Teenage depression linked to poor psychological and social outcomes in later life

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Our teenage years are a time of significant development, cognitively, emotionally and socially. At least 1 in 10 teenagers per year experience an episode of depression. Teenage depression is therefore a common and significant problem for young people.

Considerable research has been undertaken into the long-term outcomes of experiencing depression during adolescence, which include subsequent depression, higher rates of other mental health problems, increased likelihood of suicide attempts, and poor academic and occupational functioning (Fergusson & Woodward, 2002).

This review, conducted by Clayborne and colleagues at the University of Ottowa and published in the Journal of the American Academy of Child and Adolescent Psychiatry, aimed to synthesise and summarise what we know about the long term psychological and social outcomes of experiencing depression at this crucial stage of development.

At least 1 in 10 teenagers per year experience an episode of depression.

At least 1 in 10 teenagers per year experience an episode of depression.

Methods

A systematic search of a number of databases was conducted to identify papers relevant to the review question. The included papers reported on studies of teenagers age 10 to 19, with confirmed depression or depressive symptoms, and compared them to non-depressed controls. To be of relevance to the review, the papers had to report on follow-up data obtained in later life (i.e. at least 12 months after the initial assessment of depression). The quality of the research was taken into consideration.

Results

A total of 31 papers were included in the review, with 40 different outcomes reported in total. The papers were mainly moderate to high in quality, and most were studies undertaken in North America or Europe. Studies ranged in size from less than 100 participants to over 10,000 participants.

Overall, those with depression in their teens had less favourable outcomes between ages 18 to 35 than those who did not have depression. This included outcomes such as:

  • Failing to complete secondary school
  • Achieving lower grades
  • Being more likely to be (or to have recently been) unemployed.

Depression also appeared to have an unfavourable impact on relationships in later life:

  • Increasing the likelihood of being lonely
  • Needing but lacking social support in adulthood.
This review found that teenage depression was linked to poor academic outcomes, unemployment and problems with relationships in adult life. 

This review found that teenage depression was linked to poor academic outcomes, unemployment and problems with relationships in adult life.

Conclusions

The review concludes that those teens who experience depression are more likely to subsequently experience a number of unfavourable psychological and social outcomes.

This may be the long term effects of the symptoms of and/or impairment caused by depression during the teenage years (e.g. poor concentration and/or missing school due to depression could contribute to poorer educational attainment and could affect friendships too).

It could also be that those who experience depression in their teens are more likely to experience the recurrence of depression later in life (Fombonnne, Wostear, Cooper, Harrington & Rutter, 2001).

Strengths and limitations

  • This review comprehensively sought out the available evidence pertaining to the long term outcomes of depression in adolescence, although only papers in English were included.
  • Furthermore, it may be that confounding factors not considered in this review (e.g. ethnicity or treatment) could be relevant to understanding the links between teenage depression and outcomes in later life.
  • The length of follow-up varied between the papers included, and from the data, it is not possible to establish the direction of causality between depression and the unfavourable outcomes under consideration; that is, the unfavourable outcomes may have pre-dated the depression, but were not measured until follow-up.

Implications for practice

The findings of this review highlight the potential gamut of unfavourable outcomes that can be associated with experiencing depression as a teenager.

Given that those who access mental health services in their teens are less likely to have depression when followed up 3 years later (Bone, 2017), this adds weight to the case for early intervention and prevention, especially targeted at young people transitioning to their teens.

Teens who are known to be at greater risk of developing depression such as those with a family history of depression, and those who have experienced recent stressful life events (Stapley, 2017), could specifically be offered preventative approaches.

This evidence adds weight to the case for early intervention and prevention of youth depression, especially targeted at young people transitioning to their teens.

This evidence adds weight to the case for early intervention and prevention of youth depression, especially targeted at young people transitioning to their teens.

Conflicts of interest

None identified.

Links

Primary paper

Clayborne ZM, Varin M, Colman I. (2018) Systematic Review and Meta-Analysis: Adolescent Depression and Long-Term Psychosocial Outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, Volume 58, Issue 1, 2019, Pages 72-79.

Other references

Bone, J. (2017). Use of mental health services may reduce adolescent depression. Mental Elf blog 24th March 2017.

Fergusson, D.M. & Woodward, L.J. (2002). Mental health, educational and social role outcomes of adolescents with depression. Archives of General Psychiatry, 59, 225-231.

Fombonne, E., Wostear, G., Cooper, V., Harrington, R. & Rutter, M. (2001). The Maudsley long-term follow-up of child and adolescent depression. 1. Psychiatric outcomes in adulthood. British Journal of Psychiatry, 179, 210-217.

Stapley, E. (2017). Antecedents of depression in children and young people. Mental Elf blog 17th March 2017.

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Maria Loades

Dr Maria Loades is a Senior Lecturer/Clinical Tutor for the Doctorate in Clinical Psychology programme at the University of Bath, UK. Maria qualified as a Clinical Psychologist from the University of East Anglia in 2008. Since qualification, she has worked a variety of mental health settings, including adult mental health, a children’s inpatient unit, and various community Child and Adolescent Mental Health Services (CAMHS). She completed a post-graduate diploma in cognitive behaviour therapy (CBT) for children, young people and families at the Anna Freud Centre/University College London in 2013, and a Postgraduate Certificate in the Supervision of Applied Psychology Practice at the University of Oxford in 2015. Maria secured an NIHR doctoral research fellowship in 2016 to further her research into depression in paediatric Chronic Fatigue Syndrome (CFS), which she is undertaking in collaboration with colleagues at the University of Bristol, and the Paediatric CFS team at the Royal United Hospital in Bath. Maria’s research interests also include: Developing and delivering Cognitive and/or Behavioural treatments for children and young people with depression, including those with chronic illnesses, therapist competence in delivering CBT, particularly in the field of child and adolescent mental health, and CBT supervision.

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