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Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes

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Copeland, William E., Alaie, Iman, Jonsson, Ulf, Shanahan, Lilly·2021·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1016/j.jaac.2020.07.895PMC PMC8051642

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Abstract

Objective Depression is common, impairing, and the leading cause of disease burden in youths. This study aimed to identify the effects of childhood/adolescent depression on a broad range of longer-term outcomes.Method The analysis is based on the prospective, representative Great Smoky Mountains Study of 1,420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to 8 times in childhood (age 9-16 years; 6,674 observations; 1993-2000) for DSM-based depressive disorders, associated psychiatric comorbidities, and childhood adversities. Participants were followed up 4 times in adulthood (ages 19, 21, 25, and 30 years; 4,556 observations of 1,336 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric outcomes and functional outcomes.Results In all, 7.7% of participants met criteria for a depressive disorder in childhood/adolescence. Any childhood/adolescent depression was associated with higher levels of adult anxiety and illicit drug disorders and also with worse health, criminal, and social functioning; these associations persisted when childhood psychiatric comorbidities and adversities were accounted for. No sex-specific patterns were identified. However, timing of depression mattered: individuals with adolescent-onset depression had worse outcomes than those with child-onset. Average depressive symptoms throughout childhood and adolescence were associated with more adverse outcomes. Finally, specialty mental health service use was protective against adult diagnostic outcomes.Conclusion Early depression and especially persistent childhood/adolescent depressive symptoms have robust, lasting associations with adult functioning. Some of these effects may be attenuated by service use.

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Authors: Copeland, W. E., Alaie, I., Jonsson, U., & Shanahan, L.
Affiliations: University of Vermont (US)
Uppsala University (SE)
University of Zurich (CH)
Corresponding author: Copeland, William E.
ORCID: Copeland, William E.
Alaie, Iman
Jonsson, Ulf
Shanahan, Lilly
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 2021-05
Volume: 60
Issue: 5
Pages: 604-611
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1016/j.jaac.2020.07.895
PMC: PMC8051642
OpenAlex: W3047452675
Cited by: 310
References: 35
Citations by year: 2026: 81 · 2025: 74 · 2024: 54 · 2023: 52 · 2022: 27 · 2021: 19
FWCI: 10.09
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institute of Mental Health
Topics: Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: childhood depression, adolescent depression, functional outcome, anxiety disorders, social functioning, adolescent-onset depression, mental health service utilization, psychiatric comorbidity, childhood adversity, persistent depressive symptoms, Great Smoky Mountains Study
MeSH terms: Adolescent, Adult, Anxiety Disorders, Child, Depression, Family, Humans, Mental Health Services, Prospective Studies, Young Adult

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Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes

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