title: Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years.
abstract: Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression.
  
  
  
  A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression.
  
  
  
  Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found.
  
  
  
  Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden. hannes.bohman@neuro.uu.se.|Department of Women's and Children's Health, Akademiska sjukhuset, SE-75185, Uppsala, Sweden. hannes.bohman@neuro.uu.se.|Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden. hannes.bohman@neuro.uu.se.|Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. hannes.bohman@neuro.uu.se.
authors.forename: Hannes
authors.initials: H
authors.lastname: Bohman
authors.affiliation: Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-10691, Stockholm, Sweden.
authors.forename: Sara Brolin
authors.initials: SB
authors.lastname: Låftman
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden.
authors.forename: Aivar
authors.initials: A
authors.lastname: Päären
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, SE-75124, Uppsala, Sweden.|Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jonsson
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D004243:Divorce / Q000523:psychology* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012111:Residence Characteristics; D012307:Risk Factors
keywords: Adolescence; Bipolar; Depression; Divorce; Family structure; Family type; Prospective