Prevalence, 20-month incidence and outcome of unipolar depressive disorders in a community sample of adolescents.
BACKGROUND
This article presents prospective longitudinal findings on prevalence, incidence, patterns of change and stability of depressive disorders in a community sample of 1228 adolescents.


METHODS
Data were collected at baseline and follow-up (20 months later) in a representative population sample of 1228 adolescents, aged 14-17 at baseline. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI).


RESULTS
The overall cumulative lifetime incidence of any depressive condition was 20.0% (major depressive disorder (MDD), 12.2%; dysthymia, 3-5%; subthreshold MDD, 6.3%), of which about one-third were incident depressions in the period between baseline and follow-up. Depressive disorders rarely started before the age of 13. Females were about twice as likely as males to develop a depressive disorder. Overall, the 20-month outcome of baseline depression was unfavourable. Dysthymia had the poorest outcome of all, with a complete remission rate of only 33% versus 43% for MDD and 54% for subthreshold MDD. Dysthymia also had the highest number of depressive episodes, and most psychosocial impairment and suicidal behavioural during follow-up. Treatment rates were low (8-23%). Subthreshold MDD associated with considerable impairment had an almost identical course and outcome as threshold MDD.


CONCLUSIONS
DSM-IV MDD and dysthymia are rare before the age of 13, but frequent during adolescence, with an estimated lifetime cumulative incidence of 14%. Only a minority of these disorders in adolescence is treated, and more than half of them persist or remit only partly.
Oldehinkel
A J
AJ
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Munich, Germany.
Wittchen
H U
HU
Schuster
P
P
D000293:Adolescent; D017668:Age of Onset; D003156:Community Mental Health Services; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013997:Time Factors