Journal of the American Academy of Child & Adolescent Psychiatry
New researchEarly Pubertal Timing and Testosterone Associated With Higher Levels of Adolescent Depression in Girls
Section snippets
Pubertal Timing
Interindividual variation in the onset of pubertal processes can create a period of contrast during which same-aged girls differ significantly from one another with respect to highly salient physical attributes such as breast size, distribution of subcutaneous fat, hip-to-waist ratio, and body hair. Girls who mature earliest have been shown to be at greater risk for depressive symptoms or disorders by some studies 4, 5, 6 but not by others.7 Proposed mechanisms for early pubertal timing effects
Participants
The Great Smoky Mountains Study is a longitudinal study of the development of psychiatric disorder in rural and urban youth.21 A representative sample of 3 cohorts of children, aged 9, 11, and 13 years at intake, was recruited from 11 counties in western North Carolina. Potential participants were selected from the population of some 20,000 children where each household had an equal probability of selection. The study used a two-stage sampling design. A screening questionnaire was administered
Missing Data
Of the 3,005 available observations on 630 female participants aged 9 to 16 years, 1,089 participants (36%) had data missing on Tanner stage, testosterone, or estradiol. Missingness was not associated with the probability of depression (Tanner stage: odds ratio [OR] = 0.9, 95% CI 0.5−1.9, p = .87; estradiol: OR = 1.1, 95% CI = 0.6−2.3, p = .73; testosterone: OR = 1.2, 95% CI = 0.6−2.6, p = .64; any pubertal variable: OR = 1.1, 95% CI = 0.5−2.2, p = .89). Furthermore, 566 or 89.8% of the 630
Discussion
In two earlier papers based on the first three waves of the Great Smoky Mountains Study, estradiol and testosterone explained all of the effects of age and Tanner stage on the prevalence of depression in girls.13, 19 Furthermore, there were no effects of the timing of puberty on increases in depression diagnosis. When three additional data waves between ages 12 and 16 years were collected, strengthening data coverage in mid to late puberty, and almost doubling the number of total assessments,
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The work presented here was supported by the National Institute of Mental Health (NIMH; MH080230, MH63970, MH63671, MH48085, MH075766, MH094605, MH117559, and MH104576), the National Institute on Drug Abuse (NIDA; DA/MH11301, DA011301, DA016977, DA036523, and DA023026), the National Institute for Child Health and Development (NICHD; HD093651), and the William T. Grant Foundation.
Dr. Copeland had full access to all the data in the study, performed all statistical analyses, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
The authors would like to thank the participants of the Great Smoky Mountains Study and their families for their longstanding involvement in this study.
Disclosure: Dr. Copeland has received research support from NIMH, NIDA, and NICHD. Dr. Shanahan has received research support from NIMH. Drs. Costello and Angold are currently retired. Dr. Worthman reports no biomedical financial interests or potential conflicts of interest.