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Estimates of Anxiety Symptoms Among US Adolescents
Tanner J Bommersbach1, Cynthia A Fontanella2,3, Mark Olfson4,5,6
1Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison.
Importance:
Anxiety symptoms are common among US adolescents and associated with substantial psychiatric burden, yet contemporary nationally representative estimates of anxiety symptom severity, associated clinical conditions, and treatment utilization are lacking.
Objectives:
To estimate the prevalence of anxiety symptoms and symptom severity among US adolescents and examine associated co-occurring psychiatric conditions and treatment utilization.
Design, Setting, And Participants:
This cross-sectional study used data from the 2024 National Survey on Drug Use and Health, a nationally representative survey of the US civilian, noninstitutionalized population. Participants included adolescents aged 12 to 20 years. Data were analyzed in June 2026.
Exposure(S):
Anxiety symptoms were assessed using the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire, a brief self-report screener designed to identify probable generalized anxiety disorder and measure symptom severity.
Main Outcomes And Measures:
National estimates of anxiety symptom severity were generated overall and by sociodemographic characteristics. Co-occurring psychiatric and substance use conditions and past-year mental health treatment utilization were examined across anxiety symptom severity categories. Multivariable logistic regression was used to identify factors associated with severe anxiety and receipt of mental health treatment.
Results:
Among 15 730 adolescents (7725 [48.9%] female), 3642 (23.7%) reported mild anxiety symptoms, 1599 (9.6%) reported moderate symptoms, and 1252 (7.2%) reported severe symptoms. Female adolescents had substantially higher rates of moderate (13.4% vs 6.0%) and severe (10.8% vs 3.7%) anxiety symptoms than males. Among adolescents with severe anxiety symptoms, 802 (65.8%) met criteria for a past-year major depressive episode, 536 (48.2%) reported past-year suicidal thoughts, and 392 (31.0%) reported past-month substance use. Despite this high burden of co-occurring mental health conditions, 512 adolescents (41.2%) with severe anxiety symptoms and 793 (48.3%) of those with moderate anxiety symptoms received no mental health treatment during the preceding year. In multivariable analyses, mental health treatment was less likely among male adolescents, racial and ethnic minoritized adolescents, and uninsured adolescents.
Conclusions And Relevance:
Per the results of this cross-sectional study, approximately 1 in 6 US adolescents reported moderate or severe anxiety symptoms in 2024, yet a substantial proportion received no mental health treatment. The high prevalence of anxiety symptoms, frequent co-occurrence with depression and suicidal thoughts, and large unmet need underscore the importance of improving early identification and access to evidence-based treatment for adolescents with anxiety symptoms.