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Gitanjali Saluja, PhD; Ronaldo Iachan, PhD; Peter C. Scheidt, MD, MPH; Mary D. Overpeck, DrPH; Wenyu Sun, MD, MPH; Jay N. Giedd, MD

Arch Pediatr Adolesc Med. 2004;158:760-765.

Objective  To determine the prevalence, risk factors, and risk behaviors associated with depressive symptoms in a nationally representative, cross-sectional sample of young adolescents.

Design  A school-based survey collected through self-administered questionnaires in grades 6, 8, and 10 in 1996.

Setting  Schools in the United States.

Participants  9863 students in grades 6, 8, and 10 (average ages, 11, 13, and 15).

Main Outcome Measures  Depressive symptoms, substance use, somatic symptoms, scholastic behaviors, and involvement in bullying.

Results  Eighteen percent of youths reported symptoms of depression. A higher proportion of females (25%) reported depressive symptoms than males (10%). Prevalence of depressive symptoms increased by age for both males and females. Among American Indian youths, 29% reported depressive symptoms, as compared with 22% of Hispanic, 18% of white, 17% of Asian American, and 15% of African American youths. Youths who were frequently involved in bullying, either as perpetrators or as victims, were more than twice as likely to report depressive symptoms than those who were not involved in bullying. A significantly higher percentage of youths who reported using substances reported depressive symptoms as compared with other youths. Similarly, youths who reported experiencing somatic symptoms also reported significantly higher proportions of depressive symptoms than other youths.

Conclusions  Depression is a substantial and largely unrecognized problem among young adolescents that warrants an increased need and opportunity for identification and intervention at the middle school level. Understanding differences in prevalence between males and females and among racial/ethnic groups may be important to the recognition and treatment of depression among youths.

From the National Institute of Child Health and Human Development, Rockville, Md (Drs Saluja, Scheidt, and Sun); Macro International Inc, Calverton, Md (Dr Iachan); Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville (Dr Overpeck); and the National Institute of Mental Health, Bethesda, Md (Dr Giedd).

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