Evolving landscape of depression among 10-24-year-olds in G20 countries from 1990 to 2035: epidemiological trends, modifiable risk factors, drivers of change, and forecasts.

OBJECTIVE: This study evaluated temporal trends in depression burden among 10-24-year-olds in G20 countries during 1990-2023, identified key risk factors and disparities, quantified drivers of change, and projected trends to 2035. METHODS: Using GBD 2023 data, we analyzed age-standardized incidence (ASIR), prevalence (ASPR), and disability-adjusted life year (DALY) rates (ASDR) for depression. Temporal trends were assessed using estimated annual percentage change (EAPC). Burden attributable to bullying victimization (BV), childhood sexual abuse (CSA), and intimate partner violence (IPV) was quantified. Decomposition analysis partitioned changes into population growth, aging, and epidemiological components. Exponential smoothing models forecasted burden. RESULTS: From 1990 to 2023, G20 countries experienced significant increases in depression burden: ASIR rose from 3069.65 to 3441.15 per 100,000 (EAPC = 0.81%, 95% CI: 0.53%-1.08%); ASPR increased from 2935.88 to 3646.70 per 100,000 (EAPC = 0.55%, 95% CI: 0.43%-0.68%); and ASDR rose from 487.44 to 630.35 per 100,000 (EAPC = 0.68%, 95% CI: 0.53%-0.84%). Females bore 1.8 times the burden of males, with the 10-14-year age group demonstrating the most pronounced growth. BV, CSA, and IPV contributed substantially to DALYs (up to 12.4%, 10.2%, and 10.0% respectively). Epidemiological change was the dominant driver in G20 countries (contributing 61.4% to prevalence increases), while population growth predominated in China. Projections indicate continued increases through 2035 with persistent sex disparities. CONCLUSIONS: Depression burden among adolescents and young adults in G20 countries has increased substantially and is projected to rise further. Females and early adolescents are disproportionately affected, and modifiable risk factors contribute significantly. Targeted, developmentally appropriate prevention strategies are urgently needed.