The Maudsley long-term follow-up of child and adolescent depression 3. Impact of comorbid conduct disorder on service use and costs in adulthood

Background Depression in childhood or adolescence often has morbidity implications continuing into adulthood, generating needs for specialist services and support. Aims To estimate the patterns of service use and costs in adulthood of former patients. Method Service use and other cost-related data were collected from former patients, Comparisons were made between those people with and without comorbid conduct disorder in childhood and with data for the general population. Results Data on 91 people with depression (only) and 49 with comorbid conduct disorder revealed high adulthood service utilisation rates and costs. Inpatient-care and criminal justice services were used more frequently by the comorbid group and total costs were significantly higher. There were also indications of higher service use by the comorbid group than the general adult population. Conclusions The high and enduring long-term costs associated with childhood depression and conduct disorder give further reason for early and effective intervention. Declaration of interest This study was funded by a special grant from the Medical Research Council and a grant from the Department of Health.