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Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adolescence?

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1
University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pa 15213, USA. birmaherb@upmc.edu

Abstract

OBJECTIVE:

To simultaneously and prospectively compare the clinical presentation, course, and parental psychiatric history between children and adolescents with major depressive disorder.

METHOD:

A group of prepubertal children (n = 46) and postpubertal adolescents (n = 22) were assessed with structured interviews for psychopathology and parental psychiatric history and followed once every 2 years for approximately 5 years.

RESULTS:

With the exception of more depressive melancholic symptoms in the adolescents, both groups had similar depressive symptomatology, duration (average 17 months), severity of the index episode, rates of recovery (85%) and recurrence (40%), comorbid disorders, and parental psychiatric history. Female sex, increased guilt, prior episodes of depression, and parental psychopathology were associated with worse longitudinal course.

CONCLUSIONS:

In general, major depressive disorder is manifested similarly in children and adolescents, and both groups have a protracted clinical course and high family loading for psychiatric disorders.

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