Prevalence and characteristics of depressive disorders in early adolescents in central Norway

Chinese Medicine

Lars Wichstrøm²  Bo Larsson³  Anne Mari Sund¹ 

[1] St.Olav's University Hospital, Trondheim, Norway;Department of Psychology, Norwegian University of Science and Technology, N- 7491, Trondheim, Norway;Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, N- 7489, Trondheim, Norway

关键词: health service;    epidemiology;    adolescence;    Depression NOS;    Dysthymia;    MDD;    Depressive disorders;   

Others  :  791542
DOI  :  10.1186/1753-2000-5-28

 received in 2011-04-16, accepted in 2011-08-31,  发布年份 2011

【 摘 要 】

Background

Prevalence of depressive disorders among adolescents has varied across studies. The present study aims to assess current and lifetime prevalence and characteristics of adolescent Major Depressive Disorder (MDD), Dysthymia and Depression NOS among adolescents in Central Norway in addition to socio-demographics and use of mental health care.

Method

In the Youth and Mental Health Study a representative sample of 2432 junior high school students (mean age 14.9 years, SD = 0.6) from two counties in Central Norway were screened with the Mood and Feelings Questionnaire (MFQ). A subset of 345 of these adolescents (72.5% girls), 220 high scorers (MFQ = > 26), 74 middle scorers (MFQ 7-25), and 50 low scorers (MFQ < 7), 1 unknown score, were drawn and interviewed with the Kiddie SADS-PL (Present-Life Version). In all, 79% had parental interviews as well. All estimates of prevalence rates and population shares were weighted back using a sandwich estimator to yield true population estimates.

Results

Almost one in four subjects (23%) had life-time depression. Prevalences of current Major Depressive Disorder (MDD), Dysthymia and "Double depression" were 2.6%, 1.0% and 0.6%, respectively, and for Depression NOS 6.3%.

All depressive disorders were characterized by long duration of episodes with large variations, and for any depressive disorder onset before 12 years of age. In multivariate analyses MDD and Dysthymia were most strongly associated with gender and not living with both biological parents. There was no gender difference for Depression NOS. Although a considerable number of depressed subjects had received mental health care, the reason for contact with services was seldom due to affective symptoms. Less than 20% had been in contact with specialist mental health services.

Conclusion

High rates of Depression NOS, early onset of depressive episodes, long duration, and low use of specialized services point to the need for improved diagnostic assessment and treatment for young individuals.

