Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study

Ssegonja, Richard; Alaie, Iman; Philipson, Anna; Hagberg, Lars; Sampaio, Filipa; Möller, Margareta; Knorring, Lars von; Sarkadi, Anna; Langenskiöld, Sophie; Knorring, Anne-Liis von; Bohman, Hannes; Jönsson, Ulf; Feldman, Inna

doi:10.1016/j.jad.2019.07.077

Cited by 24 publications

(21 citation statements)

References 53 publications

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“…9 Additionally, adolescents with MHP tend to be more susceptible to debilitating psychiatric illness in later life. 10 Given the high prevalence of insomnia, depressive and anxiety symptoms among adolescents during such a stressful life-threatening event (the COVID-19 pandemic), it is essential to assess the prevalence of insomnia, depressive and anxiety symptoms and understand the key modifiable risk/protective factors so that health professionals can timely design effective interventions for the populations at risk of developing these symptoms.…”

Section: Introductionmentioning

confidence: 99%

<p>Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic</p>

Lu¹,

Chi²,

Liang³

et al. 2020

PRBM

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Purpose This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19. Methods A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms. Results COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent. Conclusion COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety.

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Section: Introductionmentioning

confidence: 99%

<p>Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic</p>

Lu¹,

Chi²,

Liang³

et al. 2020

PRBM

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“…Depression in adolescence is linked to recurring episodes and other mental health conditions in adulthood (Johnson et al ., 2018), with a particularly poor prognosis reported for persistent depressive disorder (PDD) (Jonsson et al ., 2011). Adolescent depression is also associated with subsequent role impairment across several life domains (Clayborne et al ., 2019), and the few available cost-of-illness studies suggest substantial direct and indirect societal costs (Bodden et al ., 2018; König et al ., 2019; Ssegonja et al ., 2019).…”

Section: Introductionmentioning

confidence: 99%

Adolescent depression and subsequent earnings across early to middle adulthood: a 25-year longitudinal cohort study

Philipson

Alaie

Ssegonja

et al. 2020

Epidemiol Psychiatr Sci

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Aims The few available studies on early-onset depression and future earnings offer ambiguous findings, and potential sources of heterogeneity are poorly understood. We examined the differences in adult earnings of males and females with and without a history of depressive disorder in adolescence, with specific focuses on (1) future earnings in clinical subtypes of adolescent depression; (2) the growth and distribution of earnings over time within these subgroups and (3) the mediating role of subsequent depressive episodes occurring in early adulthood. Methods Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort study initiated in Uppsala, Sweden, in the early 1990s. Comprehensive diagnostic assessments were conducted at age 16–17 and in follow-up interviews 15 years later, while consecutive data on earnings for the years 1996 to 2016 (ages 20–40) were drawn from population-based registries. The current study included participants with a history of persistent depressive disorder (PDD) (n = 175), episodic major depressive disorder (MDD) (n = 82), subthreshold depression (n = 64) or no depression (n = 218) in adolescence. The association of adolescent depression with earnings in adulthood was analysed using generalised estimating equations. Estimates were adjusted for major child and adolescent psychiatric comorbidities and parental socioeconomic status. The indirect (mediated) effect of depression in early adulthood (ages 19–30) on earnings in mid-adulthood (31–40) was estimated in mediation analysis. The study followed the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines. Results Earnings across early to middle adulthood were lower for participants with a history of a PDD in adolescence than for their non-depressed peers, with an adjusted ratio of mean earnings of 0.85 (0.77–0.95) for females and 0.76 (0.60–0.95) for males. The differences were consistent over time, and more pronounced in the lower percentiles of the earnings distributions. The association was partially mediated by recurrent depression in early adulthood (48% in total; 61% for females, 29% for males). No reduction in earnings was observed among participants with episodic MDD in adolescence, while results for subthreshold depression were inconclusive. Conclusions Our findings suggest that future earnings of adolescents with depressive disorders are contingent on the duration and natural long-term course of early-onset depression, emphasising the need for timely and effective interventions to avoid loss of human capital.

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“…Longitudinal associations between adolescent depression subcategories and adult labor market outcome across ages[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] …”

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confidence: 99%

Adolescent depression and adult labor market marginalization: a longitudinal cohort study

Alaie

Philipson

Ssegonja

et al. 2021

Eur Child Adolesc Psychiatry

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Adolescent depression is linked to adult ill-health and functional impairment, but recent research suggests that individual/contextual factors might account for this association. This study aimed to test whether the clinical heterogeneity of adolescent depression is related to marginalization from the labor market across early to middle adulthood. Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort initially assessed with structured clinical interviews at age 16–17. The cohort (n = 321 depressed; n = 218 nondepressed) was followed up after 2+ decades through linkage to nationwide population-based registries. Outcomes included consecutive annual data on unemployment, work disability, social welfare recipiency, and a composite marginalization measure, spanning from age 21 to 40. Longitudinal associations were examined using logistic regression analysis in a generalized estimating equations modeling framework. Subsequent depressive episodes and educational attainment in early adulthood were explored as potential pathways. The results showed that adolescent depression was associated with adult marginalization outcomes, but the strength of association varied across depressed subgroups. Adolescents with persistent depressive disorder had higher odds of all outcomes, including the composite marginalization measure (adjusted OR = 2.0, 95% CI = 1.4–2.7, p < 0.001), and this was partially (31%) mediated by subsequent depressive episodes in early adulthood. Exploratory moderation analysis revealed that entry into tertiary education mitigated the association with later marginalization, but only for adolescents with episodic major depression. In conclusion, the risk for future labor market marginalization is elevated among depressed adolescents, particularly those presenting with persistent depressive disorder. Targeted interventions seem crucial to mitigate the long-lasting impact of early-onset depression.

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Depressive disorders in adolescence, recurrence in early adulthood, and healthcare usage in mid-adulthood: A longitudinal cost-of-illness study

Cited by 24 publications

References 53 publications

<p>Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic</p>

<p>Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic</p>

Adolescent depression and subsequent earnings across early to middle adulthood: a 25-year longitudinal cohort study

Adolescent depression and adult labor market marginalization: a longitudinal cohort study

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