Adolescent depression : Epidemiology, nosology, life stress, and social network

Abstract: The study engaged a total population of 16-17-year-old urban high-school students and 2300 (93%) were screened for depression and previous suicide attempts. Adolescents with high depression scores in self-evaluation (12.3%) or reporting previous suicide attempts (2.4%) were diagnostically interviewed together with one control for each, matched for gender and educational program. After the interview self-ratings were completed regarding social network, family climate, and life events.Major depression was prevalent during the last year in 5.8% and during life time in 11.4%, 4 girls for every boy. A depression lasting for a year or more was the most common type. Short hypomanic episodes had been experienced by 13.2% of those with major depressive disorder. Dysthymia was found in 2%, two girls for every boy.Anxiety disorder was comorbid to depression in one half and conduct disorder in one forth of the depressed adolescents. Alcohol was abused by 6.5% and used regularly by another 12%. Other drugs were used by 6.5% of depressed adolescents and not at all by controls. The depressed used tobacco twice as frequently.Social network and family climate were compared within the originally matched pairs. Adolescents with long-lasting depressions had a smaller and unsatisfying social network. Especially students with comorbid conduct disorder reported insufficient support from the close network and a more negative family climate. These groups also had experienced many stressful life events related to family adversities, while those with shorter depressive episodes had stress related to the peer group.

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