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First-episode major depression in adolescents

Affective, cognitive and endocrine characteristics of risk status and predictors of onset

Developmental Psychiatry Section, Department of Psychiatry, Cambridge Clinical School, University of Cambridge and Lifespan Healthcare Trust

J. HERBERT, PhD

Neuroendocrine Laboratory, Department of Anatomy, University of Cambridge

A. TAMPLIN, PhD

Developmental Psychiatry Section, Department of Psychiatry, Cambridge Clinical School, University of Cambridge and Lifespan Healthcare Trust

P. M. E. ALTHAM, PhD

Statistical Laboratory, University of Cambridge

Declaration of interest Funding from the Wellcome Trust.

Correspondence: Professor I. Goodyer, Developmental Psychiatry Section, Department of Psychiatry, Cambridge Clinical School, Douglas House, 18b Trumpington Road, Cambridge CB2 2AH

Background There is little information on whether patterns of steroids precede and are associated with depressive onset.

Aims To establish whether there is an association between salivary cortisol and or dihydroepiandrosterone (DHEA) levels and depression independent of psychosocial risk.

Method Two subgroups of adolescents in the community at high (n=181) and low (n=65) risk for psychopathology were interviewed for recent psychiatric disorder at entry and again at 12 months. Salivary samples (08.00 and 20.00 h) for hormone estimations and self-reports on current mood and cognitive style were obtained at both assessments.

Results Neither hormone was associated with risk status, current mood or cognitive style at entry. Of 31 onsets of major depression that occurred over the next 12 months, 30 came from the high-risk group but were not associated with any particular pattern of risk. Increased negative mood and feelings and DHEA (08.00 h) hypersecretion at entry were associated with subsequent major depression.

Conclusions Both negative mood and feelings and alterations in adrenal steroid function precede the onset of first-episode major depression in adolescents. Variation in levels of hormones may arise from more distal origins than recent life events and current ongoing difficulties.

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