Outcome of Childhood Depression
Does Childhood Depression Come Back?Most children and adolescents with depression experience a recurrence. Twenty to 40 percent of depressed children relapse within two years, and 70 percent will do so by adulthood. The reasons for relapse are not known, but there is some evidence that experiencing a depression leaves behind psychological "scars" that may increase vulnerability throughout early life.
The age of first onset of depression appears to play a role in its course. Children who first become depressed before puberty are at risk of some form of mental disorder in adulthood, while teenagers who first become depressed after puberty are most likely to experience another episode of depression.
These differences in the outcome of childhood depression suggest that different mechanisms may lead to superficially similar but inherently different clinical conditions. Factors that worsen the prognosis for depressed children and adolescents can include:
- Depression occurring in the context of conduct disorder
- Living in conflict-ridden families.
Children -- and particularly adolescents -- who suffer from depression are at much greater risk of committing suicide than children without depression are.
The prognosis for dysthymia is unfavorable, with most people continuing to feel depressed and to have social difficulties even after they have apparently recovered. The prognosis for double depression (major depression plus dysthymia) is worse than that for either condition alone.
Childhood Depression and Bipolar Disorder -- What's the Link?Twenty to 40 percent of adolescents with depression eventually develop bipolar disorder (manic-depression). Some factors that predict later bipolar disorder include:
- Young age at the time of the first depressive episode
- Psychotic features in the initial depression
- A family history of bipolar illness
- Symptoms of hypomania developing during treatment with antidepressants.