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Child-, adolescent- and young adult-onset depressions: differential risk factors in development?

  • L. Shanahan (a1), W. E. Copeland (a2), E. J. Costello (a2) and A. Angold (a2)



Previous research reported that childhood adversity predicts juvenile- onset but not adult-onset depression, but studies confounded potentially genuine differences in adversity with differences in the recency with which adversity was experienced. The current study paper took into account the recency of risk when testing for differences among child-, adolescent- and young adult-onset depressions.


Up to nine waves of data were used per subject from two cohorts of the Great Smoky Mountains Study (GSMS; n=1004), covering children in the community aged 9–16, 19 and 21 years. Youth and one of their parents were interviewed using the Child and Adolescent Psychiatric Assessment (CAPA) between ages 9 and 16; these same youth were interviewed using the Young Adult Psychiatric Assessment (YAPA) at ages 19 and 21. The most common psychosocial risk factors for depression were assessed: poverty, life events, parental psychopathology, maltreatment, and family dysfunction.


Consistent with previous research, most childhood psychosocial risk factors were more strongly associated with child-onset than with adolescent-/adult-onset depression. When potentially genuine risk differences among the depression-onset groups were disentangled from differences due to the recency of risk, child- and young adult-onset depression were no longer different from one another. Adolescent-onset depression was associated with few psychosocial risk factors.


There were no differences in putative risk factors between child- and young adult-onset depression when the recency of risk was taken into account. Adolescent-onset depression was associated with few psychosocial risk factors. It is possible that some adolescent-onset depression cases differ in terms of risk from child- and young adult-onset depression.


Corresponding author

*Address for correspondence: L. Shanahan, Ph.D., University of North Carolina at Greensboro, Department of Psychology, PO Box 26170, Greensboro, NC 27402, USA. (Email:


