Prevalence, 20-month incidence and outcome of unipolar depressive disorders in a community sample of adolescents

• Main Authors: Oldehinkel, Albertine J., Wittchen, Hans-Ulrich, Schuster, Peter
• Other Authors: Cambridge University Press,
• Format: Article
• Language: English
• Published: Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden 2013
• Subjects: Unipolare Depression; Jugendliche; Unipolar depressive disorder; adolescents; ddc:150; rvk:CU 3200
• Online Access: http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103336; http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103336; http://www.qucosa.de/fileadmin/data/qucosa/documents/10333/402.pdf

Background. This article presents prospective longitudinal findings on prevalence, incidence, patterns of change and stability of depressive disorders in a community sample of 1228 adolescents. Methods. Data were collected at baseline and follow-up (20 months later) in a representative population sample of 1228 adolescents, aged 14–17 at baseline. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI). Results. The overall cumulative lifetime incidence of any depressive condition was 20·0% (major depressive disorder (MDD), 12·2%; dysthymia, 3·5%; subthreshold MDD, 6·3%), of which about one-third were incident depressions in the period between baseline and follow-up. Depressive disorders rarely started before the age of 13. Females were about twice as likely as males to develop a depressive disorder. Overall, the 20-month outcome of baseline depression was unfavourable. Dysthymia had the poorest outcome of all, with a complete remission rate of only 33% versus 43% for MDD and 54% for subthreshold MDD. Dysthymia also had the highest number of depressive episodes, and most psychosocial impairment and suicidal behavioural during follow-up. Treatment rates were low (8–23%). Subthreshold MDD associated with considerable impairment had an almost identical course and outcome as threshold MDD. Conclusions. DSM-IV MDD and dysthymia are rare before the age of 13, but frequent during adolescence, with an estimated lifetime cumulative incidence of 14%. Only a minority of these disorders in adolescence is treated, and more than half of them persist or remit only partly.