Social and sex differences in psychiatric comorbidity and psychosocial functioning among adolescents with depression.
BACKGROUND
To determine social and sex differences in psychosocial functioning and psychiatric comorbidity among adolescents with depression.


METHODS
A cohort-based study in Stockholm, Sweden. Adolescents who turned 13 years during 2001-2007, were followed in registers until they turned 18 in 2005-2011, (n = 169,262). In the current study, those with depression at age 13-17 were included (n = 6,439).


RESULTS
Adolescents with parents with low (OR=1.5, CI 1.1-2.2) education were more likely to have low psychosocial functioning. Those with parents with low education and low household income were more likely to have comorbid internalizing (OR=1.3, CI 1.0-1.7/1.3, CI 1.0-1.7) and externalizing disorders (OR=2.5, CI 1.5-4.0/2.4, CI 1.4-4.2). Adolescents with parents born outside the Nordic countries were more likely to have comorbid externalizing disorders (OR=1.6, CI 1.1-2.4). No social differences were evident in relation to family receipt of unemployment benefits. Social differences were found for both girls and boys in relation to psychosocial functioning and comorbidity but the magnitude of social differences in depression with comorbidity was overall larger for boys than girls.


LIMITATIONS
The findings of the current study can only be generalized to adolescents that have sought care for and been diagnosed with depression, within a setting similar to this study, e.g. with free access to care.


CONCLUSION
Adolescents with depression and with more disadvantaged social circumstances in the childhood run a higher risk of psychiatric comorbidity and low psychosocial functioning, which can indicate a lengthy clinical course and poorer response to treatment. Both boys and girls follow this path but partly in different kinds of psychiatric comorbidity.
['Wirback|Therese|T|', 'Möller|Jette|J|', 'Larsson|Jan-Olov|JO|', 'Engström|Karin|K|']
D000293:Adolescent D002648:Child D015897:Comorbidity D003863:Depression D005260:Female D006801:Humans D008297:Male D000083623:Psychosocial Functioning D012727:Sex Characteristics D013548:Sweden
Comorbidity Psychosocial functioning Adolescence Depression Social differences