46,110,123 These rates are comparable to the rates of recurrence in adult samples.124-126 In addition to recurrent episodes during childhood and adolescence, longitudinal studies of depressed youngsters documented recurrent episodes in adult life.46,112,127 There also appears to be some specificity in the continuation of psychopathology Inhibitors,research,lifescience,medical in adult life, particularly with respect to adolescent-onset depression. Several studies of depressed adolescents documented increased risk for recurrent selleck chemical Navitoclax depressive episodes, but not other psychiatric disorders, when compared with their counterparts without depression.127-130 In contrast, there is some evidence that

childhood-onset selleck chem depression is not necessarily predictive of depression in adulthood, except for a subsample with symptoms characteristic of the adult disorder.128,130,131 Among children, adolescents, and adults, few baseline demographic or clinical characteristics Inhibitors,research,lifescience,medical predict who will or will not experience a recurrent depressive episode.

Some potential predictors of recurrence in adults include early onset, number of prior episodes, stressful experiences, cognitive vulnerability, negative family interaction patterns, comorbid personality disorders, and persistent biological dysrcgulation Inhibitors,research,lifescience,medical during recover}’.59,132 Among youth, co-occurring personality problems, specifically borderline personality disorder symptoms, were associated with recurrence.125,133 There is disagreement regarding whether girls are at increased risk for recurrent depressive episodes than boys.69,111,112,133 although no gender differences were found in recurrence rates among adults.134 Other Inhibitors,research,lifescience,medical psychiatric outcomes Although recurrent unipolar depression is the primary outcome for depressed youth, development of other psychiatric Inhibitors,research,lifescience,medical disorders has also been documented. Longitudinal studies reported that 20% to 40% of children and adolescents with major depressive disorder developed bipolar disorder within a period of 5 years.48,129,135,136

Brefeldin_A The clinical characteristics associated with increased risk for bipolar disorder in youngsters and adults with depression include early-onset illness, mood lability, depressive episode accompanied by psychomotor retardation or psychotic features, atypical depression, protracted depressive episodes, family history of bipolar disorder or heavy familial loading for mood disorders, and pharmacologically induced hypomania.94,136-139 Depressed youngsters are also at risk for developing substance use disorders in adolescence and adulthood.62,88,101,140-142 Protracted depressive episodes, comorbid anxiety or conduct disorder, and hypothalamic-pituitary-adrenal (HPA) dysregulation may be associated with increased risk for substance abuse in depressed youth.