Early markers of adult symptoms of depression and anxiety in the Raine Study

Background: Early intervention offers the potential to mitigate adult mental illness; however, trials spanning decades present significant challenges, necessitating predictive early markers useable in trial settings. We hypothesised that parent evaluation using the child behaviour checklist (CBCL) total problem score at age two years predicted adult depressive and anxious symptoms and explored other potential parent ratings. Methods: We recruited participants in a pregnancy cohort, The Raine Study, with information on age one Infant Temperament Scale (ITS) and infant monitoring questionnaire (IMQ), or age two CBCL and IMQ. Linear mixed effects models tested the association of these parent ratings on age 20–27 self-reporting of depression and anxiety assessed by the Depression, Anxiety and Stress Scale (DASS). Multivariable modelling, parental self-evaluation and teacher ratings were used to control for bias. Results: A total of 1400 participants had available data for at least one association of interest. Primarily, early markers predicted depression with 1SD higher CBCL total problem T-score increasing the odds of moderate DASS depression symptoms by 32 % (p = 0.006). Significant but diminished effects were found in exploratory analysis of CBCL externalising and internalising scores and for ITS “Intensity of reaction” and “Distractability”. The IMQ at ages one and two had no predictive value. We did not find influential familial evaluative bias or attrition bias. Conclusions: CBCL total problem scores at two years of age are imprecise, but partial markers of adult depression symptoms. Lacking a feasible alternative, we cautiously propose their utility as outcomes for low-cost early intervention trials.