Major Depressive Disorder and Cardiovascular Disease Risk in Children and Adolescents

Major depressive disorder (MDD) in youth is an independent risk factor for premature cardiovascular disease (CVD). While previous research has considered individual CVD risk factors in relation to depression, this study examined the association between depression and CVD risk among children and adolescents with MDD using a validated composite measure.

Youth with MDD were recruited through an outpatient psychiatry program and underwent semistructured psychiatric diagnostic assessment to confirm diagnosis. Healthy control participants were recruited from community settings. All participants completed the Center for Epidemiological Studies Depression Scale for Children to assess depressive symptoms. The continuous metabolic syndrome score, a validated measure for cardiometabolic risk assessment in youth, was computed using aggregated standardized z-scores of CVD risk factors, including fasting blood glucose, body mass index, blood pressure, fasting triglycerides, and high-density lipoprotein cholesterol. Hierarchical multiple regression models tested the association between depression (diagnosis and symptoms) and CVD risk while accounting for covariates.

Participants (N=277; 73.6% female) had a mean age of 15.2 (SD=1.8) years. Cardiovascular disease risk was significantly higher among youth with depression (n=196, mean=0.77, SD=2.98) compared with healthy controls (n=81, mean=-0.39, SD=2.77; P=.002). Depression diagnosis and depressive symptoms were associated with increased CVD risk (β=0.40, P=.004; β=0.15, P=.02, respectively), after adjusting for covariates.

Adolescents with MDD demonstrate increased cardiovascular disease risk compared with healthy youth, highlighting early evidence of association between depression and cardiovascular disease. Consequently, childhood and adolescence may serve as crucial periods for preventive intervention targeting cardiovascular health among youth with depression.