Longitudinal investigation into childhood- and adolescence-onset depression: psychiatric outcome in early adulthood.

BACKGROUND Major depression in childhood or adolescence increases the risk off affective disorder in adulthood. The precise nature and course of the subsequent disorder remain unclear. AIMS To investigate long-term psychiatric outcome of school-age depression in community and clinic samples. METHOD A group of 113 young adults were followed up after a mean of 7.8 years (s.e.=15). RESULTS Groups with persistent and recurrent depression were identified. Recurrence of affective disorder was similar in clinic and community groups. The clinic group had significantly longer index episodes; these were predicted by an early psychiatric history, longer episode duration before treatment and greater impairment. Being female, having higher self-report depression scores and comorbidity at index episode predicted earlier recurrence. Males were more likely to have persistent depression. CONCLUSIONS Prognosis is similar in young people with depression from community and clinical samples. Boys from a clinical sample are at higher risk than girls of becoming persistently and severely mentally ill.