OBJECTIVES : To investigate the association between adolescent depression and earnings in adulthood.

METHODS : This study was based on Uppsala Longitudinal Adolescent Depression study (ULADS), initiated in Uppsala in 1991, in which all first-year students in upper secondary school (16–17 years old) were screened for depression. Comprehensive diagnostic interviews conducted in adolescence and early adulthood were combined with yearly register-based data on earnings from 1996 to 2016 (up to approximately age 40). Statistical analyses of the effect of depression during adolescence on earnings up to mid-adulthood were performed using Generalized Estimating Equations (GEE). A possibility of depression or recurrence in early adulthood to influence earnings was examined using mediation analysis.

RESULTS : A total of 539 individuals (78.8% females) with a history of persistent depressive disorder, episodic major depressive disorder, subthreshold depression, or no depression in adolescence were included. Persistent depressive disorder, but not the other subcategories of adolescent depression, was significantly associated with reduced earnings in adulthood in both males and females. After adjustments for parental characteristics and psychiatric comorbidity at baseline, the relative differences in earnings were 0.85 (0.77-0.95) for females and 0.76 (0.60-0.95) for males. The relative mean difference remained unchanged over time, was mainly driven by the lower percentiles in each group, and was partially mediated by depression in early adulthood.

CONCLUSIONS : Increased understanding of labor market outcomes in depressed adolescents can guide interventions to strengthen the human capital. Our findings demonstrate the importance of differentiating between diagnostic subgroups of adolescent depression. The duration and continued course of depressive episodes in adolescence proved decisive for adult earnings, underscoring the importance of early treatment and indicated preventive interventions.