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

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An Erratum to this article was published on 20 May 2014

Abstract

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.

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Acknowledgments

This research was partially supported by grants from the National Institute of Mental Health (K01MH0737 to DD; Intramural Research Program to EL) and the National Institutes of Drug Abuse (K12 DA000357 for LH’s effort). The authors would like to thank Mr. Michael Tonzi for administrative assistance and Dr. Michael Borenstein for statistical consultation.

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Correspondence to Leslie A. Hulvershorn.

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Loth, A.K., Drabick, D.A.G., Leibenluft, E. et al. Do Childhood Externalizing Disorders Predict Adult Depression? A Meta-Analysis. J Abnorm Child Psychol 42, 1103–1113 (2014). https://doi.org/10.1007/s10802-014-9867-8

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