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Major Depression

Definitions

Major depression is one of the most common mental disorders in the United States. For some individuals, major depression can result in severe impairments that interfere with or limit one’s ability to carry out major life activities.

Additional information can be found on the NIMH Health Topics page on Depression.

The past year prevalence data presented here for major depressive episode are from the 2016 National Survey on Drug Use and Health (NSDUH). The NSDUH study definition of major depressive episode is based mainly on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV):

  • A period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, self-image or recurrent thoughts of death or suicide.
  • Unlike the definition in the DSM-IV, no exclusions were made for a major depressive episode caused by medical illness, bereavement, or substance use disorders.

Prevalence of Major Depressive Episode Among Adults

  • Figure 1 shows the past year prevalence of major depressive episode among U.S. adults aged 18 or older in 2016.
      • An estimated 16.2 million adults in the United States had at least one major depressive episode. This number represented 6.7% of all U.S. adults.
      • The prevalence of major depressive episode was higher among adult females (8.5%) compared to males (4.8%).
      • The prevalence of adults with a major depressive episode was highest among individuals aged 18-25 (10.9%).
    • The prevalence of major depressive episode was highest among adults reporting two or races (10.5%).

Figure 1

Past Year Prevalence of Any Mental Illness Among U.S. Adults (2016)
Demographic Percent
Overall 6.7
Sex Female 8.5
Male 4.8
Age 18-25 10.9
26-49 7.4
50+ 4.8
Race/Ethnicity Hispanic or Latino* 5.6
White 7.4
Black 5.0
Asian 3.9
NH/OPI** 7.3
AI/AN*** 8.7
2 or More 10.5

*All other groups are non-Hispanic or Latino | **NH/OPI = Native Hawaiian / Other Pacific Islander | ***AI/AN = American Indian / Alaskan Native

Major Depressive Episode with Impairment Among Adults

  • In 2016, an estimated 10.3 million U.S. adults aged 18 or older had at least one major depressive episode with severe impairment. This number represented 4.3% of all U.S. adults.
  • Figure 2 shows overall past year prevalence of major depressive episode with and without severe impairment. Of adults with major depressive episode, 64% had severe impairment.

Figure 2

Past Year Severity of Major Depressive Episode Among U.S. Adults (2016)
Impairment Status Percent
Without Severe Impairment 36
With Severe Impairment 64
Overall Prevalence 100

Treatment of Major Depressive Episode Among Adults

  • Figure 3 shows data on treatment received within the past year by U.S. adults aged 18 or older with major depressive episode. Treatment types include health professional only, medication only, and health professional and medication combined.
    • An estimated 44% received combined care by a health professional and medication treatment.
    • Treatment with medication alone was least common (6%).
    • Approximately 37% of adults with major depressive episode did not receive treatment.

Figure 3

Past Year Treatment Received Among Adults with Major Depressive Episode (2016)
Treatment Percent
No Treatment 37
Health Professional Only 13
Health Professional AND Medication 44
Medication Only 6
Total 100

Prevalence of Major Depressive Episode Among Adolescents

  • Figure 4 shows the past year prevalence of major depressive episode among U.S. adolescents in 2016.
    • An estimated 3.1 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 12.8% of the U.S. population aged 12 to 17.
    • The prevalence of major depressive episode was higher among adolescent females (19.4%) compared to males (6.4%).
    • The prevalence of major depressive episode was highest among adolescents reporting two or more races (13.8%).

Figure 4

Past Year Prevalence of Any Mental Illness Among U.S. Adults (2016)
Demographic Percent
Overall 12.8
Sex Female 19.4
Male 6.4
Age 12 5.0
13 9.4
14 12.7
15 13.9
16 17.4
17 17.0
Race/Ethnicity Hispanic* 12.7
White 13.8
Black 9.1
Asian 11.9
AI/AN** 11.5
2 or more Races 13.8

*All other groups are non-Hispanic or Latino / **AI/AN = American Indian/Alaska Native

Major Depressive Episode with Impairment Among Adolescents

  • In 2016, an estimated 2.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode with severe impairment. This number represented 9.0% of the U.S. population aged 12 to 17.
  • Figure 5 shows overall past year prevalence of major depressive episode with and without severe impairment among U.S. adolescents. Of adolescents with major depressive episode, approximately 70% had severe impairment.

