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Concurrent Trajectories of Change in Adolescent and Maternal Depressive Symptoms in the TORDIA Study

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Abstract

Depression has a heightened prevalence in adolescence, with approximately 15 % of adolescents experiencing a major depressive episode by age 18. Depression in adolescence also poses a risk for future distress and impairment. Despite treatment advances, many adolescents relapse after initial remission. Family context may be an important factor in the developmental trajectory of adolescent depression, and thus in enhancing treatment. This study examined concurrent change over time in adolescent and maternal depressive symptoms in the context of the Treatment of Resistant Depression in Adolescents study. Participants were 334 adolescents (mean age: 16; SD: 1.6; 70 % female, 84 % Caucasian), and their mothers (n = 241). All adolescents were clinically depressed when they entered the study and had received previous selective serotonin reuptake inhibitor (SSRI) treatment. Adolescents received acute treatment for 12 weeks and additional treatment for 12 more weeks. Adolescent depression and suicidal ideation were assessed at 0, 6, 12, 24, 48 and 72 weeks, while maternal depressive symptoms were assessed at 0, 12, 24, 48 and 72 weeks. Latent basis growth curve analyses showed a significant correlation over 72 weeks between trajectories of maternal and adolescent depressive symptoms, supporting the hypothesis of concurrent patterns of change in these variables. The trajectories were correlated more strongly in a subsample that included only dyads in which mothers reported at least one depressive symptom at baseline. Results did not show a correlation between trajectories of maternal depressive symptoms and adolescent suicidal ideation. These findings suggest that adolescent and maternal depressive symptoms change in tandem, and that treatment for adolescent depression can benefit the wider family system. Notably, most mothers in this sample had subclinical depressive symptoms. Future research might explore these trajectories in dyads with more severely depressed mothers.

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Acknowledgments

Data used in the preparation of this article were obtained from the limited access dataset distributed from the NIH-supported “Treatment of SSRI-Resistant Depression in Adolescents” (TORDIA). This is a multisite, clinical trial of adolescents with depression comparing the effectiveness of randomly medication treatment. The study was supported by NIMH Contract MH61835 to the Western Psychiatric Institute and Clinic. The ClinicalTrials.gov identifier is NCTOOO 18902. This reflects the views of the authors and may not reflect the opinions or views of the TORDIA Study Investigators or the NIH.

Author Contributions

AP and CES developed initial study hypotheses together. AP conducted the literature review, managed and conducted analyses, wrote the first draft of the manuscript, and responded to all edits and revisions. CES edited and helped revise the manuscript. TC provided critical guidance on the statistical analyses and provided guidance in writing and revising the Methods and Results sections. KR also provided edits on an earlier draft of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Psychology, George Mason University, 4400 University Drive, MS 3F5, Fairfax, VA, 22030, USA

    Alexandra Perloe, Christianne Esposito-Smythers, Timothy W. Curby & Keith D. Renshaw

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  1. Alexandra Perloe
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  2. Christianne Esposito-Smythers
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  3. Timothy W. Curby
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  4. Keith D. Renshaw
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Correspondence to Alexandra Perloe.

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Perloe, A., Esposito-Smythers, C., Curby, T.W. et al. Concurrent Trajectories of Change in Adolescent and Maternal Depressive Symptoms in the TORDIA Study. J Youth Adolescence 43, 612–628 (2014). https://doi.org/10.1007/s10964-013-9999-0

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  • DOI: https://doi.org/10.1007/s10964-013-9999-0

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