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The onset of a mental disorder commonly occurs during the teenage years. While many mental health conditions can appear at any age, there are certain factors present that can provide a setting for symptoms to develop. The significant physical changes and brain development that occur during adolescence may serve as a catalyst for certain symptoms.

Depression, a serious mental disorder, is common among teenagers. There has been extensive research to examine various aspects of teenage depression, such as how family environment affects symptoms and the presence of other risk factors, such as substance use or anxiety.

The age at which symptoms appear for depression is important for predicting several effects of the disorder. For instance, the age of onset occurring as a teen rather than as an adult acts as a predictor of additional depressive episodes, the severity of the episodes, and more symptoms reported.

In addition, quality of life is affected more severely when the individual reports symptoms beginning during the teen years, such as lower levels of professional or academic achievement, social challenges and increased levels of suicidal ideation.

There are additional factors that can compound the negative outcomes associated with an age of onset during adolescence, such as experiencing neglect or abuse during the those years, having a family history of mood disorders or other mental health challenges. Gender also plays a role, with females experiencing more negative outcomes.

While all of these aspects of depression appearing during the teen years have been examined in research, there has been little analysis of the impact of the age of onset on the effectiveness of antidepressant treatments. Led by S.C. Sung of the Office of Clinical Sciences, researchers at the Duke-NUS Graduate Medical School in Singapore looked at how the age of onset affected antidepressant treatments.

The researchers examined how an early onset, occurring before the age of 18 in patients diagnosed with major depressive disorder, would affect the success of treatment involving antidepressants. The researchers compared the effectiveness with that of patients who were diagnosed in adulthood.

The team evaluated the treatment of 665 patients enrolled in outpatient care for major depressive disorder. The patients’ progress was measured at 12 and 28 weeks while being treated with either a combination of antidepressant and placebo, or a combination of two antidepressant medications.

The analysis showed significant differences in several areas noted between those who were diagnosed as teenagers and those who were diagnosed as adults. Differences were noted in comorbidity, quality of life, physical health and history of abuse. However, there were not measurable differences when it came to the effectiveness of antidepressants when comparing early-onset depression patients and those diagnosed as adults.

The treatment retention rates were similar among those diagnosed as teens and those diagnosed as adults. There were differences, however, in the early onset patients when it came to more prevalent depression, as well as a more chronic experience of depression. There was also more abuse and neglect during childhood reported by those with early onset depression and a higher level of current suicidal ideation.

The findings, while they did not prove to show an association between antidepressant effectiveness and the age of onset, did prove the importance of early intervention in children and teens. The longer duration of depression and the increased risk of suicide indicate that identification of youth suffering from depression is an important issue.

In clinical settings, the findings are helpful in highlighting the need to closely monitor teens being treated for depression to determine whether suicidal ideation is present. Teens can receive educational assistance to help them recognize and understand the risk associated with the diagnosis of depression at a young age.

Teens who are diagnosed with depression should receive focused treatment to try to minimize the increased risks that can affect not only mental and physical health, but also their quality of life.

The study’s findings are published in a recent issue of the journal Psychological Medicine.

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