Abstract
Experiencing conflictual relations with one’s parents while growing up has been linked to onset, recurrence, and worse treatment outcome of adolescent depression. While this suggests that significant problems in the parent–youth relationship make depressive disorders more relentless, it is not clear whether this effect lasts into adulthood. Our aim was to examine if major and minor conflict with parents while growing up predicts depression in adulthood in youth with and without a history of depression. We utilized data from the Uppsala Longitudinal Adolescent Depression Study. This community-based cohort was assessed with structured diagnostic interviews both at age 16–17 and at follow-up 15 years later. The analyses included 382 individuals (227 with a history of child or adolescent depression; 155 peers without such a history). Binary logistic regression was used, adjusting for sex, disruptive behavior disorders, and additional family-related adversities. Among individuals with adolescent depression, major conflict with parents was strongly associated with adult depression (adjusted OR 2.28, 95% CI 1.07–4.87). While major conflict with parents was rare among non-depressed controls, a non-significant association of similar magnitude was still observed. Minor conflict, on the other hand, was not significantly associated with adult depression. Overall, conflict with parents did not predict adult anxiety disorders, substance use, suicidal behavior, somatoform disorders, or psychotic disorders. In conclusion, major parent–youth conflict during upbringing seems to be linked with an increased risk of depression in adulthood. These findings underscore the need to consider contextual/familial factors in the prevention and clinical management of early-life depression.
Highlights
Depression is common worldwide and has been recognized as the leading cause of disability among youths aged 10–24 years [1]
The results revealed that participants who had reported major conflict with parents both in the past year and earlier in life (n = 14) were more likely to have depression in adulthood than those who reported having had no major conflict with parents
While adolescent depression has been linked to recurrence later in life, this study demonstrated that depressed adolescents who reported major conflict with parents clearly were at an increased risk of depression recurrence in adulthood
Summary
Depression is common worldwide and has been recognized as the leading cause of disability among youths aged 10–24 years [1]. Early-onset depression has been found to predict poor mental health outcome [2] and impaired psychosocial functioning [3] in adulthood, further underscoring the need for effective treatment and prevention. Despite the high burden of early-onset depression and recent advances in public awareness of mental disorders among youths, research indicates that the vast majority of those affected do not receive appropriate mental health care [4]. A substantial proportion of depressed adolescents do not respond to available evidence-based pharmacological and psychological treatments [5], or present with recurrent depressive episodes [6]. The effect of indicated prevention seems to wear off over time [7]. There is the need to identify relevant factors contributing to the persistence and treatment failure of adolescent
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