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The British Journal of Psychiatry (2002) 180: 19-23
© 2002 The Royal College of Psychiatrists

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

3. Impact of comorbid conduct disorder on service use and costs in adulthood

MARTIN KNAPP, PhD

PAUL McCRONE, PhD

Centre for the Economics of Mental Health, Institute of Psychiatry, King's College, London, UK

ERIC FOMBONNE, FRCPsych

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

JENNIFER BEECHAM, PhD

Centre for the Economics of Mental Health, Institute of Psychiatry, King's College, London, UK

GAIL WOSTEAR, BSc

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

Correspondence: Professor Martin Knapp, Centre for Economics of Mental Health, Institute of Psychiatry, 7 Windsor Walk, Denmark Hill, London SE5 8AF, UK

Declaration of interest This study was funded by a special grant from the Medical Research Council and a grant from the Department of Health.

Background Depression in childhood or adolescence often has morbidity implications continuing into adulthood, generating needs for specialist services and support.

Aims To estimate the patterns of service use and costs in adulthood of former patients.

Method Service use and other cost-related data were collected from former patients. Comparisons were made between those people with and without comorbid conduct disorder in childhood and with data for the general population.

Results Data on 91 people with depression (only) and 49 with comorbid conduct disorder revealed high adulthood service utilisation rates and costs. Inpatient care and criminal justice services were used more frequently by the comorbid group and total costs were significantly higher. There were also indications of higher service use by the comorbid group than the general adult population.

Conclusions The high and enduring long-term costs associated with childhood depression and conduct disorder give further reason for early and effective intervention.




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