The Maudsley long-term follow-up of child and adolescent depression 1. 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. Declaration of interest The study was funded by a special grant from the Medical Research Council.