Impact of the COVID-19 pandemic on depressive disorder among young adults in the United States: Analysis of the Behavioral Risk Factor Surveillance System data, 2018-2022

Purpose: Depressive disorder during early adulthood has been a rising public health concern, potentially further compounded by the COVID-19 pandemic. Using nationally representative large survey samples, this study addressed the knowledge gaps in how COVID-19 affected depressive disorder among U.S. young adults. Methods: The analysis included 348,994 U.S. non-institutionalized young adults aged 18-34 years from the Behavioral Risk Factor Surveillance System for 2018-2022. Changes in the prevalence of diagnosed depressive disorder before and during COVID-19 were assessed by weighted bi-variate analysis using Rao-Scott Chi-Square test, with multivariable logistic regression models fitted to assess the magnitude of depressive disorder before and during COVID-19. Results: Overall, the prevalence of depressive disorder increased by 13.7% (p<0.001) from 20.5% before COVID-19 to 23.3% during COVID-19. Adjusted for sociodemographic and lifestyle factors, the odds of depressive disorder during COVID-19 as compared to before COVID-19 were highest for females (OR: 1.35, 95% CI: 1.29-1.40), aged 18-24 years (OR: 1.34, 95% CI: 1.27-1.41), other races (OR: 1.46, 95% CI: 1.31-1.62), attended college or technical school (OR: 1.33, 95% CI: 1.26-1.40), employed (OR: 1.32, 95% CI: 1.27-1.37), and married (OR: 1.32, 95% CI: 1.24-1.40). Conclusion: The study findings revealed the importance of recognizing and understanding the most affected groups of young adults during a pandemic like COVID-19, providing essential insights for developing targeted interventions and policies.