In Brief

• In 2004, an estimated 14% 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%, 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% of those aged 12 to 17

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).

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).

The suicide-related questions asked youths if (during their worst or most recent 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% of youths aged 12 to 17, approximately 3.5 million youths, had experienced at least one MDE in their lifetime. Almost 20% of females aged 12 to 17 and 8.5% of males had at least one of these depressive episodes. Rates of lifetime MDE were similar among racial/ethnic groups and increased with age.

MDE and Suicidal Thoughts

Among youths aged 12 to 17, about 9%, 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%, 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.

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.

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.

MDE and Suicide Attempts
An estimated 900,000 youths, or 3.6% 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% 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% of females and 1.7% of males) or to have attempted suicide (4.7% of females and 1.1% of males).