By Alexandra H. Bettis, Richard T. Liu, Jama Pediatrics, October 21, 2019
Depression in adolescence is highly prevalent and associated with negative long-term outcomes.1 Despite decades of research on treatment for adolescent depression, sexual minority youths remain a particularly at-risk group.2 Temporal trends inform progress in addressing the need to eliminate health disparities among sexual minority populations.3 To our knowledge, this study presents the first population-representative analysis of temporal trends in depressed mood among sexual minority and heterosexual youths. An 18-year period is examined.
The Youth Risk Behavior Surveillance System (YRBSS) obtains biannual data representative of students in grades 9 through 12 using a multistage cluster-sample design.4 Data were drawn from the Massachusetts YRBSS for calendar years 1999 through 2017. This study did not undergo institutional review board review at any institution but was believed by the authors to be exempt because the dataset used is publicly available for use (https://www.cdc.gov/healthyyouth/data/yrbs/data.htm). These analyses used previously collected data through the YRBSS, a national survey conducted by the US Centers for Disease Control and Prevention, who works with local schools to collect data and obtain parental permission.
Sexual minority status was assessed with 2 items: self-reported sexual identity and same-sex behavior. For sexual identity, respondents were classified as members of sexual minorities if they self-identified as gay, lesbian, bisexual, or unsure. For same-sex behavior, respondents who endorsed having same-sex partners in their lifetime were classified as sexual minority youths. Respondents who reported no sexual partners were excluded from analyses examining sexual behavior. Youths were asked about feeling depressed and/or hopeless in the past year with the question, “During the past 12 months, did you ever feel so sad or hopeless almost every day for 2 weeks or more in a row that you stopped doing some usual activities?”