Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK
The Lancet Psychiatry
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Neufeld, S., Dunn, V., Jones, P., Croudace, T., & Goodyer, I. (2017). Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK. The Lancet Psychiatry, 4 (2), 120-127. https://doi.org/10.1016/S2215-0366(17)30002-0
Background: Evidence regarding the association between service contact and subsequent mental health in adolescents is scarce, and previous findings are mixed. We aimed to longitudinally assess the extent to which depressive symptoms in adolescents change after contact with mental health services. Methods: As part of a longitudinal cohort study, between April 28, 2005, and March 17, 2010, we recruited 1238 14-year-old adolescents and their primary caregivers from 18 secondary schools in Cambridgeshire, UK. Participants underwent follow-up assessment at months 18 and 36. Trained researchers assessed the adolescents for current mental disorder using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL). Caregivers and adolescents reported contact with mental health services in the year before baseline. Adolescents self-reported depressive symptoms (Mood and Feelings Questionnaire [MFQ]) at each timepoint. We assessed change in MFQ sum scores from baseline contact with mental health services using multilevel mixed-effects regression adjusted for sociodemographic, environmental, individual, and mental health confounders, with multiple imputation of missing data. We used propensity score weighting to balance confounders between treatment (users of mental health services) and control (non-users of mental health services) groups. We implemented an MFQ clinical cutoff following the results of receiver operating characteristic analysis. Findings: 14-year-old adolescents who had contact with mental health services in the past year had a greater decrease in depressive symptoms than those without contact (adjusted coefficient −1·68, 95% CI −3·22 to −0·14; p=0·033). By age 17 years, the odds of reporting clinical depression were higher in individuals without contact than in service users who had been similarly depressed at baseline (adjusted odds ratio 7·38, 1·73–31·50; p=0·0069). Interpretation: Our findings show that contact with mental health services at age 14 years by adolescents with a mental disorder reduced the likelihood of depression by age 17 years. This finding supports the improvement of access to adolescent mental health services.
This study was funded by The Wellcome Trust (grant number 074296), and the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care for Cambridgeshire and Peterborough.
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (unknown)
Wellcome Trust (095844/Z/11/Z)
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External DOI: https://doi.org/10.1016/S2215-0366(17)30002-0
This record's URL: https://www.repository.cam.ac.uk/handle/1810/273240
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/
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