【 授权许可】

   
2011 Sund et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Birmaher B, Brent D, Bernet W, Bukstein O, Walter H, Benson RS, Chrisman A, Farchione T, Greenhill L, Hamilton J, et al.: Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 2007, 46(11):1503-1526.
• [2]Lewinsohn PM, Rohde P, Klein DN, Seeley JR: Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. J Am Acad Child Adolesc Psychiatry 1999, 38(1):56-63.
• [3]Keenan-Miller D, Hammen CL, Brennan PA: Health outcomes related to early adolescent depression. J Adolesc Health 2007, 41(3):256-262.
• [4]Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH: Psychosocial functioning of young adults who have experienced and recovered from major depressive disorder during adolescence. J Abnorm Psychol 2003, 112(3):353-363.
• [5]Kashani JH, McGee RO, Clarkson SE, Anderson JC, Walton LA, Williams S, Silva PA, Robins AJ, Cytryn L, McKnew DH: Depression in a sample of 9-year-old children, Prevalence and associated characteristics. Arch Gen Psychiatry 1983, 40(11):1217-1223.
• [6]Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R: Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 2003, 60(7):709-717.
• [7]McGee R, Feehan M, Williams S, Anderson J: DSM-III disorders from age 11 to age 15 years. J Am Acad Child Adolesc Psychiatry 1992, 31(1):50-59.
• [8]Costello J, Mustillo S, Erkanli A, Keeler G, Angold A: Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003, 60(8):837-844.
• [9]Oldehinkel AJ, Wittchen HU, Schuster P: Prevalence, 20-month incidence and outcome of unipolar depressive disorders in a community sample of adolescents. Psychol Med 1999, 29(3):655-668.
• [10]Olsson GI, von Knorring AL: Adolescent depression: prevalence in Swedish high-school students. Acta Psychiatr Scand 1999, 99(5):324-331.
• [11]Ford T, Goodman R, Meltzer H: The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 2003, 42(10):1203-1211.
• [12]Verhulst FC, van der Ende J, Ferdinand RF, Kasius MC: The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. Arch Gen Psychiatry 1997, 54(4):329-336.
• [13]Steinhausen H-C, Winkler M: Prevalence of affective disorders in children and adolescents: findings from the Zurich Epidemiological Studies. Acta Psych Scand 2003, 108:(suppl 418):20-23.
• [14]Costello J, Erkanli A, Angold A: Is there an epidemic of child or adolescent depression? J Child Psychology Psychiatry 2006, 47(12):1263-1271.
• [15]Merikangas K, Knight E: The epidemiology of depression in adolescents. In Handbook of Depression in Adolescence. Edited by Nolen-Hoeksema S, Hilt L. New York London: Routledge; 2009:53-73.
• [16]Essau CA: Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety 2005, 22(3):130-137.
• [17]Wu P, Hoven CW, Bird HR, Moore RE, Cohen P, Alegria M, Dulcan MK, Goodman SH, Horwitz SM, Lichtman JH, et al.: Depressive and disruptive disorders and mental health service utilization in children and adolescents. J Am Acad Child Adolesc Psychiatry 1999, 38(9):1081-1090. discussion 1090-1082
• [18]Sund AM: The development of depressive symptoms in early adolescence. The Norwegian University of Science and Technology, Institute Of Neuroscience; 2004.
• [19]Rossow I, Grøholt B, Wichstrøm L: Intoxicants and suicidal behaviour among adolescents: changes in levels and associations from 1992 to 2002. Addiction 2005, 100(1):79-88.
• [20]Kandel DB, Davies M: Epidemiology of Depressive Mood in Adolescents - an Empirical-Study. Arch Gen Psychiatry 1982, 39(10):1205-1212.
• [21]Angold A, Costello EJ, Pickles EJ, Winder F: The development of a questionnaire for use in epidemiological studies of depression in children and adolescents. London: Medical research Council; 1987.
• [22]Sund AM, Larsson B, Wichstrom L: Depressive symptoms among young Norwegian adolescents as measured by the Mood and Feelings Questionnaire (MFQ). Eur Child Adolesc Psychiatry 2001, 10(4):222-229.
• [23]ISCO-1988: International Standard Classification of Occupation. Geneva; 1990.
• [24]Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington DC: American Psychiatric Association; 1994.
• [25]Daviss WB, Birmaher B, Melhem NA, Axelson DA, Michaels SM, Brent DA: Criterion validity of the Mood and Feelings Questionnaire for depressive episodes in clinic and non-clinic subjects. J Child Psychol Psychiatry 2006, 47(9):927-934.
• [26]Wood A, Kroll L, Moore A, Harrington R: Properties of the mood and feelings questionnaire in adolescent psychiatric outpatients: a research note. J Child Psychol Psychiatry 1995, 36(2):327-334.
