There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Major depressive disorder (MDD) that arises in adolescence impairs functioning and
is associated with suicide risk, but little is known about its continuity into adulthood.
To describe the clinical course of adolescent-onset MDD into adulthood.
Prospective case-control study. Seventy-three subjects had onset of MDD based on systematic
clinical assessment during adolescence (Tanner stage III-V) and 37 controls had no
evidence of past or current psychiatric disorders, and also were assessed in adolescence
(assessment years: 1977-1985). Follow-up was conducted 10 to 15 years after the initial
assessment by an independent team without knowledge of initial diagnosis (follow-up
years: 1992-1996).
Cases were identified at Columbia Presbyterian Hospital, New York City, NY; controls
were recruited from the community.
Suicide and suicide attempts, psychiatric diagnoses, treatment utilization, and social
functioning.
Clinical outcomes of adolescent-onset MDD into adulthood compared with control subjects
without psychiatric illness include a high rate of suicide (7.7%); a 5-fold increased
risk for first suicide attempt; a 2-fold increased risk of MDD, but not other psychiatric
disorders; an increased occurrence of psychiatric and medical hospitalization; and
impaired functioning in work, social, and family life. Thirty-seven percent of those
with adolescent MDD survived without an episode of MDD in adulthood vs 69% of the
control participants (relative risk, 2.2 [95% confidence interval, 1.0-4.7; P<.05]).
There is substantial continuity, specificity, morbidity, and potential mortality from
suicide into adulthood in adolescent-onset MDD patients. Now that empirically based
guides to their treatment are becoming available, early identification and treatment
seems warranted.