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The association between pubertal status and depressive symptoms and diagnoses in adolescent females: A population-based cohort study

Lewis, G; Ioannidis, K; van Harmelen, A-L; Neufeld, S; Stochl, J; Lewis, G; Jones, PB; (2018) The association between pubertal status and depressive symptoms and diagnoses in adolescent females: A population-based cohort study. PLoS One , 13 (6) , Article e0198804. 10.1371/journal.pone.0198804. Green open access

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Abstract

Background: There is an association between puberty and depression, but many things remain poorly understood. When assessing puberty in females, most studies combine indicators of breast and pubic hair development which are controlled by different hormonal pathways. The contributions of pubertal timing (age at onset) and pubertal status (stage of development, irrespective of timing) are also poorly understood. We tested the hypothesis that stage of breast development in female adolescents, controlled largely by increased estradiol, would be more strongly associated with depression than pubic hair development which occurs in both males and females, and is controlled by adrenal androgens. We investigated whether this association was independent of pubertal timing. Methods: ROOTS is an ongoing cohort of 1,238 adolescents (54% female) recruited in Cambridgeshire (UK) at age 14.5, and followed-up at ages 16 and 17.5. Depression was assessed using the Mood and Feelings Questionnaire (MFQ) and clinical interview. Breast and pubic hair development were assessed at 14.5, using Tanner rating scales. Results: For each increase in Tanner breast stage at 14.5, depressive symptoms increased by 1.4 MFQ points (95% CI 0.6 to 2.3), irrespective of age at onset. Pubic hair status was only associated with depressive symptoms before adjustment for breast status, and was not associated with depression in males. The same pattern was observed longitudinally, and for depression diagnoses. Limitations: We did not directly measure hormone levels, our findings are observational, and the study had a relatively low response rate. Conclusions: Females at more advanced stages of breast development are at increased risk of depression, even if their age at pubertal onset is not early. Alongside social and psychological factors, hormones controlling breast but not pubic hair development may contribute to increased incidence of female depression during puberty.

Type: Article
Title: The association between pubertal status and depressive symptoms and diagnoses in adolescent females: A population-based cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0198804
Publisher version: http://doi.org/10.1371/journal.pone.0198804
Language: English
Additional information: Copyright: © 2018 Lewis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10050889
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