OR WAIT null SECS
Sex, Age, Racial Disparities Persist in Adolescent Depression, With Andrew Yockey, PhD
Yockey discusses why girls, older teens, and multiracial youth remain at greater risk for depression despite overall post-pandemic improvements.
Although national data show a nearly 40% decline in adolescent major depressive episodes between 2021 and 2024, persistent disparities across sex, age, and race and ethnicity continue to shape clinical risk assessment and care delivery, according to Andrew Yockey, PhD, assistant professor at the University of Mississippi.
In an interview with HCPLive, Yockey discussed findings from a recent analysis of the National Survey on Drug Use and Health data, which reported a decrease in past-year major depressive episodes among adolescents aged 12–17 years from 20.5% in 2021 to 14.8% in 2024. Despite the overall improvement, girls, older teens, and multiracial youth were more likely to experience depression. Girls had 3-fold greater odds of having depression than boys.
Yockey emphasized that clinicians should respond to this disparity with more targeted and developmentally informed screening and treatment approaches. He noted that girls may be more vulnerable to risk factors such as rumination, body image concerns, and social comparison, all of which can contribute to depressive symptoms during adolescence. He also stressed the importance of screening earlier and more frequently, rather than relying on single assessments.
“Someone gets screened, and then they don’t get screened for another 10 years,” Yockey said. “This just does not go away.”
He encouraged clinicians to move beyond the misconception that depression primarily presents as sadness. Instead, screening should include irritability, somatic complaints, lack of motivation, and other nontraditional symptoms. Yockey also pointed to social media exposure, peer dynamics, academic pressure, and gender expectations as additional contributors that clinicians may consider during assessment.
The study also found that older adolescents had greater odds of major depressive episodes, consistent with the broader understanding that late adolescence is a critical developmental period for mental health challenges.
“This a very stressful time in your life,” Yockey said. “If you think about adolescence, it's navigating the unknowns in life…it's also discovering yourself.”
Older adolescents are more likely to experiment with substances, encounter academic and social pressures, and navigate transitions toward independence, he noted. These stressors can coincide with the onset of mental health disorders, making early and repeated screening particularly important. Yockey also highlighted the role of parent education, encouraging clinicians to help families recognize warning signs and support adolescents as they approach adulthood.
Yockey noted that clinicians need to increase screening and raise awareness of mental health difficulties.
“We're still in this phase that, when people hear about depression, it's, ‘oh, just don't be sad.’ Well, that's easier said than done,” he said.
The analysis also identified racial and ethnic differences, with multiracial teens being more likely to experience depression. While some minoritized groups reported lower odds of depression, Yockey cautioned that these findings may reflect underdiagnosis rather than lower true prevalence. For example, Black adolescents may report lower diagnosed depression but experience greater unmet mental health needs and more severe outcomes.
Yockey attributed these patterns to multiple factors, including reduced access to care, stigma surrounding mental health, and cultural differences in symptom expression. He encouraged clinicians not to rely solely on screening scores and instead engage adolescents in conversations about how they experience stress, sadness, or irritability. Asking culturally sensitive questions may help identify symptoms that standardized tools miss.
Building trust with families and communities was another key recommendation. Yockey noted that historical mistrust and stigma continue to affect engagement in mental health care. Involving caregivers, respecting family beliefs, and addressing misconceptions may improve uptake and retention in treatment.
He also highlighted the importance of follow-up, noting that minoritized adolescents are more likely to disengage from care. Strategies such as early follow-up visits, reminder check-ins, and monitoring engagement, not just symptoms, may help improve continuity of care.
Yockey stressed that clinicians should not assume improvements at the population level translate to reduced risk for individual patients, particularly those within greater-risk groups.
References
