Consequence of child and adolescent depressive symptom trajectories for adult depressive disorders and symptoms: A systematic review & meta-analysis.

BACKGROUND

Group differences in longitudinal patterns of child and adolescent depressive symptoms are commonly observed. However, the implications for adult mental health are unclear. This study presents a systematic review of child and adolescent depressive symptom trajectory research and meta-analysis of their longitudinal effects on adult depressive symptoms and disorders.

METHODS

A systematic search identified 12 longitudinal studies (12 cohorts, N = 35,058) that were harmonized to identify common symptom trajectories prior to age 18 years. Examination of follow-up in the same groups was made (at average age 20.5 years) to estimate longitudinal associations with adult depressive symptoms (Sx) and disorders (Dx), using random effects meta-analyses.

RESULTS

The included studies identified Low (70.3 %), Moderate (17.9 %), High (9.5 %), Increasing (9.5 %) and Decreasing (5.1 %) symptom trajectories. These trajectories were found to predict variation in symptoms and disorders in adulthood: Low, Dx = 4.5 %, 95 % Confidence Interval [CI] 2.7-6.8 %, Sx [Mean] = 8.33, Standard Deviation [SD] = 6.30; Moderate, Dx = 20.9 %, CI 11.9-31.5 % - Sx = 18.13, SD = 3.38; High, Dx = 34.4 % CI 17.2-54.0 % - Sx = 38.80, SD = 7.75; Increasing, Dx = 38.3 %, CI 12.7-67.5 % - Sx = 24.73, SD = 18.64; Decreasing, Dx = 15.4 %, CI 10.5-20.9 % - Sx = 17.00, SD = 12.18.

LIMITATIONS

Confidence intervals are wide for some trajectory effects. There was significant between-cohort heterogeneity in predictive effects for High trajectories, suggesting the need for further research to identify characteristics influencing variation.

CONCLUSION

Low symptom trajectories forecast lower adult depression symptoms and disorders. Programs effectively targeting reductions in Moderate, High, Increasing and Decreasing trajectories will likely prevent problems in early adulthood.