Do childhood externalizing disorders predict adult depression? A meta-analysis

Area of Science:

• Developmental Psychology
• Psychiatry
• Epidemiology

Background:

• Childhood externalizing disorders are sometimes linked to adult affective disorders, but findings are inconsistent.
• Longitudinal studies have explored the association between childhood psychopathology and adult psychiatric conditions.
• A clear understanding of this developmental pathway is crucial for early intervention strategies.

Purpose of the Study:

• To conduct a meta-analysis examining the association between childhood externalizing symptoms or disorders and the development of adult depression.
• To synthesize evidence from multiple longitudinal cohort studies to provide a robust estimate of the effect size.

Main Methods:

• Systematic literature search of PubMed up to November 2013 for relevant prospective, longitudinal, community-sampled cohort studies.
• Inclusion criteria: children (≤13 years) with externalizing disorders (aggression, conduct problems, ODD, CD) reassessed in adulthood (≥18 years) for depressive disorders.
• Random effects model used for meta-analysis; ancillary analyses explored potential covariates.

Main Results:

• Ten studies (8 cohorts, N=17,712) met inclusion criteria.
• Childhood externalizing behavior was significantly associated with adult depressive disorders (OR=1.52, 95% CI=1.27-1.80, p<0.0001).
• Fail-safe N analysis indicated the robustness of the findings, requiring 263 additional studies to nullify the effect.

Conclusions:

• Childhood externalizing psychopathology is a significant predictor of unipolar depressive disorders in adulthood.
• Findings support the long-term impact of early behavioral problems on adult mental health.
• Highlights the importance of addressing childhood externalizing behaviors to potentially mitigate later depressive disorders.