Almost three quarters of adolescents in Australia experience clinically significant depression or anxiety symptoms, with most being chronic, according to a new study. And preventive strategies outside our clinics are urgently required to address this considerable public health problem facing the nation.

The research, led by Murdoch Children’s Research Institute (MCRI) and published in The Lancet Psychiatry, found mental health problems were frequently chronic with 64 per cent reporting symptoms three or more times across their adolescent years.  

MCRI Dr Ellie Robson said the rate and recurrence of depression and anxiety symptoms were concerning given mental health problems during adolescence had serious consequences across the lifespan.

Image: Dr Ellie Robson

“These are striking findings, particularly given how many young people experienced symptoms over multiple years of the study and how much depression and anxiety symptoms can affect young people’s functioning and can have long-lasting negative health outcomes,” she said.

For the study 1,239 children from Melbourne enrolled in the Child to Adult Transition Study (CATS) had their symptoms of anxiety and depression tracked every year from 10 to 18 years of age.

Girls were at increased risk with 84 per cent compared to 61 per cent of boys having depression or anxiety symptoms at least once during adolescence. Girls were also more likely to have a chronic course at 72 per cent and 49 per cent, respectively. 

The onset of anxiety and depression symptoms increased at times that coincided with educational stress such as the primary to secondary school transition, exam periods and the end of compulsory education.  Three quarters of participants who struggled with mental health problems during the COVID-19 years already had symptoms, highlighting factors beyond the pandemic stressors.

MCRI Professor Susan Sawyer said that despite growing concerns about adolescent mental health, until the CATS, few studies had comprehensively charted the course of common mental disorders across this key life stage.

Image: Professor Susan Sawyer

“To our knowledge, this longitudinal study shows the highest cumulative incidence of clinically significant symptoms of common mental disorders that has ever been reported across adolescence from any country,” she said.

“This high incidence of common mental health problems suggests that even the most well-resourced country would struggle to provide adequate treatment if every young person sought help. Beyond clinical care, we urgently need to fund, develop and evaluate preventive strategies that aim to reduce the onset and chronicity of depression and anxiety.”

Dr Robson said; “Adolescents today are growing up in a distinctly different psychosocial landscape than earlier generations, one that is characterised by greater mental health literacy, reduced stigma, and at times the glamorisation of mental health problems. Given this context, our next step will be to explore what impact these reported symptoms have on the functioning and health outcomes of contemporary adolescents.”

GenV, tracking the health and wellbeing of Victorians, from birth to old age, will also provide invaluable insights into the health challenges faced by our young people including mental health problems. 

One of the world’s largest-ever birth and parent cohort studies, GenV has seen almost 50,000 babies (over 100,000 newborns, mothers and fathers) sign up. Recruitment for children born in 2021-2022 is still open. Learn more on the GenV website.

Researchers from The Royal Children’s Hospital, the University of Melbourne, Deakin University and the University of Bristol also contributed to the findings.

Publication

Robson EM, Husin HM, Dashti SG, Vijayakumar N, Moreno-Betancur M, Moran, Patton GC and Sawyer SM. ‘Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population-based cohort study in Australia,’ The Lancet Psychiatry. DOI: 10.1016/S2215-0366(24)00361-4

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview

Professor Susan Sawyer, MCRI, Group Leader, Adolescent Health

Dr Ellie Robson, MCRI, Adolescent Health researcher

Funding

The study was funded by the National Health and Medical Research Council (NHMRC) of Australia, GNT 1010018 (2011-15) and GNT 1122189 (2017-20) and a grant from The Royal Children's Hospital Foundation. The following authors are supported by National Health and Medical Research Council Investigator Grants: SMS and GCP (GNT1196999), SGD (202717), MMB (2009572).

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About Murdoch Children’s Research Institute

Murdoch Children's Research Institute is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.