Trends in depression and antidepressants use by social determinants of health among adults in the United States: Data from NHANES 2005-2018.
Level 3 - non-randomized controlled study
Serial cross-sectional population-based observational survey study.
PubMed 41224008 · doi:10.1016/j.jad.2025.120662
What was done
Analyzed repeated cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018 to assess trends in age-standardized depression prevalence and antidepressant medication use among U.S. adults. Trends were evaluated across various social determinants of health (SDOH), including employment, poverty-income ratio (PIR), health insurance type, marital status, and education level, using multivariable logistic regression.
What was found
Age-adjusted depression prevalence increased from 5.60% in 2005–2006 to 8.30% in 2017–2018 (p for trend = 0.02). Antidepressant use rose from 11.34% in 2005–2006 to 14.94% in 2013–2014, settling at 12.45% in 2015–2016 and 13.87% in 2017–2018 (overall p for trend = 0.002). Depression rates increased notably among those employed/student/retired, PIR ≥ 300%, privately insured, not married/living with a partner, and across education levels. Antidepressant use increased significantly in individuals with SDOH ≥ 2, PIR < 300%, government/no insurance, high school education or higher, and unmarried individuals.
Why it matters
Demonstrates national, population-level increases in adult depression prevalence and antidepressant consumption across a 14-year period, identifying specific socioeconomic subgroups driving these shifts.
Limits
The abstract does not state the total participant sample size, specific odds ratios, or confidence intervals. The serial cross-sectional design cannot track individual longitudinal trajectories or establish causality.