The prognosis of common mental disorders in adolescents

Journal Club

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study.

27 August 2014

Facilitated by Senior Research Fellow Rae Thomas

Overall

More information is needed about the authors’ selection of regression variables. There was some confusion about the authors’ use of the term “wave” as it at times related to the data collection point and other times related to symptoms experienced by individuals (see Table 2).

Comments

The study has good retention and interesting outcomes, but unfortunately only a careful read would tell a good news story; most adolescents surveyed did not have symptoms of anxiety or depression in either adolescence or adulthood. We believe the authors under-reported optimistic outcomes.

Conversely, we are concerned the authors may have overstated other findings and their conclusions. We consider the term “disorder” used by the authors in both the conclusion of the Abstract and Discussion as not representative of the data. It would appear that these data are symptoms of anxiety and depression measured at 6 monthly intervals in adolescence and every 4 to 5 years in adulthood and are not disorders. This is an important difference. The Interpretation section of the Abstract uses the word disorder in every sentence. We agree with part of the final sentence that reads “The resolution of many adolescent [symptoms of anxiety and depression] gives reason for optimism”. But the second half of this sentence is unsupported.

We are also interested in the authors considering some reanalyses of the data. Symptoms of anxiety and depression fluctuate over
short periods of time. An analysis of within-person variability (say, for a subgroup of participants), could enable us to distinguish between clinical trends and short-term fluctuations.

Reference:

Patton GC, Coffey C, Romaniuk H, Mackinnon A, Carlin JB, Degenhardt L, Moran P. The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. Lancet, 2014.

Patton et al 2014 The prognosis of common mental disprders in adolescents a 14 year prospective cohort study