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Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes

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Abstract

Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003–2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as “good” or “fair or poor”. Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.

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References

  1. Bhatia SK, Bhatia SC (2007) Childhood and adolescent depression. Am Fam Physician 75(1):73–80

    PubMed  Google Scholar 

  2. Prager LM (2009) Depression and suicide in children and adolescents. Pediatr Rev 30(6):199–205. https://doi.org/10.1542/pir.30-6-199(quiz 206)

    Article  PubMed  Google Scholar 

  3. Dick B, Ferguson BJ (2015) Health for the world’s adolescents: a second chance in the second decade. J Adolesc Health 56(1):3–6. https://doi.org/10.1016/j.jadohealth.2014.10.260

    Article  PubMed  Google Scholar 

  4. Gore FM, Bloem PJ, Patton GC, Ferguson J, Joseph V, Coffey C, Sawyer SM, Mathers CD (2011) Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 377(9783):2093–2102. https://doi.org/10.1016/S0140-6736(11)60512-6

    Article  PubMed  Google Scholar 

  5. World Health Organization (2004) ICD-10: international statistical classification of diseases and related health problems. World Health Organization, Geneva

    Google Scholar 

  6. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington

    Book  Google Scholar 

  7. Angst J, Sellaro R, Merikangas KR (2000) Depressive spectrum diagnoses. Compr Psychiatry 41(2 Suppl 1):39–47

    Article  CAS  Google Scholar 

  8. Ayuso-Mateos JL, Nuevo R, Verdes E, Naidoo N, Chatterji S (2010) From depressive symptoms to depressive disorders: the relevance of thresholds. Br J Psychiatry 196(5):365–371. https://doi.org/10.1192/bjp.bp.109.071191

    Article  PubMed  Google Scholar 

  9. Bertha EA, Balazs J (2013) Subthreshold depression in adolescence: a systematic review. Eur Child Adolesc Psychiatry 22(10):589–603. https://doi.org/10.1007/s00787-013-0411-0

    Article  PubMed  Google Scholar 

  10. Wesselhoeft R, Sorensen MJ, Heiervang ER, Bilenberg N (2013) Subthreshold depression in children and adolescents—a systematic review. J Affect Disord 151(1):7–22. https://doi.org/10.1016/j.jad.2013.06.010

    Article  PubMed  Google Scholar 

  11. Saluja G, Iachan R, Scheidt PC, Overpeck MD, Sun W, Giedd JN (2004) Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med 158(8):760–765. https://doi.org/10.1001/archpedi.158.8.760(158/8/760 [pii])

    Article  PubMed  Google Scholar 

  12. Pettit JW, Lewinsohn PM, Seeley JR, Roberts RE, Yaroslavsky I (2010) Developmental relations between depressive symptoms, minor hassles, and major events from adolescence through age 30 years. J Abnorm Psychol 119(4):811–824. https://doi.org/10.1037/a0020980

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE (1998) Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 107(1):128–140

    Article  CAS  Google Scholar 

  14. Ge X, Natsuaki MN, Conger RD (2006) Trajectories of depressive symptoms and stressful life events among male and female adolescents in divorced and nondivorced families. Dev Psychopathol 18(1):253–273. https://doi.org/10.1017/S0954579406060147

    Article  PubMed  Google Scholar 

  15. Musliner KL, Munk-Olsen T, Eaton WW, Zandi PP (2016) Heterogeneity in long-term trajectories of depressive symptoms: patterns, predictors and outcomes. J Affect Disord 192:199–211. https://doi.org/10.1016/j.jad.2015.12.030

    Article  PubMed  Google Scholar 

  16. Yaroslavsky I, Pettit JW, Lewinsohn PM, Seeley JR, Roberts RE (2013) Heterogeneous trajectories of depressive symptoms: adolescent predictors and adult outcomes. J Affect Disord 148(2–3):391–399. https://doi.org/10.1016/j.jad.2012.06.028

    Article  PubMed  Google Scholar 

  17. Ellis RER, Seal ML, Simmons JG, Whittle S, Schwartz OS, Byrne ML, Allen NB (2017) Longitudinal trajectories of depression symptoms in adolescence: psychosocial risk factors and outcomes. Child Psychiatry Hum Dev 48(4):554–571. https://doi.org/10.1007/s10578-016-0682-z

    Article  PubMed  Google Scholar 

  18. Zuckerbrot RA, Jensen PS (2006) Improving recognition of adolescent depression in primary care. Arch Pediatr Adolesc Med 160(7):694–704. https://doi.org/10.1001/archpedi.160.7.694(160/7/694 [pii])

    Article  PubMed  Google Scholar 

  19. Cohen P, Kasen S, Chen H, Hartmark C, Gordon K (2003) Variations in patterns of developmental transitions in the emerging adulthood period. Dev Psychol 39(4):657–669

    Article  Google Scholar 

  20. Ramos E, Barros H (2007) Family and school determinants of overweight in 13-year-old Portuguese adolescents. Acta Paediatr 96(2):281–286

    Article  Google Scholar 

  21. Ramos E (2006) Health determinants in Porto adolescents: the EPITeen cohort. Unversity of Porto Medical School, Porto

