Do Predictors of First-Onset Depression Differ Between Youth with and without Anxiety Disorders?

Objective: Although anxiety disorders elevate risk for subsequent depressive disorders, most anxious youth do not develop depression. However, the factors that influence the sequential comorbidity between anxiety and subsequent depression have received little attention.

Method: We followed two samples of majority-White suburban youth. Sample 1 included 504 girls (13.5-15.5 years) who did not meet criteria for depression at baseline and assessed the presence of anxiety and depressive disorders for five follow-ups spanning 6 years. Sample 2 consisted of 437 children who never met the criteria for depression through age 12 and assessed the presence of anxiety and depressive disorders every 3 years until age 18. We examined whether established risk factors for depression, including biological sex, depressive, anxiety, and irritability symptoms, rumination, temperament, interpersonal functioning, parental history of mood disorders, parenting, reward processing, and basal cortisol moderated the association between childhood/early-adolescent anxiety disorders and the subsequent development of depressive disorders in later adolescence/early adulthood.

Results: Compared to nondepressed/nonanxious youth, the presence of a childhood/early-adolescent anxiety disorder increased the risk for subsequent depression through later adolescence/early-adulthood by 63% to 90%. Although many risk factors prospectively predicted first-onset depression over and above a history of youth anxiety disorders, none of these variables moderated the effects of prior anxiety on later depression in either sample.

Conclusions: Childhood/early-adolescent anxiety disorders and a number of other risk factors predict subsequent first-onset depression, but the predictors of depression in anxious youth do not differ from those in non-anxious youth.