OBJECTIVES: To examine the annual prevalence of non-remission major depressive disorder (NRMDD) among adolescents and young adults, and the characteristics, healthcare utilization and costs of those with NRMDD in 2022.

METHODS: Patients aged 13-24 enrolled in the Merative™ MarketScan® Commercial Database for >1 full calendar year during 2018-2022 were identified and assessed for the presence of >1 claim with an NRMDD diagnosis. The proportion of enrolled patients with NRMDD was calculated for each year and stratified by sex. Demographics, other diagnoses, all-cause healthcare utilization and costs, and NRMDD-related medical costs were assessed among those with NRMDD in 2022.

RESULTS: Overall prevalence of NRMDD increased annually among adolescents and young adults (2016-2022: 2.7%-5.9%). Prevalence was consistently greater among females vs. males (3.5%-8.4% vs. 1.8%-3.6%). There was a clear inflection point in 2020-2021 (overall: 4.8%-5.8%), driven by the increase among females (6.6%-8.2% vs. 3.0%-3.4%). In 2022, prevalence was 8.4% among 13-24 year-old females, compared to 3.6% among 13-24 year-old males, with two thirds being young adults. Common comorbid mental health conditions among females and males included anxiety (75.3% and 64.1%), adjustment disorders (25.1% and 19.2%), and ADHD (23.3% and 31.1%). Females with NRMDD had 25% more office visits and 28% more prescription claims than males, but 15% fewer inpatient admissions (all p<0.001). Total healthcare costs and NRMDD-related medical costs were similar between females and males (total: $10,076 +$30,748 vs. $10,154 +$40,617, p=0.44; MDD-related: $3,254 +$15,185 vs. $3,310 +$12,951, p=0.53).

CONCLUSIONS: The pattern of change in annual NRMDD prevalence suggests a negative impact of the early COVID-19 pandemic on mental health among adolescents and young adults. The widening gap between females and males may indicate a need for additional screening among males, and/or real biopsychosocial sex differences in MDD etiology. Despite significant sex differences in healthcare utilization, healthcare costs are similar between females and males with NRMDD.