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Although it is well-established that juvenile offenders are at an elevated risk for depression and that, within this group, females have the highest risk, little is known regarding the trends in the prevalence of depression among juvenile offenders in the U.S. In the present study, we systematically examine secular trends in major depressive episodes (MDE) and their correlates among male and female juvenile offenders and non-offenders in the United States using a large population-based survey. We hypothesized that the prevalence of depression will be higher among juvenile offenders and that female offenders will be more likely than male juvenile offenders to be diagnosed with depression.
Methods
Data were collected between 2005 and 2014 as part of the National Survey on Drug Use and Health (NSDUH). The NSDUH uses multistage area probability sampling methods to select a representative sample of the civilian, non-institutionalized population in the United States. Participants included 171,118youth aged 12–17 (159,449 non-offenders and 11,669 offenders). The primary variable of interest was self-reported past year MDE. Logistic regression assessed whether psychosocial and behavioral correlates affected the risk of MDE. All analyses were survey adjusted and controlled for age, gender, race/ethnicity, annual household income, father in household, and survey year.
Results
Between 2005 and 2014, the prevalence of MDE among female youth increased for both offender and non-offender groups: from 24.4% to 33.0% for the offenders and from 12.4% to 16.7% for the non-offenders. No significant trend changes were observed among male youth. In both male and female juvenile offenders, MDEs were associated with increased risk of illicit drug use (males OR = 1.61, 95% CI = 1.18-2.18; females OR = 1.83, 95% CI = 1.45-2.31). Additional correlates include alcohol use among male offenders (OR = 1.36, 95% CI = 1.01-1.83), and binge drinking in female offenders (OR = 1.24, 95% CI = 1.02-1.49). Crime and delinquency measures were significant correlates for both genders among the offender group, including theft of more than a $50 value (males OR = 1.53, 95% CI = 1.12-2.10; females OR = 1.64, 95% CI = 1.28-2.10) and fighting at school or work (males OR = 1.48, 95% CI = 1.13-1.94; females OR = 1.43, 95% CI = 1.16-1.77).
Conclusions and Implications
Depression occurs in juvenile offenders at higher rates than their non-offending counterparts. Risk correlates for MDE among youth offenders include substance use, theft, and fighting. The prevalence of past year MDEs continues to increase significantly for female juvenile offenders, highlighting a need for improved efforts to target these populations for prevention and treatment.