Pediatric Depression and Anxiety Increased Significantly From 2017 to 2021

The prevalence of depression and anxiety among children, adolescents, and young adults in Southern California has increased significantly from 2017 to 2021, according to findings published in JAMA Network Open.

Despite an understanding that major depressive disorder (MDD) has affected about 20% of adolescents aged 12 to 17, there is still a need to understand clinical diagnoses and disparities in mental health care among youths, especially before and during the COVID-19 pandemic.

To fill this gap, the current population-based cohort study tracked Southern California residents aged 5 to 22 from 2017 to 2021. Researchers utilized electronic medical records to track the clinical diagnoses of depression and anxiety using ICD-10 codes. Data was stratified by various factors, including age, gender, race/ethnicity, household income, weight status, and comorbidities, revealing significant disparities among different subgroups.

There was a total of 1,703,090 unique participants with a mean (SD) age of 14 (5) years, 30% of which were aged 5.0 to 10.9 and 31% were aged 18.0 to 22.9. Each year, around 51% were boys or men while 50% were Hispanic and 23% were non-Hispanic White.

The researchers found that the overall incidence of depression diagnosis rose by 55.6%, from 1.35% in 2017 to 2.10% in 2021 (P<.001 for the trend), while the prevalence increased by 60%, from 2.55% to 4.08%. Similarly, the incidence of anxiety without depression grew by 31.1% from 1.77% to 2.32%, and the prevalence rose by 35.2% from 3.13% to 4.22% (P<.001) during the same time frame.

The increase in mental health diagnoses was more pronounced during the pandemic (2020 to 2021) than in the pre-pandemic years (2017 to 2019) with mean incidences of 1.97% and 1.56% respectively (all P<.001). However, depression incidence remained consistent with earlier trends. In contrast, anxiety without depression slightly declined in 2020 but rose significantly in 2021.

Rates of depression and anxiety were highest in adolescents aged 14 to 17 and young adults aged 18 to 22. Girls and women, particularly those identifying as non-Hispanic American Indian, Alaska Native, or non-Hispanic White, also showed elevated rates. Age was the primary factor contributing to the heightened risk of depression, whereas weight status showed the strongest link to anxiety without accompanying depression.

“The significant increases were observed across all age, gender, race and ethnicity, estimated household income, weight status, and comorbidity subgroups…highlighting a need for increased mental health services for our young population,” the study authors concluded.

Study limitations include a lack of generalizability beyond Southern California and the potential underrepresentation of depression and anxiety due to barriers like symptom variability and limited healthcare access.

This research was supported by the Care Improvement Research Team of Kaiser Permanente Southern California.

This article originally appeared on Psychiatry Advisor