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National Survey on Drug Use and Health Suicidal Thoughts among Youths Aged 12 to 17 with Major Depressive Episode
September 9, 2005

Suicidal Thoughts among Youths Aged 12 to 17 with Major Depressive Episode

In Brief

  • In 2004, an estimated 14 percent of youths aged 12 to 17, approximately 3.5 million youths, had experienced at least one major depressive episode (MDE) in their lifetime

  • Over 7 percent, an estimated 1.8 million youths, had lifetime MDE and thought about killing themselves at the time of their worst or most recent episode

  • An estimated 712,000 youths had tried to kill themselves during their worst or most recent MDE; this represents 2.9 percent of those aged 12 to 17
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In 2003, suicide was the 11th leading cause of death among persons of all ages in the United States. However, among young people aged 15 to 24, suicide, or intentional self-harm, was the third leading cause of death, with 3,921 deaths, following accidents/unintentional injuries (14,966 deaths) and assaults/homicides (5,148 deaths).1

The 2004 National Survey on Drug Use and Health (NSDUH) asked youths aged 12 to 17 about symptoms of depression, including thoughts about death or suicide. Major Depressive Episode (MDE) is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had at least five of the nine symptoms of depression as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).2

The suicide-related questions asked youths if (during their worst or most recent3 episode of depression) they thought it would be better if they were dead, thought about killing themselves, and, if they had thought about killing themselves, whether they made a plan to kill themselves and whether they tried to kill themselves. This report presents estimates of the prevalence of lifetime MDE among youths. The report also presents the numbers and percentages of youths who had both lifetime MDE and suicidal thoughts.

Prevalence of MDE

An estimated 14 percent of youths aged 12 to 17, approximately 3.5 million youths, had experienced at least one MDE in their lifetime (Table 1). Almost 20 percent of females aged 12 to 17 and 8.5 percent of males had at least one of these depressive episodes. Rates of lifetime MDE were similar among racial/ethnic groups and increased with age.

Table 1. Numbers (in Thousands) and Percentages of Youths Aged 12 to 17 Reporting a Major Depressive Episode (MDE) in Their Lifetime: 2004
Table 1. Numbers (in Thousands) and Percentages of Youths Aged 12 to 17 Reporting a Major Depressive Episode (MDE) in Their Lifetime: 2004
MDE and Suicidal Thoughts

Among youths aged 12 to 17, about 9 percent, an estimated 2.3 million youths, had experienced MDE in their lifetime and thought, during their worst or most recent MDE, that it would be better if they were dead. Over 7 percent, an estimated 1.8 million youths, thought about killing themselves at the time of their worst or most recent MDE.

Females aged 12 to 17 were significantly more likely than their male peers to have had MDE and to report thinking about suicide and believing it would be better if they were dead (Figure 1).

Both 14 or 15 year olds and 16 or 17 year olds were significantly more likely than those aged 12 or 13 to have had MDE accompanied by thoughts that it would be better if they were dead and thoughts about committing suicide (Figure 2).

MDE with suicidal thoughts did not vary by urbanicity.4 Youths in large metropolitan areas, small metropolitan areas, and non-metropolitan areas were equally likely to have MDE with suicidal thoughts.

Figure 1. Percentages of Youths Aged 12 to 17 with Major Depressive Episode (MDE) in Their Lifetime and Suicidal Thoughts, by Gender: 2004 Figure 2. Percentages of Youths Aged 12 to 17 with Major Depressive Episode (MDE) in Their Lifetime and Suicidal Thoughts, by Age Group: 2004
Figure 1. Percentages of Youths Aged 12 to 17 with Major Depressive Episode (MDE) in Their Lifetime and Suicidal Thoughts, by Gender: 2004 Figure 2. Percentages of Youths Aged 12 to 17 with Major Depressive Episode (MDE) in Their Lifetime and Suicidal Thoughts, by Age Group: 2004
MDE and Suicide Attempts

An estimated 900,000 youths, or 3.6 percent of 12 to 17 year olds, made a plan to kill themselves at the time they were having their worst or most recent MDE. An estimated 712,000 youths had tried to kill themselves during such an episode; this represents 2.9 percent of those aged 12 to 17.

Female youths were more likely than male youths to have had MDE and made a plan to kill themselves (5.6 percent of females and 1.7 percent of males) or to have attempted suicide (4.7 percent of females and 1.1 percent of males).

End Notes
  1. Hoyert, D. L., Kung, H. C., & Smith, B.L. (2005). Deaths: Preliminary data for 2003. National Vital Statistics Reports, 53(15), 1-48.

  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

  3. Youths who cannot recall the period of time when their depression was the worst are asked to report about the most recent time period.

  4. Large metropolitan areas have a population of 1 million or more. Small metropolitan areas have a population of fewer than 1 million. Non-metropolitan areas are outside metropolitan statistical areas (MSAs), as defined by the Office of Management and Budget. See the U.S. Census Bureau. (2005, June 17). About metropolitan and micropolitan statistical areas. Retrieved August 30, 2005, from http://www.census.gov/population/www/estimates/aboutmetro.html

Table and Figure Notes

* Low precision; estimate not reported

Source: SAMHSA, 2004 NSDUH
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2004 data used in this report are based on information obtained from 22,301 persons aged 12 to 17, of whom 3,179 were classified as having a major depressive episode (MDE) in their lifetime. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information and data for this issue are based on the following publication and statistics:

Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2004 survey should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report please e-mail: shortreports@samhsa.hhs.gov.

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