile was associated with higher prevalence of diagnoses.
Cross-sectional data preclude hypothesising about causes of observed shifts.
We found no overall upsurge in youth anxiety/depression, although small increments between 2012 and 2017, and variability with sociodemographic characteristics suggest a possible looming trend and the merit of studying concomitant and potential explanatory shifts in social circumstances.
自我报告的数据和媒体表明，青少年的心理健康状况正在下降。为了更客观地衡量这一点，我们对加拿大安大略省的儿童和年轻人在 1997 年至 2017 年间焦虑/抑郁的诊断点患病率变化进行了一项全人群调查。
每个索引年的所有安大略省（人口约 1400 万）年龄在 5-25 岁的人都被包括在内，并分为以下几组：5-10 岁、11-15 岁、16-20 岁、21-25 岁。由于加拿大的医疗系统是公共和普遍的，所有的诊断都可以通过账单提交来跟踪。我们感兴趣的结果是任何医生在任何环境下诊断的非精神病性焦虑/抑郁。使用回归分析，将 1997 年、2002 年、2007 年、2012 年和 2017 年的横断面行政（计费）数据与性别、家庭收入、农村性和移民/难民身份的指标相联系，用于焦虑/抑郁的诊断。
焦虑/抑郁的诊断点患病率随年龄增长而增加（女孩 2.1%至 16.9%，男孩 2.9%至 10.6%），特别是从 11 岁到 20 岁。总体而言，这一比例一直保持稳定，直到 2012 年，11-15 岁和 16-20 岁的儿童和年轻人的发病率上升。这种模式因性别而异。2017 年，农村居住与发病率之间的反比关系消失了，而移民身份与无焦虑/抑郁诊断的关系越来越密切。最低家庭收入五分位数与较高的诊断率相关。
横断面数据排除了对观察到的变化原因的假设。
我们没有发现青少年焦虑/抑郁总体上的上升趋势，尽管在 2012 年至 2017 年之间有微小的增加，以及与社会人口特征的差异，表明可能存在潜在的趋势，因此有必要研究社会环境中同时发生的和潜在的解释性变化。
