Course and outcome of major depressive disorder in non-referred adolescents

BACKGROUND: Although major depressive disorder (MDD) is one of the most common disorders in adolescence, little is known about its course and outcome in non-referred adolescents. Therefore, the aims of this article were to examine the course and outcome of MDD in non-referred adolescents, and to examine factors related to its stability. METHODS: Five hundred and twenty-three adolescents were interviewed twice at an interval of about 15 months using the computerized Munich version of the Composite International Diagnostic Interview. RESULTS: Of the 90 adolescents who met the diagnosis of MDD at T1, 22 (24.4%) still met the same diagnosis at T2. Sixty-eight (75.6%) of them no longer met the diagnosis of MDD at T2, and in some of these cases, their depression was replaced by several other disorders; 44 adolescents received no diagnostic criteria for any DSM-IV disorders. The factors that were significantly associated with the stability of MDD included the presence of substance use disorders and parental alcohol problems, negative life events and negative coping, past suicidal attempt, suicidal thought, and concrete suicidal plan at the T1-interview. Adolescents with "chronic" (T1 and T2) compared to "transient" (only T1) MDD and those without any disorders were significantly more impaired in various life domains. LIMITATIONS: This study was based on a small number of adolescents with a chronic MDD. CONCLUSIONS: The course and outcome of MDD in majority of the adolescents seemed to have a favourable course, whereas in some adolescents, it tended to have a heterogeneous pattern.