Longitudinal investigation into childhood-and adolescence-onset depression: Psychiatric outcome in early adulthood

BACKGROUND: Major depression in childhood or adolescence increases the risk off affective disorder in adulthood. The precise nature and course of the subsequent disorder remain unclear. AIMS: To investigate long-term psychiatric outcome of school-age depression in community and clinic samples. METHOD: A group of 113 young adults were followed up after a mean of 7.8 years (s.e.=15). RESULTS: Groups with persistent and recurrent depression were identified. Recurrence of affective disorder was similar in clinic and community groups. The clinic group had significantly longer index episodes; these were predicted by an early psychiatric history, longer episode duration before treatment and greater impairment. Being female, having higher self-report depression scores and comorbidity at index episode predicted earlier recurrence. Males were more likely to have persistent depression. CONCLUSIONS: Prognosis is similar in young people with depression from community and clinical samples. Boys from a clinical sample are at higher risk than girls of becoming persistently and severely mentally ill.