Psychosocial risks for major depression in late adolescence: a longitudinal community study.

OBJECTIVE

An ongoing 14-year longitudinal study examined psychosocial antecedents of major depression in late adolescence in a community population.

METHOD

Subjects were 385 adolescents followed between the ages of 5 and 18 years. Early health, familial, behavior, academic, and environmental risks for major depression were identified using data collected at ages 5, 9, 15, and 18 years. At age 18, a lifetime diagnosis of major depression was assessed using the NIMH Diagnostic Interview Schedule (DIS-III-R).

RESULTS

For males, neonatal health problems, dependence problems at age 5 years, perceived unpopularity and poorer perceptions of their role in the family at age 9 years, remarriage of a parent, early family discord, and anxiety at age 15 years significantly increased the risk of developing major depression. Females with major depression, compared with nondepressed females, had older parents and came from larger families, and at age 9 years had greater perceived unpopularity and anxiety, lower self-esteem, and poorer perceptions of their role in the family. Depressed females also reported more stressful life events, including death of parent and pregnancy.

CONCLUSIONS

Underscoring the importance of early psychosocial factors in the later development of major depression and pointing to specific risks, our findings can aid in developing strategies for prevention and early intervention.