MAJOR DEPRESSION IN COMMUNITY ADOLESCENTS - AGE AT ONSET, EPISODE DURATION, AND TIME TO RECURRENCE

Objective: This paper presents retrospective and prospective data rega rding time course parameters of major depressive disorder (MDD) in com munity adolescents (14 to 18 years old): time to onset and recovery an d, among those who recovered, time to recurrence. Method: Diagnostic i nterviews were conducted with 1,508 randomly selected high school stud ents. Three hundred sixty-two had experienced at least one past or cur rent episode of MDD. Results: Mean age at onset of first episode was 1 4.9 (SD = 2.8). Early MDD onset was associated with female gender and suicidal ideation. MDD episode duration ranged from 2 to 520 weeks, wi th a mean of 26.4 weeks (SE = 3.3) and a median of 8.0 weeks. Longer e pisodes were observed in those whose depression occurred early (at or before age 15), whose depression had been accompanied by suicidal idea tion, and for whom treatment was sought. Of the adolescents who recove red, 5% relapsed within 6 months, 12% within 1 year, and approximately 33% within 4 years. Shorter time to recurrence was associated with pr ior suicidal ideation and attempt and with later first onset. Conclusi ons: Risk of MDD is low in childhood, increasing substantially with ad olescence. The majority of episodes in community adolescents are relat ively brief, although the risk of recurrence is substantial. Suicidal behaviors are important mediators of episode duration and of recurrenc e.