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The British Journal of Psychiatry (2001) 179: 210-217
© 2001 The Royal College of Psychiatrists

DEVELOPMENTAL PSYCHOPATHOLOGY PAPERS, PART 2

The Maudsley long-term follow-up of child and adolescent depression

1. Psychiatric outcomes in adulthood{dagger},{ddagger}

ERIC FOMBONNE, FRCPsych

GAIL WOSTEAR, BSc and VANESSA COOPER, BSc

Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College, London

RICHARD HARRINGTON, FRCPsych

Department of Child and Adolescent Psychiatry, University of Manchester

MICHAEL RUTTER, FRS

Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College, London, UK

Correspondence: Dr Eric Fombonne, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK

Declaration of interest The study was funded by a special grant from the Medical Research Council.

{dagger} See editorial, pp. 189–190, this issue.

{ddagger} See part 2, pp. 218–223, this issue.

ABSTRACT

Background Strong links exist between juvenile and adult depression but comorbid conduct disorder in childhood may mitigate this continuity.

Aims To test the impact of comorbid conduct disorder on psychiatric adult outcomes.

Method A group of 149 subjects assessed at the Maudsley Hospital in the period 1970-1983 and meeting DSM—IV criteria for major depressive disorder with (n=53) or without (n=96) conduct disorder were interviewed 20 years later. Data were collected on the lifetime history of psychiatric disorders.

Results Adult depressive recurrence was high for major depression (62.4%) and any depression (75.2%), and survival analyses showed no difference between the two groups. The group with conduct disorders had higher rates of drug misuse and dependence, alcoholism and antisocial personality disorders.

Conclusions Adolescent depression carries an elevated risk of adult depression irrespective of comorbidity. Comorbid conduct disorder in childhood is associated with raised rates of other psychiatric outcomes.


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