Journal of Affective Disorders Reports (Jul 2021)
United States national trends in prevalence of major depressive episode and co-occurring suicidal ideation and treatment resistance among adults
Abstract
Background: Improvement in depression screening and treatment has emerged as a national priority in the US. This study examined temporal trends in prevalence of sub-populations of individuals with past-year major depressive episode (MDE), including those with suicidal ideation (SI), a suicide plan or attempt (SP/SA), and treatment-resistant depression (TRD). Methods: Using the National Survey on Drug Use and Health (NSDUH; 2009–2017), yearly prevalence and trends over time of sub-populations among US adults overall and among those with MDE were determined; prevalence estimates were stratified by sociodemographic characteristics. Results: Over the 9-year period, prevalence of MDE+SI increased significantly by 29.3%, from 1.7% to 2.2% (adjusted odds ratio [aOR]=1.38, 95% CI=1.20–1.59); the increase was most prominent among young adults, women, Caucasians, and Native Americans/Alaskan Natives. Among those with MDE, prevalence of SI increased by 21.2%, from 25.6% to 31.1% (aOR=1.25, 95% CI=1.06–1.48). Among those with an MDE in 2017, 31.1% reported SI, 11.5% reported a SP/SA, 9.1% had TRD, and 4.3% experienced TRD+SI. Limitations: The NSDUH is based on self-report data; rates of diagnoses and SI from objective assessments and clinical evaluations may be different. Additionally, the survey is cross-sectional rather than longitudinal. Conclusions: Substantial increases in the prevalence of SI among adults and among those with MDE were observed from 2009 to 2017; disproportionate trends were observed among some sociodemographic groups. These findings underscore the importance of understanding the reasons for these concerning trends, as well as the need for improvements in identification and treatment for at-risk individuals.
