Study finds more extremes in adolescent mental health

More teenagers report high mental wellbeing – yet at the same time, those who are struggling rate their depressive symptoms significantly higher than previous cohorts did at the same age, according to a study from the University of Gothenburg.

The study, published in Journal of Affective Disorders Reports, examined changes in how young teenagers in Sweden rated their depressive symptoms over two decades.

Researchers compared two groups of 13–16-year-olds: one from 2004 and one from 2019–2020. Both groups rated their depressive symptoms using the internationally established Children’s Depression Inventory (CDI), a self-report assessment.

More extremes in mental wellbeing

The results show that the overall proportion of adolescents reporting depressive symptoms increased from 21 percent in 2004 to 29 percent in 2019–2020-an increase that is not considered dramatic in this context.

However, a key shift is evident: more adolescents than before report feeling extremely well. In the 2019–2020 group, 33 percent had very low CDI scores, indicating strong mental wellbeing, compared to just 15 percent in 2004.

At the same time, those who are struggling report feeling significantly worse than before. Adolescents with depressive symptoms in 2019–2020 rated themselves higher on self-deprecating and negative thoughts compared to their counterparts in 2004.

Those who report high levels of depressive symptoms today rate themselves significantly higher than those in previous cohorts. We also see notable increases in certain areas, particularly self-deprecation-something that primarily affects young women.”

Carl Wikberg, district nurse and adjunct senior lecturer in community medicine and public health at Sahlgrenska Academy, University of Gothenburg

Despair but also hope

The CDI assessment measures various aspects of mental wellbeing, including negative mood, self-esteem, ineffectiveness, and interpersonal problems. In the 2019–2020 group, three statements stood out among those reporting depressive symptoms:

• “Nothing is fun at all.”
• “I am bad all the time.”
• “I can never be as good as other kids.”

“The fact that some young people report strong self-loathing is concerning and can make us feel despair. However, there is also hope: we are seeing a larger proportion of adolescents at the very lowest end of the scale, meaning their mental wellbeing has improved. So, the trend is not entirely negative,” says Wikberg.

Identifying and supporting at-risk youth

While the study does not provide definitive answers as to why these changes are occurring, the researchers highlight the role of evolving public discourse on mental health. A more open attitude toward mental health issues and treatment may influence how young people describe their wellbeing in self-report assessments.

At the same time, the study underscores the importance of school health services and primary care in identifying adolescents with high CDI scores. Screening tools like CDI create opportunities to detect and support those in need.The study included 617 adolescents (aged 13–16) from 2019–2020 as part of a larger research project on depression. The comparison group consisted of 80 adolescents of the same age from 2004, who participated in a CDI validation study in a Swedish context.