2026 ECNP Congress

PS02-2119

Major depression in young adults – data from a Bavarian pharmacovigilance project

Paavo Lehmann — F. Seemüller, K. Gabriele, B. Katharina · Klinik für Psychiatrie- Psychotherapie- Neuropsychiatrie und Psychosomatik Kbo- Lech-Mangfall-Klinik- Garmisch-Partenkirchen, Psychiatry, Garmisch-Partenkirchen, Germany

2026 ECNP Congress

Objectives

A considerable proportion of major depressive disorders (MDDs) manifests for the first time in young adulthood (18-25 years). Specific research on this age-group is relatively scarce, with most studies on adults using much broader age-groups. Previous research indicates that the phenomenology of MDD might be age-dependant, potentially affecting treatment choices. This study aimed to describe the subgroup of young adults with MDD in terms of comorbidities, pharmacological treatment and potential adverse drug reactions. Secondly, an exploratory search for trends over time and systemic differences to older adults (>25 years) in diagnosing and prescription data was conducted.

Methods

The database of the ongoing Bavarian pharmacovigilance program PharmacoEpiVig was searched for inpatients aged 18-25 with main diagnosis MDD, yielding 6029 cases from 2014 to 2024. These were analysed for antidepressive pharmacotherapy, psychiatric comedication, psychiatric and somatic comorbidities and severe adverse drug reactions. By-year data were analysed for trends in prescription and diagnosing practice using linear regressions. Aggregated data were compared to that of older adults using chi-square tests.

Results

In contrast to older adults, the number of young adults in inpatient treatment rose significantly over the study period. 23.8% of young adults received no antidepressive pharmacotherapy, 18.5% received more than one antidepressive medication. The most prescribed class of antidepressants in young adults were SSRI (38.53%), followed by SSNRI (22.47%) and NaSSas (mostly Mirtazapine, 15.46%). The three most prescribed antidepressants Sertraline, Venlafaxine and Mirtazapine accounted for 57.1% of antidepressants prescribed. The most prescribed non-antidepressive medications were Quetiapine (23.2%), Lorazepam (10.9%), and Aripiprazole (6.6%). The most prevalent comorbidity in young adults were personality disorders (F60, 17.7%), reactions to stress (F43, 10.8%) and cannabis use disorders (F11, 6.7%). In comparison to older adults, young adults were more often treated with SSRI, but received less SSNRI, NaSSas, TCAs and MAO-I. They received less antidepressants on average and were more likely to not receive any antidepressive treatment. For 14 out of the 15 most prescribed non-antidepressive psychiatric medications, prescription rates were significantly different between age groups. Young adults were more likely to have secondary psychiatric diagnoses (54.7% vs. 44.8%). Psychiatric comorbidity data were significantly different for 9 out of the 10 most prevalent diagnoses, with personality disorders (F60), cannabis use disorders (F11), attention-deficit hyperactivity disorders (F90) and eating disorders (F50) being more prevalent in young adults. Older adults were much more often diagnosed with somatoform disorders (F45).

Conclusions

In this descriptive study young adults appear to be a distinct subgroup of MDD-patients. The reasons behind the consistent rise of patient numbers as well as the differences to older adults in comorbidity and pharmacotherapy should be investigated in other study designs. A better understanding of young adults with MDD and their needs might enable the creation of targeted guideline recommendations, thereby enhancing treatment quality.

References

no references