Adolescent Inpatients with Depression: Comparison to Inpatients without Depression and to Peers without Psychiatric Disorders

Family background, social support and psychological characteristics are known to be associated with depression in adolescence, but scientific data in complex, naturalistic settings are scarce. To investigate the characteristics of adolescent psychiatric inpatients with depressive disorders compared to peers without psychiatric disorders and to adolescent psychiatric inpatients without depression. The study population of 206 inpatients (13-17 years old) and 203 age and gendermatched non-referred adolescents was evaluated using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) interview, and clinical interview and clinical records when available. Structured self-reports provided information on family background, defense styles, self-image and perceived social support. We compared firstly subjects with current depressive disorders (n=120) to subjects without any psychiatric disorder (n=159) and secondly within the inpatient population, those with depressive disorders (n=117) to those with any other psychiatric diagnoses (n=89). Current depressive disorders were characterized by worse self-image, less mature defenses and less perceived social support particularly from the family. Adversities in the family were more prevalent in subjects with depression compared to subjects without any psychiatric diagnosis, while among inpatients, no significant differences were observed. Psychiatric comorbidity was common in all inpatients, whereas suicidality was more prevalent among inpatients with depression. Negative self-image, less mature defense style and low perceived social support particularly from the family were characteristics of depression in adolescents.