title: Trajectories of depressive symptoms during the transition to young adulthood: the role of chronic illness.
abstract: BACKGROUND
  Little is known about the natural course of depressive symptoms among youth with chronic illness during their transition from adolescence to young adulthood.
  
  
  METHODS
  A representative epidemiological sample of 2825 youth aged 10-11 years from the National Longitudinal Survey of Children and Youth were followed until 24-25 years of age. Presence of chronic illness was measured using self-report and symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Multilevel modeling was used to investigate trajectories of depressive symptoms, adjusting for family environment and sociodemographic characteristics during the transition to young adulthood.
  
  
  RESULTS
  Trajectories showed cubic change over time - increasing from early to mid-adolescence, decreasing to early young adulthood, increasing again to late young adulthood. Youth with chronic illness (n=753) had significantly less favorable trajectories and significantly higher proportions of clinically relevant depressive symptoms over time compared to their peers without chronic illness (n=2072).
  
  
  CONCLUSIONS
  This study is limited by selective attrition, self-reported chronic illness and no assessment of illness severity, and mediating effects of family environment factors could not be examined.
  
  
  CONCLUSIONS
  Findings support the diathesis-stress model; chronic illness negatively influenced depressive symptoms trajectories, such that youth with chronic illness had higher depression scores and less favorable trajectories over time. The health and school system are uniquely positioned to support youth with chronic illness navigate this developmental period in an effort to prevent declines in mental health.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Department of Pediatrics, McMaster University, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada; CanChild Centre for Childhood Disability Research, McMaster University, Canada. Electronic address: ferroma@mcmaster.ca.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ferro
authors.affiliation: Department of Pediatrics, McMaster University, Canada; CanChild Centre for Childhood Disability Research, McMaster University, Canada.
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Gorter
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Boyle
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease / Q000523:psychology*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D055815:Young Adult
keywords: Adolescence; Chronic illness; Depression; Epidemiological study; Longitudinal cohort; Young adults