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| May 13, 2008 |
Major Depressive Episode among Youths Aged 12 to 17 in the United States: 2004 to 2006
In Brief
- Combined 2004 to 2006 data show that rates of past year major depressive episode (MDE) among youths aged 12 to 17 generally increased with increasing age
- Among youths aged 12 to 17 with a past year MDE, nearly half (48.3 percent) reported severe impairment in at least one of four role domains (i.e., home, school/work, family relationships, or social life), and nearly one quarter (21.0 percent) reported very severe impairment in at least one of the domains
- Youths with a past year MDE who reported no more than mild impairment in any domain of role functioning were unable to carry out normal activities on an average of 11.7 days in the past year, while those who reported a very severe impairment were unable to carry out normal activities on an average of 58.4 days in the past year
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During the past few years, increasing attention has been paid to the prevalence and severity of major depressive episode (MDE) among children and adolescents.1 Recent research has shown that depression experienced during early adolescence may adversely affect growth and development, school performance, and peer/family relationships in later adolescence, as well as increase the risk of negative health outcomes in young adulthood.2,3
The National Survey on Drug Use and Health (NSDUH) includes questions for youths aged 12 to 17 to assess MDE. For these estimates, MDE is defined using the diagnostic criteria set forth in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),4 which specifies a period of 2 weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.5
NSDUH also includes questions from the Sheehan Disability Scale (SDS) that measure the impact of MDE on a person's life. The SDS asks youths to give a rating of 0 to 10 (with 10 being the highest) for the level of impairment caused by the disorder in each of four role domains: (1) chores at home, (2) school or work, (3) close relationships with family, and (4) social life.6
This issue of The NSDUH Report examines demographic differences in the rate of past year MDE among youths aged 12 to 17, levels of impairment resulting from MDE as measured by the SDS, average number of days of inability to carry out normal activities due to MDE, and history of previous depressive episodes. All findings presented in this report are annual averages based on combined 2004 to 2006 NSDUH data.
Past Year MDE
Combined data from 2004 to 2006 indicate that an annual average of 8.5 percent of youths aged 12 to 17 (an estimated 2.1 million persons) experienced at least one MDE in the past year. Female adolescents were more than twice as likely to have experienced MDE in the past year as male adolescents (12.7 vs. 4.6 percent). Rates of past year MDE generally increased with increasing age until ages 16 and 17 (Figure 1).
Figure 1. Percentages of Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE), by Age: 2004-2006
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Figure 1 Table. Percentages of Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE), by Age: 2004-2006
| Age |
Percent |
| 12 |
4.1% |
| 13 |
6.2% |
| 14 |
7.9% |
| 15 |
9.7% |
| 16 |
11.5% |
| 17 |
11.5% |
| Source: SAMHSA, 2004-2006 NSDUHs. |
Past Year Impairment among Youths with Past Year MDE
Less than 1 percent (0.4 percent) of youths aged 12 to 17 with past year MDE reported having experienced no resulting impairment across the role domains of home, school/work, family relationships, and social life (Figure 2). Nearly half (48.3 percent) reported severe impairment in at least one of these role domains, and nearly one quarter (21.0 percent) reported very severe impairment in at least one of the domains.
Figure 2. Overall Severity of Role Impairment* among Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE): 2004-2006
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Figure 2 Table. Overall Severity of Role Impairment* among Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE): 2004-2006
| Severity |
Percent |
| None |
0.4% |
| Mild |
5.3% |
| Moderate |
25.0% |
| Severe |
48.3% |
| Very Severe |
21.0% |
| Source: SAMHSA, 2004-2006 NSDUHs. |
As the severity of role impairment increased, the average number of days in the past year when youths were unable to carry out normal activities also generally increased. Youths with past year MDE who reported no more than mild impairment in any domain of role functioning were unable to carry out normal activities on an average of 11.7 days in the past year, while those who reported a very severe impairment were unable to carry out normal activities on an average of 58.4 days in the past year (Figure 3).
Figure 3. Mean Number of Days Unable to Carry Out Normal Activities Due to Depression among Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE), by Overall Severity of Role Impairment*: 2004-2006
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Figure 3 Table. Mean Number of Days Unable to Carry Out Normal Activities Due to Depression among Youths Aged 12 to 17 Who Experienced a Past Year Major Depressive Episode (MDE), by Overall Severity of Role Impairment*: 2004-2006
| Severity |
Number of Days |
| Mild |
11.7 |
| Moderate |
14.1 |
| Severe |
25.8 |
| Very Severe |
58.4 |
| Source: SAMHSA, 2004-2006 NSDUHs. |
History of Prior MDE among Youths with Past Year MDE
Among youths aged 12 to 17 who experienced at least one MDE in the past year, 91.7 percent reported more than one period in their lifetime during which they were feeling sadness, discouragement, or boredom and also were having other problems for 2 weeks or longer.
End Notes
1 Costello, E. J., Erkanli, A., & Angold, A. (2006). Is there an epidemic of child or adolescent depression? Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47, 1263-1271.
2 Keenan-Miller, D., Hammen, C. L., & Brennan, P. A. (2007). Health outcomes related to early adolescent depression. Journal of Adolescent Health, 41, 256-262.
3 Bhatia, S. K., & Bhatia, S. C. (2007). Childhood and adolescent depression. American Family Physician, 75, 73-80.
4 American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
5 In assessing MDE, no exclusions were made for MDE caused by medical illness, bereavement, or substance use disorders.
6 Respondents are asked to think of the time in the past 12 months when the problem(s) with their mood was the worst. They are shown a scale from 0 to 10 and are instructed to use it to describe how much their mood caused problems with each activity during that time. On the scale shown to respondents, the value of 0 is labeled as No Problems; values from 1 to 3 are labeled as Mild; values from 4 to 6 are labeled as Moderate; values from 7 to 9 are labeled as Severe; and the value of 10 is labeled as Very Severe.
Figure Note
* Overall severity of role impairment is defined as the highest level of severity of role impairment reported across all four SDS role domains.
Suggested Citation
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (May 13, 2008). The NSDUH Report - - Major Depressive Episode among Youths Aged 12 to 17 in the United States: 2004 to 2006. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2004 to 2006 data used in this report are based on information obtained from 67,706 youths aged 12 to 17. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Information for earlier NSDUHs is available in the following publications:
2005 NSDUH: (DHHS Publication No. SMA 06-4194, NSDUH Series H-30)
2004 NSDUH: (DHHS Publication No. SMA 05-4062, NSDUH Series H-28)
Also available online: http://oas.samhsa.gov.
Because of improvements and modifications to the 2002 NSDUH, estimates from the 2004 through 2006 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time. |
| The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.
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This page was last updated on December 30, 2008.
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