Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Institute for Social Research, University of Michigan, Ann Arbor.
JAMA Netw Open. 2024 Aug 1;7(8):e2427748. doi: 10.1001/jamanetworkopen.2024.27748.
Depressive symptoms have increased among US adolescents since 2010. It remains unclear as to what extent this increase will persist into young adulthood, potentially turning the youth mental health crisis into a young adult mental health crisis.
To test the association between birth cohort and adolescent depressive symptoms at ages 18, 19 to 20, and 21 to 22 years and changes in these symptoms by cohort.
DESIGN, SETTING, AND PARTICIPANTS: This panel cohort study analyzed data from the Monitoring the Future longitudinal survey from 1990 to 2019, including birth cohorts from 1972 to 2001. Survey respondents were recruited from US high schools in 12th grade and were approximately aged 18 years (at baseline) through age 21 to 22 years (during mail and web follow-up). Data analysis was conducted from April to October 2023.
Depressive symptoms score (>12 vs ≤12, with >12 representing top-decile scores) on a scale examining affective items (eg, "Life often seems meaningless").
High (vs lower) depressive symptoms at ages 19 to 20 years and 21 to 22 years.
The 36 552 respondents included 18 597 females (50.5%), and most reported having a parent who graduated from college (44.8%). Among females, 19.1% (95% CI, 16.7%-21.4%) of the most recent birth cohort (born: 1997-2001) had high depressive symptoms at age 18 years, higher than any previous birth cohort. While prevalence declined by age 21 to 22 years, it remained higher than previous cohorts at that age. Among males, 13.4% (95% CI, 11.2%-15.6%) of the most recent birth cohort had high depressive symptoms at age 18 years, and prevalence increased through young adulthood. Males with high baseline depressive symptoms had 10.24 (95% CI, 7.01-14.97) times the odds of symptoms at age 19 to 20 years and 6.20 (95% CI, 3.93-9.78) times the odds of symptoms at age 21 to 22 years. Females with high baseline depressive symptoms had 9.16 (95% CI, 6.57-12.76) times the odds of symptoms at age 19 to 20 years and 7.28 (95% CI, 4.92-10.78) times the odds of symptoms at age 21 to 22 years. The magnitude of the associations did not vary over time. Population attributable fractions indicated that the total proportion of young adult symptoms associated with depressive symptoms at age 18 years among females has increased; in the most recent birth cohort, 55.25% (95% CI, 38.11%-65.13%) of depressive symptoms at age 21 to 22 years were associated with symptoms at age 18 years.
This panel cohort study found that increases in depressive symptoms in adolescence persisted into young adulthood, suggesting the need for primary prevention and mental health resources during the adolescent years.
自 2010 年以来，美国青少年的抑郁症状有所增加。目前尚不清楚这种增长在多大程度上会持续到成年早期，这可能会使青少年心理健康危机演变成成年早期心理健康危机。
检验出生队列与青少年 18 岁、19 至 20 岁和 21 至 22 岁时的抑郁症状之间的关联，以及这些症状随队列的变化。
设计、地点和参与者：本面板队列研究分析了 1990 年至 2019 年监测未来纵向调查的数据，包括 1972 年至 2001 年的出生队列。调查对象是从美国 12 年级的高中招募的，年龄大约在 18 岁（基线）到 21 至 22 岁（在邮件和网络随访期间）。数据分析于 2023 年 4 月至 10 月进行。
在评估情感项目的量表上（例如，“生活常常毫无意义”），抑郁症状评分（>12 分与≤12 分，>12 分代表最高十分位数分数）。
19 至 20 岁和 21 至 22 岁时出现（高）抑郁症状。
共有 36552 名受访者，包括 18597 名女性（50.5%），大多数人报告其父母中有一方毕业于大学（44.8%）。在女性中，最近出生队列（1997-2001 年出生）的 19.1%（95%CI，16.7%-21.4%）在 18 岁时出现高抑郁症状，高于以往任何一个出生队列。虽然患病率在 21 至 22 岁时下降，但仍高于该年龄段的前几个队列。在男性中，最近出生队列的 13.4%（95%CI，11.2%-15.6%）在 18 岁时出现高抑郁症状，且患病率在成年早期有所增加。基线时有高抑郁症状的男性在 19 至 20 岁时出现症状的几率是基线时没有高抑郁症状的男性的 10.24 倍（95%CI，7.01-14.97），在 21 至 22 岁时出现症状的几率是基线时没有高抑郁症状的男性的 6.20 倍（95%CI，3.93-9.78）。基线时有高抑郁症状的女性在 19 至 20 岁时出现症状的几率是基线时没有高抑郁症状的女性的 9.16 倍（95%CI，6.57-12.76），在 21 至 22 岁时出现症状的几率是基线时没有高抑郁症状的女性的 7.28 倍（95%CI，4.92-10.78）。这些关联的幅度随时间没有变化。人群归因分数表明，与女性 21 至 22 岁时的抑郁症状相关的年轻成人症状总比例有所增加；在最近的出生队列中，55.25%（95%CI，38.11%-65.13%）的 21 至 22 岁时的抑郁症状与 18 岁时的症状相关。
本面板队列研究发现，青春期抑郁症状的增加持续到成年早期，这表明需要在青少年时期进行初级预防和心理健康资源。
