Developmental changes in the phenomenology of depression in girls compared to boys from childhood onward

Background: Although it is well documented that teenage girls are at increased risk for depression, little is known about the importance of sex and development subsequent to onset of depression. In this article, we therefore report on sex differences in the developmental phenomenology of depression in a clinical sample. Methods: Longitudinal analyses were used to examine changes in the risk of depression, patterns of comorbid diagnoses, and depressive symptoms from ages 8–13 years up to young adulthood (age 21) among 87 patients. Results: Girls and boys were at similar risk for recurrent depression during follow-up. As girls got older, they had higher rates of comorbid eating disorders and lower rates of externalizing and substance use disorders than did boys; high risk periods for comorbid conditions also differed by sex. Comorbid disorders were usually contemporaneous with depression among girls but not among boys, and comorbidity patterns were influenced by age at depression onset. Girls with earlier (compared to later) onset depression were at lower risk for nonaffective disorders; boys evidenced the opposite pattern and were at particularly high risk for substance use disorders. There also were sex differences in developmental symptom patterns. Limitations: Results based on this initially clinically referred sample may not generalize to youths in other settings. Conclusions: Among depressed youths, sex-associated developmental trajectories in comorbid disorders and depressive symptoms have implications for intervention. Such information may help identify optimal timing of efforts to reduce the risk of or to treat comorbid disorders, and help select developmentally appropriate target symptoms for girls versus boys.