Effects of age and pubertal status on depression in a large clinical sample

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Abstract
The rate of depression rises overall between childhood and adolescence, and by early adulthood depression is twice as common in women as in men. However, study results are conflicting as to the relative rates of depression in prepubertal boys and girls, and it is not clear whether the rates in adolescent boys rise, fall, or remain steady. It is also uncertain when in adolescence the female preponderance emerges. A number of studies point to effects of the biological developments of puberty as having an important place in these changes. From a developmental point of view, the fact that the hormonal and physical changes of puberty differ in boys and girls, mean that a “biological explanation” fits in well with the gender differentiation in rates of depression across puberty. In a sample of 3,519 8–16-year-old psychiatric patients, both boys and girls shared increasing levels of depression across this age range, but the rate of increase was faster in girls. There was no difference in the rates of depression between boys and girls before the age of 11, but by the age of 16 girls were twice as likely as boys to have significant depressive symptomatology. When age was controlled for, pubertal status had no effect on depression scores. Thus, these results did not support the idea that the biological changes of puberty are a primary motive force in producing the changes in the sex ratio in depression in adolescence. Therefore, further research on this topic needs not only to address the etiology of depression in young people, but also to search for etiologic factors with differential distributions or effects on boys and girls.