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Achenbach, TM, Edelbrock, C (1983). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Queen City Printers: Burlington, VT.
Angold, A, Costello, EJ (1995). A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C). Psychological Medicine 25, 755762.
Angold, A, Costello, EJ (2000). The Child and Adolescent Psychiatric Assessment (CAPA). Journal of the American Academy of Child and Adolescent Psychiatry 39, 3948.
Angold, A, Cox, A, Prendergast, M, Rutter, M, Simonoff, E, Costello, EJ, Asher, BH (1999). The Young Adult Psychiatric Assessment (YAPA). Duke University Medical Center: Durham, NC.
Angold, A, Erkanli, A, Silberg, J, Eaves, L, Costello, EJ (2002). Depression scale scores in 8–17-year-olds: effects of age and gender. Journal of Child Psychology and Psychiatry 43, 10521063.
Angold, A, Worthman, C, Costello, EJ (2003). Puberty and depression. In Gender Differences at Puberty (ed. Hayward, C.), pp. 137164. Cambridge University Press: New York, NY.
Birmaher, B, Ryan, ND, Williamson, DE, Brent, DA (1996). Childhood and adolescent depression: a review of the past 10 years, Part I. Journal of the American Academy of Child and Adolescent Psychiatry 35, 14271439.
Brown, GW, Harris, TO (1978). The Social Origins of Depression: A Study of Psychiatric Disorder in Women. Free Press: New York, NY.
Canli, T, Lesch, KP (2007). Long story short: the serotonin transporter in emotion regulation and social cognition. Nature Neuroscience 10, 11031109.
Christie, KA, Burke, JD, Regier, DA, Rae, DS (1988). Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults. American Journal of Psychiatry 145, 971975.
Cicchetti, D, Toth, SL (1998). The development of depression in children and adolescents. American Psychologist 53, 221241.
Copeland, WE, Shanahan, L, Costello, EJ, Angold, A (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry 66, 764772.
Copeland, WE, Shanahan, L, Miller, S, Costello, EJ, Angold, A, Maughan, B (2010). Outcomes of early pubertal timing in young women: a prospective population-based study. American Journal of Psychiatry 167, 12181225.
Costello, EJ, Angold, A, Burns, BJ, Stangl, DK, Tweed, DL, Erkanli, A, Worthman, CM (1996). The Great Smoky Mountains Study of youth: goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry 53, 11291136.
Costello, EJ, Angold, A, March, J, Fairbank, J (1998). Life events and post-traumatic stress: the development of a new measure for children and adolescents. Psychological Medicine 28, 12751288.
Costello, EJ, Mustillo, S, Erkanli, A, Keeler, G, Angold, A (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry 60, 837844.
Costello, EJ, Worthman, C, Erkanli, A, Angold, A (2007). Prediction from low birth weight to female adolescent depression: a test of competing hypotheses. Archives of General Psychiatry 64, 343350.
Danese, A, Moffitt, TE, Harrington, H, Milne, BJ, Polanczyk, G, Pariante, CM, Poulton, R, Caspi, A (2009). Adverse childhood experiences and adult risk factors for age-related disease. Archives of Pediatric and Adolescent Medicine 163, 11351143.
Ge, X, Conger, RD, Elder, Jr. GH (2001). Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Developmental Psychology 37, 404417.
Giaconia, RM, Reinherz, HZ, Silverman, AB, Pakiz, B (1994). Ages of onset of psychiatric disorders in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 33, 706717.
Gilman, SE, Kawachi, I, Fitzmaurice, GM, Buka, SL (2003). Socio-economic status, family disruption and residential stability in childhood: relation to onset, recurrence and remission of major depression. Psychological Medicine 33, 13411355.
Goodyer, IM (2001). Life events: their nature and effects. In The Depressed Child and Adolescent, 2nd edn (ed. Goodyer, I. M.), pp. 204232. Cambridge University Press: New York, NY.
Harrington, R (2006). Affective disorders. In A Clinician's Handbook of Child and Adolescent Psychiatry (ed. Gillberg, C., Harrington, R. and Steinhausen, H.), pp. 110143. Cambridge University Press: New York, NY.
Hill, J, Pickles, A, Rollinson, L, Davies, R, Byatt, M (2004). Juvenile- versus adult-onset depression: multiple differences imply different pathways. Psychological Medicine 34, 14831493.
Jaffee, SR, Moffitt, TE, Caspi, A, Fombonne, E, Poulton, R, Martin, J (2002). Differences in early childhood risk factors for juvenile-onset and adult-onset depression. Archives of General Psychiatry 59, 215222.
Kasch, KL, Klein, DN (1996). The relationship between age at onset and comorbidity in psychiatric disorders. Journal of Nervous and Mental Disease 184, 703707.
Kaufman, J, Martin, A, King, RA, Charney, D (2001). Are child-, adolescent-, and adult-onset depression one and the same disorder? Biological Psychiatry 49, 980–1001.
Kessler, RC, Davis, CG, Kendler, KS (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine 27, 11011119.
Kovacs, M, Feinberg, TL, Crouse-Novac, M, Paulauskas, SL, Pollok, M, Finkelstein, R (1984). Depressive disorders in childhood. II. A longitudinal study of the risk for a subsequent major depression. Archives of General Psychiatry 41, 643649.
Kraemer, HC, Stice, E, Kazdin, A, Offord, D, Kupfer, D (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry 158, 848856.
Miller, GE, Chen, E, Fok, AK, Walker, H, Lim, A, Nicholls, EF, Cole, S, Kobor, MS (2009). Low early-life social class leaves a biological residue manifested by decreased glucocorticoid and increased proinflammatory signaling. Proceedings of the National Academy of Sciences USA 106, 1471614721.
Moffitt, TE (2006). Life-course-persistent versus adolescence-limited antisocial behavior. In Developmental Psychopathology, vol. 3: Risk, Disorder, and Adaptation, 2nd edn (ed. Cicchetti, D. and Cohen, D. J.), pp. 570598. John Wiley & Sons Inc.: Hoboken, NJ.
Moffitt, TE, Arseneault, L, Jaffee, SR, Kim-Cohen, J, Koenen, KC, Odgers, CL, Slutske, WS, Viding, E (2008). Research review: DSM-V conduct disorder: research needs for an evidence base. Journal of Child Psychology and Psychiatry 49, 333.
Power, C, Manor, O, Matthews, S (1999). The duration and timing of exposure: effects of socioeconomic environment on adult health. American Journal of Public Health 89, 10591065.
Rao, U, Ryan, ND, Birmaher, B, Dahl, RE (1995). Unipolar depression in adolescents: clinical outcome in adulthood. Journal of the American Academy of Child and Adolescent Psychiatry 34, 566578.
SAS Institute (2004). SAS/STAT®Software Version 9. SAS Institute Inc.: Cary, NC.
Schaie, KW (1965). A general model for the study of developmental problems. Psychological Bulletin 64, 92–107.
Susman, EJ (1997). Modeling developmental complexity in adolescence: hormones and behavior in context. Journal of Research on Adolescence 7, 283306.
Weissman, MM, Wolk, S, Wickramaratne, P, Goldstein, RB, Adams, P, Greenwald, S, Ryan, ND, Dahl, RE, Steinberg, D (1999). Children with prepubertal-onset major depressive disorder and anxiety grown up. Archives of General Psychiatry 56, 794801.
Zalsman, G, Brent, DA, Weersing, VR (2006). Depressive disorders in childhood and adolescence: an overview: epidemiology, clinical manifestation and risk factors. Child and Adolescent Psychiatric Clinics of North America 15, 827841.


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Child-, adolescent- and young adult-onset depressions: differential risk factors in development?

  • L. Shanahan (a1), W. E. Copeland (a2), E. J. Costello (a2) and A. Angold (a2)


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