Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context
Summary: Background: Despite the recent rise in depressive symptoms among adolescents, trends in at-risk groups remain poorly understood. This study estimated national trends in depressive symptoms among high school students with and without health-risk behaviors. Methods: Data were analyzed from t...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X25000109 |
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| author | Tanner J. Bommersbach Mark Olfson Taeho Greg Rhee |
| author_facet | Tanner J. Bommersbach Mark Olfson Taeho Greg Rhee |
| author_sort | Tanner J. Bommersbach |
| collection | DOAJ |
| description | Summary: Background: Despite the recent rise in depressive symptoms among adolescents, trends in at-risk groups remain poorly understood. This study estimated national trends in depressive symptoms among high school students with and without health-risk behaviors. Methods: Data were analyzed from the 2007 to 2021 Youth Risk Behavior Survey (YRBS), a biennial cross-sectional survey of US high school students (n = 119,654). Depressive symptoms were defined as past-year feelings of sadness/hopelessness almost every day for ≥2 weeks impacting usual activities. 24 health-risk behaviors across five categories (violence, substance use, sexual, physical/sedentary, and weight-related) were considered. Multivariable-adjusted logistic regression identified health-risk behaviors independently associated with depressive symptoms. National trends in depressive symptoms among students with and without these health-risk behaviors were estimated. National trends in health-risk behaviors were also estimated among those with depressive symptoms. Findings: Among 119,654 students (mean age, 16.0 [SD = 1.2] years; 50.1% females; and 45.3% non-Hispanic White), depressive symptoms increased from 28.4% (2007) to 42.3% (2021) (biennial average percent change (BAPC), 3.0% [95% confidence interval (CI), 2.6–3.4%]). The largest increases occurred among females (BAPC, 3.3% [2.9–3.8%]) and non-Hispanic White students (BAPC, 3.6% [3.0–4.1%]). Depressive symptoms increased more among students engaging in ≤1 risk category (BAPC = 4.6% [3.6–5.7%]) than students engaging in 4–5 risk categories (BAPC = 2.9% [2.4–3.3%]) (interaction, p = 0.037) and there was a general trend toward decreasing engagement in risk behaviors among students with depressive symptoms. In subgroup analyses, there was a disproportionately large increase in depressive symptoms among students reporting cannabis use, high-risk screen time, shorter sleep hours, and unhealthy weight perception. Interpretation: Depressive symptoms increased faster among high school students without than with multiple behavioral risk factors. A broadening of the depression risk profile underscores the potential value of universal depression screening to identify students who may otherwise go undetected by targeted screening. Funding: The study was not funded. |
| format | Article |
| id | doaj-art-2913404193b04556bd6746916dea1552 |
| institution | Kabale University |
| issn | 2667-193X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj-art-2913404193b04556bd6746916dea15522025-01-24T04:45:53ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-02-0142101000Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in contextTanner J. Bommersbach0Mark Olfson1Taeho Greg Rhee2Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USADepartment of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USADepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; New England Mental Illness, Research Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA; Corresponding author. UConn School of Medicine and Yale School of Medicine, USA.Summary: Background: Despite the recent rise in depressive symptoms among adolescents, trends in at-risk groups remain poorly understood. This study estimated national trends in depressive symptoms among high school students with and without health-risk behaviors. Methods: Data were analyzed from the 2007 to 2021 Youth Risk Behavior Survey (YRBS), a biennial cross-sectional survey of US high school students (n = 119,654). Depressive symptoms were defined as past-year feelings of sadness/hopelessness almost every day for ≥2 weeks impacting usual activities. 24 health-risk behaviors across five categories (violence, substance use, sexual, physical/sedentary, and weight-related) were considered. Multivariable-adjusted logistic regression identified health-risk behaviors independently associated with depressive symptoms. National trends in depressive symptoms among students with and without these health-risk behaviors were estimated. National trends in health-risk behaviors were also estimated among those with depressive symptoms. Findings: Among 119,654 students (mean age, 16.0 [SD = 1.2] years; 50.1% females; and 45.3% non-Hispanic White), depressive symptoms increased from 28.4% (2007) to 42.3% (2021) (biennial average percent change (BAPC), 3.0% [95% confidence interval (CI), 2.6–3.4%]). The largest increases occurred among females (BAPC, 3.3% [2.9–3.8%]) and non-Hispanic White students (BAPC, 3.6% [3.0–4.1%]). Depressive symptoms increased more among students engaging in ≤1 risk category (BAPC = 4.6% [3.6–5.7%]) than students engaging in 4–5 risk categories (BAPC = 2.9% [2.4–3.3%]) (interaction, p = 0.037) and there was a general trend toward decreasing engagement in risk behaviors among students with depressive symptoms. In subgroup analyses, there was a disproportionately large increase in depressive symptoms among students reporting cannabis use, high-risk screen time, shorter sleep hours, and unhealthy weight perception. Interpretation: Depressive symptoms increased faster among high school students without than with multiple behavioral risk factors. A broadening of the depression risk profile underscores the potential value of universal depression screening to identify students who may otherwise go undetected by targeted screening. Funding: The study was not funded.http://www.sciencedirect.com/science/article/pii/S2667193X25000109AdolescentDepressionYouthMental healthSubstance use |
| spellingShingle | Tanner J. Bommersbach Mark Olfson Taeho Greg Rhee Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context The Lancet Regional Health. Americas Adolescent Depression Youth Mental health Substance use |
| title | Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context |
| title_full | Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context |
| title_fullStr | Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context |
| title_full_unstemmed | Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context |
| title_short | Trends in depressive symptoms among high school students with and without health-risk behaviors in the United States: A population-based studyResearch in context |
| title_sort | trends in depressive symptoms among high school students with and without health risk behaviors in the united states a population based studyresearch in context |
| topic | Adolescent Depression Youth Mental health Substance use |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X25000109 |
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