Factors Associated with the Prevalence and Treatment of Depression in Adolescent Males in the US during the Period of the COVID-19 Pandemic

Background: Much of the research on the effect of the COVID-19 pandemic on mental health has overlooked the experiences of adolescent boys. Objective: To examine the prevalence of depression, treatment trends, and associated risk factors among adolescent boys, controlling for the pandemic year. Methods: Data for boys aged 12 to 17 years (n = 4518) in the 2021 National Survey on Drug Use and Health were analyzed. Time trends and factors associated with depression were examined using a multiple regression analysis. Results: The prevalence of 12-month major depressive episodes (TMDEs) was 11.6% during the first year of the COVID-19 pandemic. Among the boys with TMDEs, 37.8% received treatment overall, and 19.0% received prescription medication. Higher rates of TMDEs were estimated in boys who were older (adjusted odds ratio (AOR): 1.66, p < 0.001), lived in single-mother households (AOR: 1.47, p < 0.001), did not have authoritative parents (AOR: 1.78, p < 0.001), and had negative school experiences (AOR: 2.45, p < 0.001). Although Black boys were less likely to report depression than white boys (AOR: 0.70, p < 0.05), nonwhite boys who had depression were significantly less likely to receive treatment. Boys living in a household without a mother were also less likely to receive treatment (AOR: 0.49, p < 0.05). Conclusions: This study reveals the unique developmental, social, and psychological factors that influence depression among adolescent boys. During the pandemic, more than one out of ten adolescent boys had a major depressive episode, and four of ten of them received treatment; half of these treatments were prescription medication. Recognizing these factors may allow for more targeted and effective interventions to improve mental health outcomes for this demographic.