title: Adolescent depression, adult mental health and psychosocial outcomes at 30 and 35 years.
abstract: BACKGROUND
  There is limited information on long-term outcomes of adolescent depression. This study examines the associations between severity of depression in adolescence and a broad array of adult functional outcomes.
  
  
  METHODS
  Data were gathered as part of the Christchurch Health and Development Study, a 35-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand in 1977. Severity of depression at age 14-16 years was classified into three levels according to DSM symptom criteria for major depression (no depression/sub-threshold symptoms/major depression). This classification was related to adult functional outcomes assessed at ages 30 and 35 years using a generalized estimating equation modeling approach. Outcome measures spanned domains of mental disorder, education/economic circumstances, family circumstances and partner relationships.
  
  
  RESULTS
  There were modest but statistically significant bivariate associations between adolescent depression severity and most outcomes. After covariate adjustment there remained weak but significant (p < 0.05) associations with rates of major depression, anxiety disorder, illicit substance abuse/dependence, any mental health problem and intimate partner violence (IPV) victimization. Estimates of attributable risk for these outcomes ranged from 3.8% to 7.8%. For two outcomes there were significant (p < 0.006) gender interactions such that depression severity was significantly related to increased rates of unplanned pregnancy and IPV victimization for females but not for males.
  
  
  CONCLUSIONS
  The findings reinforce the importance of the individual/family context in which adolescent depression occurs. When contextual factors and probable maturational effects are taken into account the direct effects of adolescent depression on functioning in mature adulthood appear to be very modest.
authors.affiliation: Christchurch Health and Development Study,Department of Psychological Medicine,University of Otago Christchurch,Christchurch,New Zealand.
authors.forename: G F H
authors.initials: GF
authors.lastname: McLeod
authors.affiliation: Christchurch Health and Development Study,Department of Psychological Medicine,University of Otago Christchurch,Christchurch,New Zealand.
authors.forename: L J
authors.initials: LJ
authors.lastname: Horwood
authors.affiliation: Christchurch Health and Development Study,Department of Psychological Medicine,University of Otago Christchurch,Christchurch,New Zealand.
authors.forename: D M
authors.initials: DM
authors.lastname: Fergusson
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D019548:Crime Victims / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012306:Risk; D012720:Severity of Illness Index; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders
keywords: Adolescence; adult; depression; longitudinal study; mental health; psychosocial