Journal of Abnormal Child Psychology

, Volume 42, Issue 7, pp 1103–1113

Do Childhood Externalizing Disorders Predict Adult Depression? A Meta-Analysis

  • Annemarie K. Loth
  • Deborah A. G. Drabick
  • Ellen Leibenluft
  • Leslie A. Hulvershorn

DOI: 10.1007/s10802-014-9867-8

Cite this article as:
Loth, A.K., Drabick, D.A.G., Leibenluft, E. et al. J Abnorm Child Psychol (2014) 42: 1103. doi:10.1007/s10802-014-9867-8


Childhood externalizing disorders have been linked to adult affective disorders, although some studies fail to substantiate this finding. Multiple longitudinal cohort studies identifying childhood psychopathology and their association with adult psychiatric illness have been published. To examine the association between childhood externalizing symptoms or disorders and the development of adult depression across cohorts, a meta-analysis was performed. Potential studies were identified using a PubMed search through November 2013. All published, prospective, longitudinal, community-sampled cohort studies of children (≤ 13 years) with externalizing symptoms or disorders (aggression, conduct problems, oppositional defiant disorder, conduct disorder), reassessed in adulthood (≥ 18 years) for depressive disorders (major depressive disorder, depressive disorder NOS, or dysthymic disorder) were included. A random effects model was used to summarize the pooled effect sizes. Ancillary analyses considered covariates that could account for variance among studies. Ten studies representing eight cohorts of children initially assessed at age 13 or younger (N = 17,712) were included in the meta-analysis. Childhood externalizing behavior was associated with adult depressive disorders (OR = 1.52, 95 % confidence interval = 1.27–1.80, p < 0.0001). Utilizing Orwin’s Fail-safe N approach, 263 studies with a mean odds ratio of 1.0 would have to be added to the analysis before the cumulative effect would become trivial. Externalizing psychopathology in childhood is associated with the development of unipolar depressive disorders in adulthood.


Depression Externalizing disorders Conduct Meta-analysis Childhood predictors 

Supplementary material

10802_2014_9867_MOESM1_ESM.docx (22 kb)
Supplementary Table 1(DOCX 22 kb)
10802_2014_9867_MOESM2_ESM.docx (22 kb)
Supplementary Table 2(DOCX 22 kb)

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Annemarie K. Loth
    • 1
  • Deborah A. G. Drabick
    • 2
  • Ellen Leibenluft
    • 3
  • Leslie A. Hulvershorn
    • 1
  1. 1.Department of PsychiatryIndiana University School of Medicine, Riley Hospital for ChildrenIndianapolisUSA
  2. 2.Department of PsychologyTemple UniversityPhiladelphiaUSA
  3. 3.Section on Bipolar Spectrum Disorders, Emotion and Development BranchNational Institute of Mental Health, National Institutes of Health, Department of Health and Human ServicesBethesdaUSA

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