To examine factors related to the persistence of depressive symptoms, we used a longitudinal follow-up survey of 1,176 adolescents aged 12 to18 in the United States who reported notable depressive symptoms at baseline. Adolescents were interviewed by telephone at baseline in 1989 and at follow-up in 1993. The outcome of interest was a self-report measure of depressive symptoms experienced within the past 12 months at follow-up. Overall, 38.5% of adolescents reported persistent depressive symptoms. Marked gender differences were found, with 44.5% of girls reporting notable depressive symptoms at follow-up compared with 28.2% for boys. Moreover, current established smokers or experimenters were significantly more likely to report notable depressive symptoms compared with never smokers (42.2%, 41.4% and 33.6%, respectively). Significant multivariate predictors of notable depressive symptoms at follow-up were female gender, change in sleep problems from 1989 to 1993, change in cigarette smoking status from 1989 to 1993, engaging in physical fights, and lack of participation in sports. Many adolescents report continued depressive symptoms over a period spanning four years. Several predictors of persistent depression were identified that could be important components of interventions targeting depressed adolescents.
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