The Maudsley long-term follow-up of child and adolescent depression: I. Psychiatric outcomes in adulthood

Background: Strong links exist between juvenile and adult depression but comorbid conduct disorder in childhood may mitigate this continuity. Aims: To test the impact of comorbid conduct disorder on psychiatric adult outcomes. Method: A group of 149 subjects assessed at the Maudsley Hospital in the period 1970-1983 and meeting DSM-IV criteria for major depressive disorder with (n=53) or without (n=96) conduct disorder were interviewed 20 years later. Data were collected on the lifetime history of psychiatric disorders. Results: Adult depressive recurrence was high for major depression (62.4%) and any depression (75.2%), and survival analyses showed no difference between the two groups. The group with conduct disorders had higher rates of drug misuse and dependence, alcoholism and antisocial personality disorders. Conclusions: Adolescent depression carries an elevated risk of adult depression irrespective of comorbidity. Comorbid conduct disorder in childhood is associated with raised rates of other psychiatric outcomes.