Changes in Self-Reported Depressive Symptoms Among Adults in the United States From 2005 to 2016

Abstract

BACKGROUND: This study examined interview data from the National Health and Nutrition Examination Survey from 2005 to 2016. AIM: To determine national trends in self-reported depressive symptoms. METHOD: Depressive symptoms were assessed using self-reported data on the nine-item Patient Health Questionnaire (PHQ-9), with a total score ≥10 and an individual item score of 2 or 3, indicating greater severity. RESULTS: A total of 31,191 individuals contributed PHQ-9 data from 2005 to 2016. The absolute proportion of individuals with total PHQ-9 score ≥10 increased from 6.2% to 8.1%. After adjustment for participant demographic characteristics and comorbid conditions, the odds ratio for high PHQ-9 score at the end versus the beginning of the study interval was 1.27 (95% confidence interval [CI: 1.07, 1.50]). Anhedonia, guilt/worthlessness, appetite, and hypoactivity/hyperactivity had the largest increases in individual item risk after adjusting for demographic and comorbid characteristics. CONCLUSIONS: There were sizeable increases in the prevalence of self-reported depressive symptoms in the United States over an 11-year period. Further work is needed to understand the reasons for and implications of this increase. However, the results suggest greater efforts should be made by health care providers to screen for depressive symptoms that may warrant further assessment, treatment, or referral to mental health services as needed.

Keywords

depression self-report prevalence Patient Health Questionnaire

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References

American Psychiatric Association. (2013). Major depressive disorder. In American Psychiatric Association (Ed.), Diagnostic and statistical manual of mental disorders (5th ed., p. 165).

Brody

D. J.

Pratt

L. A.

Hughes

(2018). Prevalence of depression among adults aged 20 and over: United States, 2013-2016 (NCHS Data Brief No. 303). National Center for Health Statistics.

Cagney

K. A.

Browning

C. R.

Iveniuk

English

(2014). The onset of depression during the Great Recession: Foreclosure and older adult mental health. American Journal of Public Health, 104(3), 498-505. https://doi.org/10.2105/ajph.2013.301566

Center for Behavioral Health Statistics and Quality. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). http://www.samhsa.gov/data/

Centers for Disease Control and Prevention. (2005-2016). National Center for Health Statistics: National Health and Nutrition Examination Survey data. https://www.cdc.gov/nchs/nhanes/index.htm

Centers for Disease Control and Prevention. (2017). National Center for Health Statistics (NCHS). NCHS Research Ethics Review Board (ERB) approval. https://www.cdc.gov/nchs/nhanes/irba98.htm

Compton

W. M.

III. Cottler

L. B.

Jacobs

J. L.

Ben-Abdallah

Spitznagel

E. L.

(2003). The role of psychiatric disorders in predicting drug dependence treatment outcome. American Journal of Psychiatry, 160(5), 890-895. https://doi.org/10.1176/appi.ajp.160.5.890

Everson-Rose

S. A.

House

J. S.

Mero

R. P.

(2004). Depressive symptoms and mortality risk in a national sample: Confounding effects of health status. Psychosomatic Medicine, 66(6), 823-830. https://doi.org/10.1097/01.psy.0000145903.75432.1f

Fullerton

C. A.

Busch

A. B.

Normand

S. T.

McGuire

T. G.

Epstein

A. M.

(2011). Ten-year trends in quality and spending for depression: 1996-2005. Archives of General Psychiatry, 68(12), 1218-1226. https://doi.org/10.1001/archgenpsychiatry.2011.146

10.

Greenberg

P. E.

Fournier

Sisitsky

Pike

C. T.

Kessler

R. C.

(2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). Journal of Clinical Psychiatry, 76(2), 155-162. https://doi.org/10.4088/jcp.14m09298

11.

Haber

Billings

C. V.

(1995). Primary mental health care: A model for psychiatric-mental health nursing. Journal of the American Psychiatric Nurses Association, 1(5), 154-163. https://doi.org/10.1177/107839039500100504

12.

Hill

R. R.

(2013). Improving depression screening in patients with chronic illness. American Nurse Today, 8(10). https://www.americannursetoday.com/improving-depression-screening-in-patients-with-chronic-illness/

13.

Institute for Health Metrics and Evaluation. (2018). United States. http://www.healthdata.org/united-states

14.

Katikireddi

S. V.

Niedzwiedz

C. L.

Popham

(2012). Trends in population mental health before and after the 2008 recession: a repeat cross-sectional analysis of the 1991-2010 health surveys of England. BMJ Open, 2:e001790. https://doi.org/10.1136/bmjopen-2012-01790

15.

Kessler

R. C.

(2012). The costs of depression. Psychiatric Clinics of North America, 35(1), 1-14. https://doi.org/10.1016/j.psc.2011.11.005

16.

Kessler

R. C.

Berglund

Demler

Jin

Merikangas

K. R.

Walters

E. E.

(2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. https://doi.org/10.1001/archpsyc.62.6.593

17.

Kroenke

Spitzer

R. L.

Williams

J. B. W.

(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

18.

Marcus

S. C.

Olfson

(2010). National trends in the treatment for depression from 1998 to 2007. Archives of General Psychiatry, 67(12), 1265-1273. https://doi.org/10.1001/archgenpsychiatry.2010.151

19.

Mathers

C. D.

Loncar

(2006). Projections of global mortality and burden of disease from 2002 to 2030. PLOS Medicine, 3(11), e442. https://doi.org/10.1371/journal.pmed.0030442

20.

Meertens

Scheepers

Tax

(2003). Depressive symptoms in the Netherlands 1975-1996: A theoretical framework and an empirical analysis of socio-demographic characteristics, gender differences and changes over time. Sociology of Health & Illness, 25(2), 208-231. https://doi.org/10.1111/1467-9566.00332

21.

Mojtabai

Olfson

Han

(2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6), e20161878. https://doi.org/10.1542/peds.2016-1878

22.

Osypuk

T. L.

Caldwell

C. H.

Platt

Misra

(2012). The consequences of foreclosure for depressive symptomatology. Annals of Epidemiology, 22(6), 379-387. https://doi.org/10.1016/j.annepidem.2012.04.012

23.

Poole

Steptoe

(2018). Depressive symptoms predict incident chronic disease burden 10 years later: Finding from the English Longitudinal Study of Ageing (ELSA). Journal of Psychosomatic Research, 113, 30-36. https://doi.org/10.1016/j.jpsychores.2018.07.009

24.

Pratt

L. A.

Brody

D. J.

(2014). Depression in the U.S. household population, 2009-2012 (NCHS Data Brief No. 172). National Center for Health Statistics.

25.

Pratt

L. A.

Brody

D. J.

(2017). Antidepressant use among persons aged 12 and over: United States, 2011-2014 (NCHS Data Brief No. 283). National Center for Health Statistics.

26.

Saint Onge

J. M.

Krueger

P. M.

Rogers

R. G

. (2014). The relationship between major depression and nonsuicide mortality for U.S. adults: The importance of health behaviors. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 69(4), 622-632. https://doi.org/10.1093/geronb/gbu009

27.

Shim

R. S.

Baltrus

Rust

(2011). Prevalence, treatment, and control of depressive symptoms in the United States: Results from the National Health and Nutrition Examination Survey (NHANES), 2005-2008. Journal of the American Board of Family Medicine, 24(1), 33-38. https://doi.org/10.3122/jabfm.2011.01.100121