Comparison of Physical Health Conditions among Adolescents Aged 12 to 17 with and without Major Depressive Episode

Authors

SAMHSA: Sarra L. Hedden, Gary Blau, Rachel Lipari, and Lisa Rubenstein; RTI International: Valerie L. Forman-Hoffman and Cristie Glasheen

Research suggests that physical health conditions, particularly asthma and diabetes, may be more common among people with a history of depression. However, studies of the association between depression and physical health conditions among adolescents are rare and tend to use only samples recruited from treatment settings. The purpose of this report is to examine the association between major depressive episode (MDE), self-rated overall health, and selected health conditions (including asthma, bronchitis, pneumonia, obesity, and diabetes) among adolescents in a U.S. nationally representative sample.

Combined data from the 2005 to 2014 National Surveys on Drug Use and Health (NSDUHs) showed worse overall health ratings among those with past year MDE compared with those without past year MDE. Asthma, bronchitis, and pneumonia were more likely among adolescents with past year MDE compared with adolescents without past year MDE. Results were similar by age, gender, race/ethnicity, and poverty status, which showed relatively consistent findings with one notable exception. Past year asthma did not differ significantly among adolescent males with MDE and males without MDE. Female adolescents with MDE had a higher prevalence of obesity and a lower prevalence of normal weight status compared with females without MDE. Lifetime diabetes estimates were higher among female adolescents with MDE compared with those without MDE, among adolescents aged 14 years or older with MDE compared with those without MDE, and among adolescents with MDE among non-Hispanic white and non-Hispanic black adolescents compared with their counterparts without MDE.

Although an association between MDE and these physical health conditions was observed, the cause of these associations cannot be determined using NSDUH data. Because NSDUH is a cross-sectional dataset, temporality cannot be assessed. More research would be needed to determine whether having a physical health condition causes depression or vice versa. However, information in this report on the association between physical health conditions and depression can be used to provide information that can guide prevention, early identification, and treatment of these co-occurring health conditions. These findings may also motivate future research into whether treating depression helps improve physical health conditions and if treating physical health conditions can improve depression. For example, treating depression may improve adolescents' ability to engage in activities needed to monitor and care for chronic conditions like diabetes, and asthma treatment might lead to improved quality of life, which might help reduce depression.

Highlights

Data from the National Surveys on Drug Use and Health show that asthma, bronchitis, pneumonia, obesity (in females only), and diabetes are associated with past year major depressive episode (MDE) among adolescents.
Adolescents with past year MDE were significantly more likely to self-report having fair or poor overall health and were less likely to report having excellent, very good, or good health than those without past year MDE in the past year.
Estimates of past year and lifetime asthma, bronchitis, and pneumonia were all higher among adolescents with past year MDE compared with those without past year MDE.
Lifetime diabetes estimates were significantly higher among adolescents with MDE compared with those without MDE.
Female adolescents with MDE were more likely to be obese than those without MDE. This association did not hold for males.