[Evolution of depression in the child and adolescent]

Outcome of depressive disorder in adolescents is now better known. Despite methodological differences between studies there is an agreement to emphasize frequency of relapse and recurrence in the follow-up (50 to 60%). Others modalities have also been described, anxiety disorders seemed to be the more frequent. For some authors, affective disorder in adolescents could presage manic depressive illness. Psychosocial functioning after the follow-up seems to be impaired as well as in professional, relational, or social fields. These data suggest a clear distinction between affective states in adolescents and symptoms related to psychological transformations of adolescence. We have conducted a follow-up study with adolescents hospitalized in the child and adolescent psychiatric department of R. Debré hospital, for major depressive episode (MDE) or dysthymic disorder (DD). On the 122 patients meeting initially inclusion criteria, 75 have been evaluated after one year follow-up at least. Duration of the follow-up was on average 4 years. 44 met initially DSM III and DSM III-R criteria for MDE and 31 for DD. Rating has been done during a phone interview with a standardized questionnaire. We did use criteria defined by Prien et al. (1984) for relapse, recurrence and remission. Our results showed a good short-term outcome in both groups (72.7% remission in MDE and 80.6% in DD). Relapse rate was superior in the first group. At the end of the follow-up, cumulative probability of recurrence was 52.9% in MDE group and 35.7% in DD group. Chronic evolution was more frequent in TD group.(ABSTRACT TRUNCATED AT 250 WORDS)