    Google Scholar 

  22. Beck AT, Steer RA, Brown GK (1996) Manual for the beck depression inventory-II. Psychological Corp, San Antonio

    Google Scholar 

  23. Coelho R, Martins A, Barros H (2002) Clinical profiles relating gender and depressive symptoms among adolescents ascertained by the Beck Depression Inventory II. Eur Psychiatry 17(4):222–226 (S0924933802006636 [pii])

    Article  CAS  Google Scholar 

  24. Bowling A (2005) Just one question: if one question works, why ask several? J Epidemiol Community Health 59(5):342–345. https://doi.org/10.1136/jech.2004.021204

    Article  PubMed  PubMed Central  Google Scholar 

  25. Pinheiro J, Bates D (2000) Mixed-effects models in S and S-PLUS. Springer, New York

    Book  Google Scholar 

  26. Fraley C, Raftery AE (2002) Model-based clustering, discriminant analysis, and density estimation. J Am Stat Assoc 97(458):611–631. https://doi.org/10.1198/016214502760047131

    Article  Google Scholar 

  27. Fraley C, Raftery AE (2007) Bayesian regularization for normal mixture estimation and model-based clustering. J Classif 24(2):155–181. https://doi.org/10.1007/s00357-007-0004-5

    Article  Google Scholar 

  28. Schwarz G (1978) Estimating the dimension of a model. Ann Statist 6(2):461–464. https://doi.org/10.1214/aos/1176344136

    Article  Google Scholar 

  29. Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol 25:111–163. https://doi.org/10.2307/271063

    Article  Google Scholar 

  30. Chaiton M, Contreras G, Brunet J, Sabiston CM, O'Loughlin E, Low NC, Karp I, Barnett TA, O'Loughlin J (2013) Heterogeneity of depressive symptom trajectories through adolescence: predicting outcomes in young adulthood. J Can Acad Child Adolesc Psychiatry 22(2):96–105

    PubMed  PubMed Central  Google Scholar 

  31. Sabiston CM, O'Loughlin E, Brunet J, Chaiton M, Low NC, Barnett T, O'Loughlin J (2013) Linking depression symptom trajectories in adolescence to physical activity and team sports participation in young adults. Prev Med 56(2):95–98. https://doi.org/10.1016/j.ypmed.2012.11.013

    Article  PubMed  Google Scholar 

  32. Schubert KO, Clark SR, Van LK, Collinson JL, Baune BT (2017) Depressive symptom trajectories in late adolescence and early adulthood: a systematic review. Aust N Z J Psychiatry 51(5):477–499. https://doi.org/10.1177/0004867417700274

    Article  PubMed  Google Scholar 

  33. Bulhoes C, Ramos E, Severo M, Dias S, Barros H (2017) Measuring depressive symptoms during adolescence: what is the role of gender? Epidemiol Psychiatr Sci. https://doi.org/10.1017/S2045796017000312

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mazza JJ, Fleming CB, Abbott RD, Haggerty KP, Catalano RF (2010) Identifying trajectories of adolescents’ depressive phenomena: an examination of early risk factors. J Youth Adolesc 39(6):579–593. https://doi.org/10.1007/s10964-009-9406-z

    Article  PubMed  Google Scholar 

  35. Jonsson U, Bohman H, von Knorring L, Olsson G, Paaren A, von Knorring AL (2011) Mental health outcome of long-term and episodic adolescent depression: 15-year follow-up of a community sample. J Affect Disord 130(3):395–404. https://doi.org/10.1016/j.jad.2010.10.046

    Article  CAS  PubMed  Google Scholar 

  36. Pettit JW, Lewinsohn PM, Roberts RE, Seeley JR, Monteith L (2009) The long-term course of depression: development of an empirical index and identification of early adult outcomes. Psychol Med 39(3):403–412. https://doi.org/10.1017/S0033291708003851

    Article  CAS  PubMed  Google Scholar 

  37. Diamantopoulou S, Verhulst FC, van der Ende J (2011) Gender differences in the development and adult outcome of co-occurring depression and delinquency in adolescence. J Abnorm Psychol 120(3):644–655. https://doi.org/10.1037/a0023669

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported through FEDER from the Operational Programme Factors of Competitiveness—COMPETE and through national funding from the Portuguese Foundation for Science and Technology—FCT (Portuguese Ministry of Education and Science) within the project PTDC/DTP-EPI/6506/2014, and by the Epidemiology Research Unit—Institute of Public Health, University of Porto (UID/DTP/047507/2013). An individual grant attributed to CB (SFRH/SINTD/60138/2009) was supported by the Portuguese Foundation for Science and Technology—FCT.

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Authors and Affiliations

  1. EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal

    C. Bulhões, E. Ramos, M. Severo & H. Barros

  2. Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal

    E. Ramos, M. Severo & H. Barros

  3. Escola Nacional de Saúde Pública, Centro de Investigação Em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal

    S. Dias

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  1. C. Bulhões
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Correspondence to C. Bulhões.

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Bulhões, C., Ramos, E., Severo, M. et al. Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes. Eur Child Adolesc Psychiatry 30, 65–74 (2021). https://doi.org/10.1007/s00787-020-01493-9

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  • DOI: https://doi.org/10.1007/s00787-020-01493-9

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