Figure 5

Past Year Severity of Major Depressive Episode Among U.S. Adolescents (2016)
Impairment Status Percent
Without severe impairment 30
With severe impairment 70
Overall Prevalence 100

Treatment of Major Depressive Episode Among Adolescents

  • Figure 6 shows data on treatment received within the past year by U.S. adolescents aged 12-17 with major depressive episode in 2016. Treatment types included health professional only, medication only, and combined health professional and medication.
    • An estimated 19% received care by a health professional alone, and another 19% received combined care by a health professional and medication treatment.
    • Treatment with medication alone was least common (2%).
    • Approximately 60% of adolescents with major depressive episode did not receive treatment.

Figure 6

Past Year Treatment Received Among Adolescents with Major Depressive Episode (2016)
Treatment Percent
No Treatment 60
Health Professional Only 19
Health Professional AND Medication 19
Medication Only 2
Total 100

Data Sources

Statistical Methods and Measurement Caveats

Diagnostic Assessment:

  • For the NSDUH survey — unlike DSM-IV criteria — no exclusions were made for a major depressive episode caused by medical illness, bereavement, or substance use disorders.
  • For the NSDUH survey, methodology developed prior to the 2013 publication of the current DSM-5 was used to facilitate year-to-year comparisons.
  • Modules related to major depressive episode derived from DSM-IV (1994) criteria for major depression were included in the NSDUH questionnaire. The adult and adolescent questions were adapted from the depression module in the National Comorbidity Survey Replication (NCS-R). Revisions to the questions in the modules were made primarily to reduce their length and to modify the NCS-R questions, which are interviewer-administered, to the audio computer-assisted self-interviewing (ACASI) format used in NSDUH. In addition, some revisions, based on cognitive testing, were made to improve comprehension. Furthermore, even though titles similar to those used in the NCS-R were used for the NSDUH modules, the results of these items may not be directly comparable. This is mainly due to differing modes of administration in each survey (ACASI in NSDUH vs. computer-assisted personal interviewing in NCS-R), revisions to wording necessary to maintain the logical processes of the ACASI environment, and possible context effects resulting from deleting questions not explicitly pertinent to major depression.
  • Some questions in the adult depression module differ slightly from questions in the adolescent depression module; as such, major depressive episode data for adults aged 18 or older should not be compared to or combined with major depressive episode data for youths aged 12 to 17.
  • The Sheehan Disability Scale (SDS) was used to assess the impact of major depressive episode on a person’s life. The SDS is a brief self-report tool with ratings from 0 to 10 (with 10 being the highest) for the level of impairment caused by the disorder in each of four role domains: home management, work, close relationships with others, and social life. A rating of ≥7 in at least one domain is considered to be severe impairment. Respondents were excluded if SDS role impairment severity was unknown, or if particular activities listed in the SDS were not applicable. For SDS level of impairment, the role domains for adolescents aged 12 to 17 were slightly modified from those for adults to be made age appropriate.

Population:

  • The entirety of NSDUH respondents for the major depressive episode estimates is the civilian, non-institutionalized population aged 12-17 (adolescents) and 18 years old or older (adults) residing within the United States.
  • The survey covers residents of households (persons living in houses/townhouses, apartments, condominiums; civilians living in housing on military bases, etc.) and persons in non-institutional group quarters (e.g., shelters, rooming/boarding houses, college dormitories, migratory workers' camps, and halfway houses).
  • The survey does not cover persons who, for the entire year, had no fixed address (e.g., homeless and/or transient persons not in shelters); were on active military duty; or who resided in institutional group quarters (e.g., correctional facilities, nursing homes, mental institutions, long-term hospitals).
  • Some adults and adolescents in these excluded categories may have had a major depressive episode in the past year, but they are not accounted for in the NSDUH major depressive episode estimates.

Survey Non-response:

  • In 2016, 31.6% of the selected NSDUH sample did not complete the interview.
  • Reasons for non-response to interviewing include: refusal to participate (22.2%); respondent unavailable or no one at home (4.5%); and other reasons such as physical/mental incompetence or language barriers (4.6%).
  • Adults and adolescents with major depressive episode may disproportionately fall into these non-response categories. While NSDUH weighting includes non-response adjustments to reduce bias, these adjustments may not fully account for differential non-response by mental illness status.

Please see the 2016 National Survey on Drug Use and Health Methodological Summary and Definitions report for further information on how these data were collected and calculated.

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