Depressive symptoms in adolescence and adult educational and employment outcomes: a structured life course analysis.

BACKGROUND: Depression is a common mental health disorder that often starts during adolescence, with potentially important future consequences including 'Not in Education, Employment or Training' (NEET) status. METHODS: We took a structured life course modeling approach to examine how depressive symptoms during adolescence might be associated with later NEET status, using a high-quality longitudinal data resource. We considered four plausible life course models: (1) an early adolescent sensitive period model where depressive symptoms in early adolescence are more associated with later NEET status relative to exposure at other stages; (2) a mid adolescent sensitive period model where depressive symptoms during the transition from compulsory education to adult life might be more deleterious regarding NEET status; (3) a late adolescent sensitive period model, meaning that depressive symptoms around the time when most adults have completed their education and started their careers are the most strongly associated with NEET status; and (4) an accumulation of risk model which highlights the importance of chronicity of symptoms. RESULTS: Our analysis sample included participants with full information on NEET status (N = 3951), and the results supported the accumulation of risk model, showing that the odds of NEET increase by 1.015 (95% CI 1.012-1.019) for an increase of 1 unit in depression at any age between 11 and 24 years. CONCLUSIONS: Given the adverse implications of NEET status, our results emphasize the importance of supporting mental health during adolescence and early adulthood, as well as considering specific needs of young people with re-occurring depressed mood.

Depressive symptoms and academic achievement in UK adolescents: a cross-lagged analysis with genetic covariates.

BACKGROUND: The relationship between adolescent depressive symptoms and academic achievement remains poorly understood. The aim of this study was to help clarify the nature and directionality of this association. METHODS: We used a sample of 13,599 British adolescents (main sample of N=3,809 participants). We fitted cross-lagged panel models using four repeated measures of self-reported depressive symptoms and four measures of academic achievement based on British national records between 11-18 years, separately for male and female adolescents and considering polygenic risk scores (PRS) for educational attainment and depression, alongside other child and parental covariates. RESULTS: We found evidence of an overall negative association that was stronger in boys (R=-0.21, 95% CI -0.31 to -0.11) than in girls (-0.13, -0.31 to 0.05). Higher depressive symptoms were associated with lower academic achievement at a later stage up to the end of compulsory education (16 years), when the direction of the association reversed, although girls with lower achievement also appeared vulnerable to depressive symptoms at previous stages. The genetic variables derived for this study showed stronger associations for academic achievement, but the PRS for depression also showed a negative association with academic achievement in girls. Child intelligence quotient and peer victimization also showed relevant associations. LIMITATIONS: Observational design, variation around measurement times, missing data. CONCLUSIONS: Depressive symptoms and academic achievement should be considered jointly when designing school-based programmes for children and adolescents, alongside gender, child ability and school experience. Including genetic information in research can help to disentangle average from time-varying effects.

Trajectories of depressive symptoms and adult educational and employment outcomes.

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.