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One-Year Course and Predictors of Outcome of Adolescent Depression: A Case-Control Study in Finland

J Clin Psychiatry 2008;69(5):844-853

Background: Clinical studies on the outcome of adolescent depression beyond treatment trials are scarce.

Objective: To investigate the impact of characteristics of the depressive episode and current comorbidity on the 1-year outcome of depression.

Method: A sample of 174 consecutive adolescent psychiatric outpatients (aged 13 through 19 years) and 17 school-derived matched controls, all with unipolar depressive disorders at baseline, were reinterviewed for DSM-IV Axis I and Axis II disorders at 12 months. The study was conducted between January 1998 and May 2002.

Results: The outpatients had equal recovery rate and episode duration but shorter time to recurrence than the controls. Among the outpatients, Axis II comorbidity predicted shorter time to recurrence (p = .02). Longer time to recovery was predicted by earlier lifetime age at onset for depression (p = .02), poor psychosocial functioning (p = .003), depressive disorder diagnosis (p <= .05), and longer episode duration by study entry (p = .001), with an interaction between episode duration and depressive disorder diagnosis (p = .04).

Conclusions: Characteristics of depression generally predicted the outcome better than comorbidity. Axis II comorbidity has prognostic value in adolescent depression.