The effect of timing and tempo of adrenarche on depression and anxiety in adolescence: A prospective cohort analysis

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A considerable proportion of life-time depression and anxiety emerges during childhood and adolescence. Some research has shown that pubertal maturity is associated with depression and anxiety. While most research has focused on gonadarche, the earlier phase of adrenarche remains less explored and understood. We aimed to examine the effects of timing and tempo of adrenarche on incidence and chronicity of depression and anxiety during adolescence. Data were from the Child to Adult Transition Study (CATS), a longitudinal population-based cohort from Melbourne, Australia. CATS recruited Grade 3 students in 2012, who were followed up annually across adolescence. Adrenarchal timing was modelled as the level of adrenal hormones (DHEA, DHEAS, and testosterone) relative to peers at age 9 and tempo as the adrenal hormone progression rate relative to peers between 9 and 12. Incidence and chronicity of common mental disorders were defined using self-reported depressive and anxiety symptoms collected annually from age 12 to 18. G-computation was used to adjust for confounding. Missing data were handled via multiple imputation using chained equations. The study comprised 667 females and 572 males. Depression incidence (76% females, 44% males) and chronicity (34% females, 7% males) and anxiety incidence (69% females, 36% males) and chronicity (29% females, 7% males) were more common in female adolescents than males. Regardless of using DHEA, DHEAS, or testosterone as the index for adrenarche, the risk ratios for the association between timing and tempo of adrenarche and the incidence and chronicity of depression or anxiety were close to null and 95% confidence intervals were inconclusive. This study did not identify a meaningful effect of adrenarchal timing and tempo on depression and anxiety in adolescents, suggesting that individual differences in adrenarche may not influence risk for later significant mental health difficulties. • Pubertal maturity is associated with depression and anxiety. While most research has focused on gonadarche, the earlier phase of adrenarche remains less explored and understood. • This study did not identify a meaningful effect of timing and tempo of adrenarche on depression and anxiety in adolescents, suggesting that timing and tempo of adrenarche may not influence risk for significant mental health difficulties during adolescence. • Future research is recommended that explores the interactions between adrenal hormones and social context factors in the development of common mental health problems during adolescence.

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