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76. Adolescent age at onset of depression: a unique psychological symptom network
Adolescence is vulnerable time in the development of brain and mind (Spear, 2013). Onset of depression in adolescence confers specific psychosocial, psychiatric, and medical risks in adulthood (Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2003; Zisook et al., 2007). While onset of depression in adolescence does not necessarily increase the likelihood of a major depressive episode in adulthood (Copeland, Shanahan, Costello, & Angold, 2009), adolescent-onset depression may be associated with unique symptom-level phenomenology in adulthood. The goal of the present study was to examine the extent to which the developmental timing of depression onset impacts adult symptomatology. 11 items from the Hamilton Depression Rating Scale in 3,184 treatment-seeking adults from the STAR*D trial were analyzed. Participants were split into quartiles based on age at onset (N=796 for child, adolescent, young adult, and middle age groups). L1-regularized GLASSO partial correlation networks were estimated in each group (qgaph, Epskamp et al., 2012) after controlling for the effects of current age, length of current episode, number of past episodes, and quality of life, to examine unique associations between symptoms. The adolescent symptom network was significant different from the young adult and middle age networks in both total strength (young adult p=.028; middle age p=.017) and global structure (young adult p=.014; middle age p=.005). The roles of sleep disturbance, guilt, psychomotor disturbance, and anhedonia were integral in distinguishing the adolescent network from the two adult networks. These phenomenological differences shed light on the impact of developmental timing of depression. Implications for pathophysiology treatment are discussed.