Children, teens and young adults in Southern California were struggling with increased rates of depression and anxiety for years before the pandemic. Then COVID-19 came along and made theirs mental health struggles even worse.
Of the 1.7 million young patients who were part of Kaiser Permanente Southern California Across the health system, the prevalence of clinically diagnosed depression was 60% higher in 2021 than five years ago, according to a new study. The researchers found that the prevalence of anxiety increased by 35% during that period among young patients who did not have depression.
For both conditions, the annual rate of increase during the pandemic years of 2020 and 2021 was significantly higher than the three years preceding them.
Furthermore, this trend was seen across all demographic groups regardless of age, gender, race, ethnicity or income. Report Published Tuesday in JAMA Network Open.
“COVID was initially considered an infectious-disease crisis,” said Dr. Siddharth KumarA child and adolescent psychiatrist at Kaiser and senior author of the study. “This was the other side of COVID. “The mental health effects are long-lasting and have a huge impact on society.”
It’s no secret that young people are suffering.
in 2016 when National Survey of Children’s Health Asked parents and other caregivers how their youngsters were faring, their responses revealed that 3.1% of children ages 3 to 17 were depressed. by 2020, that figure was 4%,
That survey also found that the prevalence of anxiety among those children increased from 7.1% to 9.2% during the same period.
Another study of adolescents aged 12 to 17 who participated in 2021 National Survey on Drug Use and Health he got it 20% of them Had experienced major depressive disorder in the past year.
And US Surgeon General Vivek Murthy Focused the country’s attention on this issue by issuing public health advice About youth mental health in 2021. The advisory cited studies that found 25% of children and adolescents aged 4 to 17 around the world had experienced symptoms of depression during the pandemic, while 20% had symptoms of anxiety. Both measures were doubled Since the beginning of the pandemic.
The new study is believed to be the first large-scale examination of youth mental health in the COVID era based on official diagnoses rather than survey data, according to Kumar and his colleagues at Kaiser Permanente Southern California, whose region extends from Ventura County. Extends to Ventura County. Inland Empire and Kern County to San Diego.
The study authors focused on approximately 1.7 million health plan members who were between the ages of 5 and 22 on the first day of at least one year between 2017 and 2021.
Those children and young adults reflected the diversity of Southern California as a whole, the researchers wrote. About half were Latino, 23% were white, 8% were Asian and 8% were black. (Data was missing for some plan members.)
Slightly more than half – 55% – were from households with annual incomes of $50,000 to $99,999. An additional 29% were from households that earned less, and 16% were from households that earned more.
The researchers checked whether the young patients had been formally diagnosed with any type of clinical depression. To qualify, a doctor had to determine that a patient was experiencing “depressed or irritable mood or loss of interest in activities” that caused “significant impairment in daily living.”
They found that 1.35% of patients were newly diagnosed with depression in 2017. This figure increased to 1.58% in 2018, 1.76% in 2019, 1.84% in 2020, and 2.1% in 2021, with incidence increasing in all groups regardless of age. , gender, race, ethnicity or income.
The researchers found that the incidence of depression was highest among high school-aged adolescents aged 14 to 17 and college-age young adults aged 18 to 22 across the study. In general, girls and women were more likely to be diagnosed with depression than boys and men, and the risk was consistently higher for patients who were white and who came from the highest income households.
When researchers matched all children and young adults with a new or existing depression diagnosis, they found that the prevalence was 2.55% in 2017, 2.92% in 2018, 3.27% in 2019, 3.53% in 2020, and 4.08% in 2021. The researchers said the annual rate of increase during the pandemic was higher than before, and the difference was large enough to be statistically significant.
He also examined patients suffering from anxiety, saying that the condition was characterized by “extreme feelings of anxiety or persistent, even intrusive thoughts about some fear or constant fear in general.”
About 37% of young patients with anxiety were also diagnosed with depression. The researchers kept them separate and focused solely on those who had anxiety.
According to that measure, the incidence of newly diagnosed cases was 1.77% in 2017, 2.03% in 2018, 2.1% in 2019, 1.93% in 2020, and 2.32% in 2021.
The incidence of anxiety without depression was highest among college-age young adults. According to the study, the risk was also higher for people who were white and in the highest income brackets.
The prevalence of new or existing anxiety in patients without depression followed a similar pattern – 3.13% in 2017, 3.51% in 2018, 3.75% in 2019, 3.61% in 2020, and 4.22% in 2021.
Researchers found that both new and total cases of anxiety without depression increased significantly more in the COVID years than in previous years.
“Anxiety, mild depression, despair, hopelessness – these are normal emotions that we all have from time to time. But when it reaches the clinical level, it is a different thing,” Kumar said.
And when this happens to youth, the effects can be lasting.
“Adolescence is when you build your sense of self,” he said. “When adults go through stressful situations in their lives, often their reactions are based on what their sense of self was like when they were younger.”
Christina BethelA social epidemiologist and director Child and Adolescent Health Measurement Initiative At Johns Hopkins University, it was agreed that the pandemic has exacerbated the mental health crisis affecting youth across the country. But he said medical records don’t capture the full scope of the problem.
Patients with depression or anxiety may not have access to a doctor, and those who do may not feel comfortable seeking treatment, he said. Primary care doctors have to do the screening teenagers And adults For depression, but this is not always the case. When this happens, patients may still not be able to answer the screening questions honestly. Sometimes doctors make mistakes that lead to misdiagnosis. And sometimes a patient who was correctly diagnosed recovers from depression or anxiety, but their medical records are not updated to reflect this.
Bethel, who was not involved in the study, said, “Medical records are often inaccurate, incomplete and available only to those involved in health care.”
In his view, the most important question is not whether someone has a diagnosis of depression or anxiety, but rather how they are actually faring.
“There’s a whole group of people who have a diagnosis and they thrive, and there’s a whole group of people who don’t have a diagnosis and don’t thrive,” he said. “We want to keep our eyes on the prize, which is youth well-being.”
