The mean episode duration of adolescent major depression is 4 – 9 months among clinically referred youths, recovery rates vary between 35% - 90%, and recurrent episodes are common. In naturalistic studies comprising less selected populations than clinical trials, comorbid psychiatric disorders, poor psychosocial functioning and severity of depression at study entry are among the most consistently reported clinical predictors of less favorable prognosis of youthful depression.

The study aimed at studying the one-year course and at investigating the impact of characteristics of the depressive episode and comorbidity on the one-year outcome of adolescent depression.

A sample of 179 consecutive adolescent (13-19 years) psychiatric outpatients and 17 school-derived matched controls, all with unipolar depressive disorders at baseline, were reinterviewed for DSM-IV Axis I and II disorders at 12 months.

The outpatients had equal recovery rate and episode duration, but shorter time to recurrence than the controls. Fifty percent of the outpatients and 65 % of the depressed controls recovered during the follow-up, 13% of the outpatients and 29% of controls had at least one recurrent depressive episode. Among the outpatients, Axis II comorbidity predicted shorter time to recurrence. Longer time to recovery was predicted by earlier lifetime age of onset for depression, poor psychosocial functioning, depressive disorder diagnosis, and longer episode duration by study entry, with an interaction between episode duration and depressive disorder diagnosis.

Characteristics of depression generally predicted the outcome better than comorbidity. Axis II comorbidity has prognostic value in adolescent depression.

In November 2007, a student shot eight people and himself at Jokela High School, Finland. This study aims to evaluate the long-term effects of exposure to a school shooting among adolescents.

Associations between psychological outcomes and background factors were analysed and compared with “comparison students” four months after the incident. A questionnaire including Impact of Event Scale (IES) and General Health Questionnaire (GHQ-36) was used.

Half of the females and a third of the males suffered from posttraumatic distress. High level of posttraumatic distress (IES ≥ 35), predicting PTSD, was observed in 27% of the females and 7% of the males. The odds ratio was 6.4 (95% confidence interval 3.5–10.5) for having high levels of posttraumatic distress. Severe or extreme exposure and female gender were found to increase the risk. Forty-two percent of the females and 16% of the males had psychiatric disturbance (GHQ ≥ 9). Severe or extreme exposure, older age and female gender increased the risk. Perceived support from family and friends was found to be protective.

The observed risk and protective factors were similar to earlier studies. Follow-up will be essential in identifying factors predicting persisting trauma-related symptoms in adolescence.