Heron, J. | Search bioRxiv

bioRxiv2018

Identifying Critical Points of Trajectories of Depressive Symptoms From Childhood to Young Adulthood: Evidence of Sex Differences from the Avon Longitudinal Study of Parents and Children (ALSPAC)

Depression is a common mental illness associated with increased substance misuse and risk of suicide. Potential risk factors for depression include sex and depressive symptoms in early life, however the mechanisms responsible are not yet understood. Research has focused on late childhood and adolescence as this developmental period may be a modifiable risk factor that prevents or reduces depression at a later stage. It is also important to establish at what ages the level of depression is changing as this will help identify critical points to intervene with treatment. We used multilevel growth-curve models to explore adolescent trajectories of depressive symptoms in the Avon Longitudinal Study of Parents and Children, a UK based pregnancy cohort. Using data from 9301 individuals, trajectories of depressive symptoms were constructed for males and females between 10.6 and 22.8 years old. We calculated the age of peak velocity for depressive symptoms (the age at which depressive symptoms increases most rapidly) and the age of maximum depressive symptoms. Adjusted results suggested that being female was associated with a steeper trajectory compared to being male (per 1 year increase in relation to depressive symptoms: 0.128, SE = 0.035, [95% CI: 0.059, 0.198]; p <0.001). We found evidence suggesting that females had an earlier age of peak velocity of depressive symptoms (females 13.7 years old, SE = 0.321, [95% CI: 12.9, 14.4] and males 16.4 years old, SE = 0.096, [95% CI: 16.2, 16.6]; p <0.001), but weak evidence of an earlier age of maximum depressive symptoms (p = 0.125). Possible mechanisms that underlie this sex difference include the roles of pubertal development and timing. Using multilevel growth curve models to estimate the age of peak velocity and maximum depressive symptoms for different population subgroups may provide useful knowledge for treating and preventing later depression.

epidemiology↗

bioRxiv2017

Autistic traits and suicidal thoughts, plans and self-harm in late adolescence: population based cohort study

ImportanceThere have been recent concerns about a higher incidence of mortality by suicide in people with autism spectrum disorder (ASD). To our knowledge, no large cohort studies have examined which features of autism may lead to suicidal ideation and behaviour, and whether there are any potential modifiable mechanisms.\n\nObjectiveTo examine the hypothesis that ASD diagnosis and traits in childhood are associated with suicidal thoughts, plans and self-harm at 16 years, and that any of the observed associations are explained by depression in adolescence at 12 years.\n\nDesign, setting and participantsProspective investigation of associations between ASD diagnosis and autistic traits with suicidal ideation and behaviour and a potential risk pathway via depression in early adolescence in 5,031 members of the Avon Longitudinal Study of Parents and Children.\n\nMain outcomes and measuresHistory of self-harm with and without suicidal intent, suicidal thoughts and plans at 16 years assessed using a detailed self-report questionnaire. Exposures were ASD diagnosis and four measures (the coherence subscale of the Childrens Communication Checklist, the Social and Communication Disorders Checklist, a repetitive behaviour measure, and the sociability temperament subscale of the Emotionality, Activity and Sociability scale) dichotomised to represent the autism trait groups. Depressive symptoms in early adolescence were measured by the Short Moods and Feelings Questionnaire at 12 years.\n\nResultsChildren with impaired social communication had a higher risk of self-harm with suicidal intent (RR 2.10, 95% CI 1.28, 3.34), suicidal thoughts (1.42 times (95% CI 1.06, 1.91) and suicidal plans (RR 1.95, 95% CI 1.09, 3.47) by the age of 16 years as compared to those without. There was no evidence for an association between ASD diagnosis and the outcomes although these analyses were imprecise due to small numbers. There was also no evidence of an association between other autism trait measures and the outcomes. Approximately 32% of the total estimated association between social communication impairment and self-harm was explained by depressive symptoms at age 12 years.\n\nConclusionsImpairments in social communication are important in relation to suicidality. Early identification and management of depression may be a preventative mechanism and future research identifying other modifiable mechanisms may lead to preventative action or interventions against suicidal behaviour in this high-risk group.

epidemiology↗