Mental health outcome of long-term and episodic adolescent depression: 15-year follow-up of a community sample.
BACKGROUND
Recent studies have highlighted the unfavourable natural course of chronic/long-term depression. We investigated the adult mental health outcome of adolescent depression, with specific focus on long-term and episodic adolescent major depression (MD).


METHODS
A community sample of depressed adolescents and non-depressed peers was followed-up with a structured diagnostic interview after 15 years. The participants (n=382) were divided into five groups depending on their status in adolescence: no depression (n=155); long-term MD (n=91); episodic MD (n=63); dysthymia (n=33); and subthreshold symptoms (n=40). Outcomes (age 19-31) included mood disorders, other mental disorders, suicidality, and treatment for mental disorders.


RESULTS
The long-term group overall had a poorer outcome than the non-depressed group, with the episodic group in an intermediate position. The outcome of the dysthymic group was similar to that of the long-term group, while the subsyndromal group did not differ markedly from the non-depressed group. The long-term group was more likely than the episodic group to report adult anxiety disorders, multiple mental disorders, suicide attempts, and treatment; they also seemed to develop more persistent adult depressions, with a higher number of recurrent episodes and longer duration of antidepressant treatment. Even after adjustment for adolescent factors of clinical and etiological importance, the long-term group had a markedly less favourable outcome than the episodic group.


CONCLUSIONS
The participation rate at follow-up was 64.6%.


CONCLUSIONS
Longstanding depression in adolescence is a powerful predictor of continued mental health problems in adulthood. It is now important to evaluate if early interventions can alter this severe course.
Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, SE-751 85 Sweden. ulf.jonsson@neuro.uu.se
U
U
Jonsson
H
H
Bohman
L
L
von Knorring
G
G
Olsson
A
A
Paaren
A-L
AL
von Knorring
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D019263:Dysthymic Disorder / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008603:Mental Health; D011379:Prognosis; D012111:Residence Characteristics; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult