Adolescent depression and stressful life events: A case-control study within diagnostic subgroups

Abstract

Life events in depressed adolescents were studied in a case-control design. A total population of 16- to 17-year-old students in the 1st year of high school were screened for depression (n=2300). Every student with indication of depression and one control matched for sex, age, and grade in school was interviewed diagnostically (DICA-R-A). All participating matched pairs in whom the control had no lifetime depressive disorder were used for analysis of life events (177 pairs). They were divided into six subgroups on the basis of depressive and conduct disorders. Depressed and control adolescents were compared with regard to 21 events and conditions of stressful character. Events for total life were studied. Adolescents with depressive disorder had experienced more stressful events and conditions in life than healthy controls. The most characteristic events concerned the important relations to family and friends. The subgroup with comorbid conduct disorder was the most burdened and had much more illness, conflicts, and changes in the family than their controls. Those with oppositional defiant disorder had problems in relation to both parents and peers. Adolescents with major depression during the past year also had met more stress than controls but, most typically, had experienced changes in acceptance by peers. If they had a long-lasting depression, they reported more conflicts in the family as well. Those with dysthymia reported fewer life events than those with major depression. The group with subsyndromal depressive symptoms had fewer events than all groups with depressive diagnosis and did not differ from their controls.