Psychological Medicine

Puberty and depression: the roles of age, pubertal status and pubertal timing

A. ANGOLD a1c1, E. J. COSTELLO a1 and C. M. WORTHMAN a1
a1 From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, NC and Department of Anthropology, Emory University, GA, USA


Background. Previous work has indicated that the 2[ratio]1 female[ratio]male sex ratio in unipolar depressive disorders does not emerge until some time between ages 10 and 15.

Methods. Data from four annual waves of data collection from the Great Smoky Mountains Study (GSMS) involving children aged nine to 16 were employed.

Results. Pubertal status better predicted the emergence of the expected sex ratio than did age. Only after the transition to mid-puberty (Tanner Stage III and above) were girls more likely than boys to be depressed. The timing of this transition had no effect on depression rates. Before Tanner Stage III, boys had higher rates of depression than girls, and the prevalence of depression appeared to fall in boys at an earlier pubertal stage than that at which it began to rise in girls. In addition, recent transition to Tanner Stage III or higher had a transient effect in reducing the prevalence of depression in boys.

Conclusions. The period of emergence of increased risk for depression in adolescent girls appears to be a relatively sharply demarcated developmental transition occurring in mid-puberty. Previously reported effects of the timing of puberty (which have tended to be transient) appeared less important in increase of risk for depression than pubertal status.

c1 Address for correspondence: Dr Adrian Angold, Developmental Epidemiology Program, Box 3454 DUMC, Durham, NC 27710, USA.