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An integrative literature review of birth cohort and time period trends in adolescent depression in the United States

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Abstract

Purpose

The aim of this literature review is to examine evidence of time trends and birth cohort effects in depressive disorders and symptoms among US adolescents in peer-reviewed articles from January 2004 to April 2022.

Methods

We conducted an integrative systematic literature review. Three reviewers participated at different stages of article review. Of the 2234 articles identified in three databases (Pubmed, ProQuest Central, Ebscohost), 10 met inclusion criteria (i.e., adolescent aged United States populations, included information about birth cohort and survey year, focused on depressive symptoms/disorders).

Results

All 10 articles observed increases in depressive symptoms and disorders in adolescents across recent survey years with increases observed between 1991 and 2020. Of the 3 articles that assessed birth cohort trends, birth cohort trends were less prominent than time period trends. Proposed explanations for increases included social media, economic-related reasons, changes in mental health screening and diagnosis, declining mental health stigma, increased treatment, and, in more recent years, the COVID-19 pandemic.

Conclusions

Multiple cross-sectional surveys and cohort studies documented rising prevalence of depressive symptoms and disorder among adolescents from 1991 to 2020. Mechanisms driving this increase are still unknown. Research to identify these mechanisms is needed to inform depression screening and intervention efforts for adolescents.

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Funding

DWB is a fellow of the Canadian Institute for Advanced Research (CIFAR) Child Brain Development (CBD) Network.

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Authors and Affiliations

  1. Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA

    Melanie S. Askari, Daniel W. Belsky, Sandhya Kajeepeta, Emilie Bruzelius & Katherine M. Keyes

  2. New York State Psychiatric Institute, Columbia University, 1051 Riverside Dr, New York, NY, 10032, USA

    Mark Olfson

  3. RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA, 15213, USA

    Joshua Breslau

  4. Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 797, Baltimore, MD, 21205, USA

    Ramin Mojtabai

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  1. Melanie S. Askari
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  2. Daniel W. Belsky
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  3. Mark Olfson
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  4. Joshua Breslau
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  5. Ramin Mojtabai
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  7. Emilie Bruzelius
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  8. Katherine M. Keyes
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Contributions

Dr. Melanie Askari conceptualized and designed the study, conducted the literature review, drafted the article, and revised the manuscript text. Drs. Daniel Belsky, Mark Olfson, Joshua Breslau, and Ramin Mojtabai helped with interpretation of findings and reviewed/revised the article critically for important intellectual content. Drs. Sandhya Kajeepeta and Emilie Bruzelius helped conduct the literature review and reviewed/revised the article critically for important intellectual content. Dr. Katherine Keyes provided guidance for the conceptualization and design of the study, helped with interpretation of findings, and reviewed/revised the article critically for important intellectual content.

Corresponding author

Correspondence to Melanie S. Askari.

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All authors have no competing interests to declare.

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All authors have approved the manuscript for submission.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Appendix Table: Literature review search details

Appendix Table: Literature review search details

Pubmed; searched April 6, 2022

ProQuest central (Psychology database, Public health database, social science database); searched April 6, 2022

Ebscohost (APA PSYCINFO database, SocINDEX with Full Text database, social sciences full text database); searched April 6, 2022

[(birth year) OR (birth cohort) OR (cohort effects)] AND [(time trends)] OR (time period) AND [(major depressive episode) OR (depression) OR (major depressive disorder) OR (minor depression) OR (depression) OR (depressive symptoms)] AND [(adolescent) OR (youth) OR (high school students) OR (middle school) OR (adolescence) OR (teen) OR (teenager) OR (teenagers)] AND [(epidemiologic studies) OR (cohort studies) OR (case–control studies) OR (longitudinal studies) OR (cross-sectional studies) OR (observational studies) OR (ecological studies)] AND (United States)

-Additional filters: published between 2004 and present

[(birth year) OR (birth cohort) OR (cohort effects)] AND [(time trends) OR (time period)] AND [(major depressive episode) OR (depression) OR (major depressive disorder) OR (minor depression) OR (depression) OR (depressive symptoms)] AND [(adolescent) OR (youth) OR (high school students) OR (middle school) OR (adolescence) OR (teen) OR (teenager) OR (teenagers)] AND [(epidemiologic studies) OR (cohort studies) OR (case–control studies) OR (longitudinal studies) OR (cross-sectional studies) OR (observational studies) OR (ecological studies)] AND (United States) AND loc(United States)

-Additional filters: source type = scholarly journals, language = English, exclude duplicate documents (removed duplicates across these 3 databases within proquest central), did NOT select spelling variants for your search terms or form variants for your search terms

-extra filters: published after dec 31, 2003, subject: mental health OR mental depression, document type: article, language: English, peer reviewed, full text

[(birth year) OR (birth cohort) OR (cohort effects)] AND [(time trends) OR (time period)] AND [(major depressive episode) OR (depression) OR (major depressive disorder) OR (minor depression) OR (depression) OR (depressive symptoms)] AND [(adolescent) OR (youth) OR (high school students) OR (middle school) OR (adolescence) OR (teen) OR (teenager) OR (teenagers)] AND [(epidemiologic studies) OR (cohort studies) OR (case–control studies) OR (longitudinal studies) OR (cross-sectional studies) OR (observational studies) OR (ecological studies)] AND United States

-Additional filters: peer reviewed and published between 2004 and present

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Askari, M.S., Belsky, D.W., Olfson, M. et al. An integrative literature review of birth cohort and time period trends in adolescent depression in the United States. Soc Psychiatry Psychiatr Epidemiol (2023). https://doi.org/10.1007/s00127-023-02527-8

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