Abstract

BackgroundStudies have shown that sexual initiation at earlier ages increases the risk of depressive symptoms in adolescents. However, little is known about its association with major depressive episode (MDE). MethodsThe association between age of sexual initiation and MDE at 18 years was assessed in the 1993 Pelotas Birth Cohort using multiple logistic regression. Sexual initiation characteristics (age and type of partner) were assessed at the 15- and 18-years follow-up. The age of sexual initiation was evaluated in categories (11–14, 15–16, 17+ years). The type of partner was categorized into: boyfriend/ girlfriend, casual partner and other. MDE was assessed using the Mini International Neuropsychiatric Interview (MINI). ResultsFrom the 4027 adolescents assessed, the prevalence of MDE was higher in females (10.1%) than in males (3.4%), and 66.7% of the males and 58.6% of the females reported sexual initiation up to 16 years (p < 0.001). Female adolescents who had sexual initiation <17 years had higher odds of MDE (15–16 years: OR 2.29; 11–14 years: OR 2.23), however no association was found for males. The type of partner in the first sexual intercourse was not associated to depression. LimitationsPossibility of recall bias on the age of sexual initiation, and low statistical power for some analyses. ConclusionsA positive association between age of sexual initiation and MDE was observed only in females. More investigation is needed to understand the mechanisms through which age of sexual initiation can affect the risk of depression and whether the association persists in adulthood.

Highlights

  • Physical, psychological and biological changes that occur during adolescence generally arouse questions, and stimulate concerns and behavioral changes regarding relationships and family (World Health Organization, 2016a)

  • In 1990 and 2000 depressive disorders were a leading cause of global burden of disease (GBD) and the second cause of years lived with disability (YLDs), accounting for 8.2% (5.9% − 10.8%) of global YLDs in 2010 (Ferrari et al, 2013)

  • The 1993 Pelotas Birth Cohort recruited all children born alive in hospitals in the urban area of the city of Pelotas, Southern Brazil, between 1st January and 31st December 1993 (Victora et al, 2008)

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Summary

Introduction

Psychological and biological changes that occur during adolescence generally arouse questions, and stimulate concerns and behavioral changes regarding relationships and family (World Health Organization, 2016a) In this period of life other events, such as experimentations and challenges, as well as fears and instabilities arising from the affective-sexual relationships (among other contextual and family-related situations) can make adolescents more vulnerable to develop mental disorders (Assis et al, 2014). These disorders affect about 10–20% of children and adolescents in the world, and are the leading cause of disability among young people (World Health Organization, 2016c). More investigation is needed to understand the mechanisms through which age of sexual initiation can affect the risk of depression and whether the association persists in adulthood

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