ReviewAdolescent depression: Description, causes, and interventions
Introduction
Depression is one of the most commonly occurring of the major psychiatric disorders, and it has become increasingly recognized that depression over the life span often begins in adolescence. It is a prototypical multifactorial disorder that profoundly affects individuals’ emotions, thoughts, sense of self, behaviors, interpersonal relations, physical functioning, biological processes, work productivity, and overall life satisfaction. Indeed, given the multiple effects that depression has, it has been ranked as the fourth leading cause of disability and premature death worldwide [1]. Given these factors and its typical onset during adolescence, this review focuses on three main issues: definition and description, causes, and interventions.
Section snippets
Definitions, diagnostic criteria, and classification issues in depression
According to the official psychiatric classification system (the Diagnostic and Statistical Manual, fourth edition, DSM-IV-TR) [2], an episode of major depression can be diagnosed on the basis of the same symptoms in childhood and adolescence and in adulthood (e.g., sleep changes, appetite changes, feelings of worthlessness, concentration difficulties), except that irritability can be applied as a mood symptom along with depressed, sad mood and anhedonia (loss of pleasure) in youth. DSM-IV-TR
Prevalence and development of depression over the life course
The rate of prevalence of depression has been examined in many studies with different age groups and with different methods and samples. In this review, community samples are emphasized for estimating rates of prevalence of depression because samples drawn from psychiatric clinics may be biased in various ways (e.g., actively seeking treatment, exhibiting greater severity, and revealing higher comorbidity), and these biases can artificially inflate the rates of prevalence of depression.
Potential causes of the development of depression: Vulnerabilities and stress
To understand what may cause depression in youth, a vulnerability–stress framework, in which recent stressful events trigger an underlying predisposition, may be one of the most promising approaches [56]. In this section, the role of stressors is considered first, then depression vulnerabilities are reviewed. These vulnerabilities are reviewed separately, even though it is most likely that a developmentally sensitive, integrative theoretical model can and should combine these disparate
Interventions for adolescent depression
Broadly considered, intervention includes treatment of youth diagnosed with depression, as well as prevention prior to onset of depression. Many studies have investigated various treatments (e.g., see [160], [161], [162] for reviews) and preventions (e.g., see [161] for reviews) for adolescent depression. This review briefly considers the findings from the largest randomized clinical trial to date on treatment of adolescent depression, the Treatment of Adolescent Depression Study [163], and a
Conclusion
Depression in adolescence is a prevalent mental illness with significant burden and costs in terms of social, educational, interpersonal, economic, and impaired future developmental outcomes. Adolescent depression can be identified and evaluated reliably and validly in various ways, and this is important for diagnosis and eventual treatment or prevention. Many vulnerability factors increase the risk of adolescents experiencing depression, especially when in the face of stressful life events. As
Acknowledgment
This work was supported by a NIMH Grant MH 066845 to Benjamin L. Hankin.
References (167)
Presentation and course of major depressive disorder during childhood and later years of the life span
J Am Acad Child Adolesc Psychiatry
(1996)- et al.
Mood disorders in children and adolescents: an epidemiologic perspective
Biol Psychiatry
(2001) - et al.
Emergence of gender differences in depression during adolescence: national panel results from three countries
J Am Acad Child Adolesc Psychiatry
(2002) - et al.
Prevalence of psychiatric disorders in a community population of older adolescents
J Am Acad Child Adolesc Psychiatry
(1993) - et al.
Is psychopathology associated with the timing of pubertal development?
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
General and specific childhood risk factors for depression and drug disorders by early adulthood
J Am Acad Child Adolesc Psychiatry
(2000) - et al.
Major depression in community adolescents: age at onset, episode duration, and time to recurrence
J Am Acad Child Adolesc Psychiatry
(1994) - et al.
Comorbidity of depression in children and adolescents: models and evidence from a prospective high-risk family study
Biol Psychiatry
(2001) - et al.
Stressful life events in depressed adolescents: the role of dependent events during the depressive episode
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
The role of stressful life events in the development of depressive symptoms in adolescence: a longitudinal community study
J Adolesc
(2004)
Depression-related stress generation: a longitudinal study of black adolescents
Behav Ther
The global burden of disease
The development of depression in children and adolescents
Am Psychol
Developmental differences in the phenomenology of depression
Dev Psychopathol
Phenomenology of major depression from childhood through adulthood: analysis of three studies
Am J Psychiatry
The clinical picture of major depression in children and adolescents
Arch Gen Psychiatry
Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample
J Abnorm Psychol
Informing the continuity controversy: a taxometric analysis of depression
J Abnorm Psychol
The latent structure of analogue depression: should the Beck Depression Inventory be used to classify groups?
Psychol Assess
Depression in children and adolescents
Children’s Depression Inventory: technical manual
DSM-oriented and empirically based approaches to constructing scales from the same item pools
J Clin Child Adolesc Psychol
The assessment of affective disorders in children and adolescents by semistructured interview: test–retest reliability of the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Episode Version
Arch Gen Psychiatry
Depression in adolescence
Am Psychol
Children’s over- and underestimation of academic competence: a longitudinal study of gender differences, depression, and anxiety
Child Dev
Trajectories of stressful life events and depressive symptoms during adolescence
Dev Psychol
The emergence of gender difference in depressed mood during adolescence: The role of intensified gender socialization
Dev Psychol
Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder?
Am J Psychiatry
Symptoms versus a diagnosis of depression: differences in psychosocial functioning
J Consult Clin Psychol
An epidemiological study of disorders in late childhood and adolescence: I. Age- and gender-specific prevalence
J Child Psychol Psychiatry
The Great Smoky Mountains Study of Youth: functional impairment and serious emotional disturbance
Arch Gen Psychiatry
Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey
Arch Gen Psychiatry
Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication
Arch Gen Psychiatry
Prevalence and development of psychiatric disorders in childhood and adolescence
Arch Gen Psychiatry
Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study
J Abnorm Psychol
Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort
Arch Gen Psychiatry
Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults
Am J Psychiatry
Depression scale scores in 8–17-year-olds: effects of age and gender
J Child Psychol Psychiatry
Age, gender, race, socioeconomic status, and birth cohort difference on the children’s depression inventory: a meta-analysis
J Abnorm Psychol
Offspring of depressed parents: 10 years later
Arch Gen Psychiatry
Development of gender differences in depression: description and possible explanations
Ann Med
Puberty and depression: the roles of age, pubertal status and pubertal timing
Psychol Med
Coming of age too early: pubertal influences on girls’ vulnerability to psychological distress
Child Dev
Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms
Dev Psychol
First onset versus recurrence of depression: differential processes of psychosocial risk
J Abnorm Psychol
The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders
Arch Gen Psychiatry
Adult outcomes of childhood and adolescent depression: I. Psychiatric status
Arch Gen Psychiatry
Depressive symptomatology in childhood and adolescence
Dev Psychopathol
Differences in early childhood risk factors for juvenile-onset and adult-onset depression
Arch Gen Psychiatry
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