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Continuity of Depression During the Transition to Adulthood: A 5-Year Longitudinal Study of Young Women

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ABSTRACT

Objective

To characterize the clinical course and psychosocial correlates of unipolar depression in late adolescent women and to examine the continuity in affective disturbance from adolescence of early adulthood during the post-high school transition.

Method

One hundred fifty-five women aged 17 or 18 years were recruited from 3 local public high schools and were followed at yearly intervals for 5 years for clinical and psychosocial outcomes.

Results

The 5-year incidence of first major depressive episode was 36.9%, and overall, 47% of the women had one or more episodes of major depression. Risk for recurrence was substantial, and those with onsets prior to the study were more likely to have depressive episodes during the post-high school period. The presence of nonaffective disorder also increased the risk for depression. Young women with major depression during the post-high school transition had more negative functional outcomes in school and intimate romantic relationships.

Conclusions

These results suggest that there is substantial continuity in affective disturbance from adolescence to adulthood. The risk for both new onset of depression and recurrence is remarkably high during late adolescence, and the risk continues throughout early adult years, accompanied by notable interpersonal dysfunction.

REFERENCES (43)

  • U Rao et al.

    Unipolar depression in adolescents: clinical outcome in adulthood

    J Am Acad Child Adolesc Psychiatry

    (1995)
  • U Rao et al.

    Childhood depression and risk of suicide: a preliminary report of a longitudinal study

    J Am Acad Child-Adolesc Psychiatry

    (1993)
  • ND Ryan et al.

    A secular increase in child and adolescent onset affective disorder

    J Am Acad Child Adolesc Psychiatry

    (1992)
  • M Strober et al.

    The course of major depressive disorder in adolescents, I: recovery and risk of manic switching in a follow-up of psychotic and nonpsychotic subtypes

    J Am Acad Child Adolesc Psychiatry

    (1993)
  • MM Weissman et al.

    Gender and depression

    Trends Neurosci

    (1985)
  • A Angold et al.

    Effects of age and pubertal status on depression in a large clinical sample

    Dev Psychopathol

    (1992)
  • RH Aseltine et al.

    Depression and the social developmental context of adolescence

    J Pers Soc Psychol

    (1994)
  • AM Bardone et al.

    Adult mental health and social outcomes of adolescent girls with depression and conduct disorder

    Dev Psychopathol

    (1996)
  • Bureau of the Census

    Statistical Abstract of the United States: The National Data Book

    (1997)
  • W Coryell et al.

    Predictors of relapse into major depressive disorder in a nonclinical population

    Am J Psychiatry

    (1991)
  • SE Daley et al.

    Depression and Axis II symptomatology in an adolescent community sample: concurrent and longitudinal associations

    J Pers Disord

    (1999)
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    This research was supported in part by the William T. Grant Foundation (Dr. Hammen) and NIMH Scientist Development Award MH01419 (Dr. Rao).

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