• [27]Cooper PJ, Goodyer I: A community study of depression in adolescent girls. I: Estimates of symptom and syndrome prevalence. Br J Psychiatry 1993, 163:369-374, 379-380.
• [28]Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961, 4:561-571.
• [29]Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N: Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997, 36(7):980-988.
• [30]Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S: A children's global assessment scale (CGAS). Arch Gen Psychiatry 1983, 40(11):1228-1231.
• [31]Achenbach T: Manual for the Child and Behaviour Checklist/4-18 and 1991 Profile. Burlington VT: Dept of Psychiatry; 1991.
• [32]Cantwell DP, Lewinsohn PM, Rohde P, Seeley JR: Correspondence between adolescent report and parent report of psychiatric diagnostic data. J Am Acad Child Adolesc Psychiatry 1997, 36(5):610-619.
• [33]Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). American Psychiatric Association; 2000.
• [34]Huber PJ: The behavior of maximum likelihood estmates under nonstandard conditions. In The Fifth Berkeley Symposium on Mathamatical Statiotistics and Probality: 1967; Berkeley. University of California Press; 1967:221-223.
• [35]Goodman SH, Schwab-Stone M, Lahey BB, Shaffer D, Jensen PS: Major depression and dysthymia in children and adolescents: discriminant validity and differential consequences in a community sample. J Am Acad Child Adolesc Psychiatry 2000, 39(6):761-770.
• [36]Kessler RC, Walters EE: Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depress Anxiety 1998, 7(1):3-14.
• [37]Kovacs M, Obrosky DS, Gatsonis C, Richards C: First-episode major depressive and dysthymic disorder in childhood: clinical and sociodemographic factors in recovery. J Am Acad Child Adolesc Psychiatry 1997, 36(6):777-784.
• [38]Lewinsohn PM, Hops H, Roberts RE, Seeley JR, Andrews JA: Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol 1993, 102(1):133-144.
• [39]Wichstrom L: The emergence of gender difference in depressed mood during adolescence: the role of intensified gender socialization. Dev Psychol 1999, 35(1):232-245.
• [40]Lewinsohn PM, Clarke GN, Seeley JR, Rohde P: Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry 1997, 33(6):809-818.
• [41]Zisook S, Rush AJ, Lesser I, Wisniewski SR, Trivedi M, Husain MM, Balasubramani GK, Alpert JE, Fava M: Preadult onset vs. adult onset of major depressive disorder: a replication study. Acta Psychiatr Scand 2007, 115(3):196-205.
• [42]Essau CA, Lewinsohn PM, Seeley JR, Sasagawa S: Gender differences in the developmental course of depression. J Affect Disord 2010, 127(1-3):185-190.
• [43]Marcus SM, Young EA, Kerber KB, Kornstein S, Farabaugh AH, Mitchell J, Wisniewski SR, Balasubramani GK, Trivedi MH, Rush AJ: Gender differences in depression: findings from the STAR*D study. J Affect Disord 2005, 87(2-3):141-150.
• [44]Birmaher B, Williamson DE, Dahl RE, Axelson DA, Kaufman J, Dorn LD, Ryan ND: Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adolescence? J Am Acad Child Adolesc Psychiatry 2004, 43(1):63-70.
• [45]Amato PR: Children of divorce in the 1990s: an update of the Amato and Keith (1991) meta-analysis. J Fam Psychol 2001, 15(3):355-370.
• [46]Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 2003, 157(2):98-112.
• [47]Lemstra M, Neudorf C, D'Arcy C, Kunst A, Warren LM, Bennett NR: A systematic review of depressed mood and anxiety by SES in youth aged 10-15 years. Can J Public Health 2008, 99(2):125-129.
• [48]Roberts RE, Roberts CR, Chen YR: Ethnocultural differences in prevalence of adolescent depression. Am J Community Psychol 1997, 25(1):95-110.
• [49]Sund AM, Larsson B, Wichstrom L: Psychosocial correlates of depressive symptoms among 12-14-year-old Norwegian adolescents. J Child Psychol Psychiatry 2003, 44(4):588-597.
• [50]Tracy M, Zimmerman FJ, Galea S, McCauley E, Stoep AV: What explains the relation between family poverty and childhood depressive symptoms? J Psychiatr Res 2008, 42(14):1163-1175.
• [51]Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebo AK, Plessen KJ, Bjelland I, Lie SA, et al.: Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 2007, 46(4):438-447.
• [52]Reigstad B, Jorgensen K, Wichstrom L: Changes in referrals to child and adolescent psychiatric services in Norway 1992--2001. Soc Psychiatry Psychiatr Epidemiol 2004, 39(10):818-827.
• [53]Angold A, Erkanli A, Costello EJ, Rutter M: Precision, reliability and accuracy in the dating of symptom onsets in child and adolescent psychopathology. J Child Psychol Psychiatry 1996, 37(6):657-664.