Trends in adolescent emotional problems in England: a comparison of two national cohorts twenty years apart

Background: Evidence about trends in adolescent emotional problems (depression and anxiety) is inconclusive, because few studies have used comparable measures and samples at different points in time. We compared rates of adolescent emotional problems in two nationally representative English samples of youth 20 years apart using identical symptom screens in each survey. Methods: Nationally representative community samples of 16-17-year-olds living in England in 1986 and 2006 were compared. In 1986, 4524 adolescents and 7120 parents of young people participated in the age-16-year follow-up of the 1970 British Cohort Study. In 2006, 719 adolescents and 734 parents participated in a follow-up of children sampled from the 2002/2003 Health Surveys for England. Adolescents completed the Malaise Inventory and 12-item General Health Questionnaire. Parents completed the Rutter-A scale. Individual symptoms of depression and anxiety were coded combining across relevant questionnaire items. Young people also reported frequency of feeling anxious or depressed. Results: Youth- and parent-reported emotional problems were more prevalent in 2006 for girls, and rates of parent-reported problems increased for boys. Twice as many young people reported frequent feelings of depression or anxiety in 2006 as in 1986. Some symptoms showed marked change in prevalence over time (e.g., worry, irritability, fatigue), whereas others showed no change (e.g., loss of enjoyment, worthlessness). There was no evidence of differential trends in emotional problems for young people from socially advantaged and disadvantaged or intact and non-intact families. Changes in family structure and ethnic composition did not account for trends in youth emotional problems. Conclusions: The study provides evidence for a substantial increase in adolescent emotional problems in England over recent decades, especially among girls.