Trajectories of depressive symptoms and adult educational and employment outcomes

BJPsych Open. 2019 Dec 12;6(1):e6. doi: 10.1192/bjo.2019.90.

Abstract

Background: Depressive symptoms show different trajectories throughout childhood and adolescence that may have different consequences for adult outcomes.

Aims: To examine trajectories of childhood depressive symptoms and their association with education and employment outcomes in early adulthood.

Method: We estimated latent trajectory classes from participants with repeated measures of self-reported depressive symptoms between 11 and 24 years of age and examined their association with two distal outcomes: university degree and those not in employment, education or training at age 24.

Results: Our main analyses (n = 9399) yielded five heterogenous trajectories of depressive symptoms. The largest group found (70.5% of participants) had a stable trajectory of low depressive symptoms (stable-low). The other four groups had symptom profiles that reached full-threshold levels at different developmental stages and for different durations. We identified the following groups: childhood-limited (5.1% of participants) with full-threshold symptoms at ages 11-13; childhood-persistent (3.5%) with full-threshold symptoms at ages 13-24; adolescent onset (9.4%) with full-threshold symptoms at ages 17-19; and early-adult onset (11.6%) with full-threshold symptoms at ages 22-24. Relative to the majority 'stable-low' group, the other four groups all exhibited higher risks of one or both adult outcomes.

Conclusions: Accurate identification of depressive symptom trajectories requires data spanning the period from early adolescence to early adulthood. Consideration of changes in, as well as levels of, depressive symptoms could improve the targeting of preventative interventions in early-to-mid adolescence.

Keywords: Depressive disorders; education and training; epidemiology; statistical methodology.