Pubertal timing and tempo and depression risk in adolescent boys and girls: A Danish population-based cohort study.
Level 3 - non-randomized controlled study
Prospective population-based cohort study
PubMed 42217645 · doi:10.1016/j.jad.2026.122020
What was done
Data from 15,818 participants in the Danish National Birth Cohort were analyzed to examine associations between pubertal timing and tempo and depression risk in boys and girls. Pubertal development was self-reported half-yearly from ages 11 to 18, with timing and tempo estimated using non-linear mixed-effects growth models. Depressive symptoms at age 18 were assessed using the Major Depression Inventory via multinomial logistic regression, and clinically diagnosed depression was identified via the Danish National Patient Register using binomial logistic regression.
What was found
In girls, earlier breast development was associated with depressive symptoms (RRR = 1.11, 95% CI: 1.00-1.23) and clinically diagnosed depression (RR = 1.27, 95% CI: 1.00-1.60). Faster breast development was associated with depressive symptoms (RRR = 1.69, 95% CI: 1.08-2.64), and earlier menarche was associated with clinically diagnosed depression (RR = 1.36, 95% CI: 1.03-1.79). In boys, earlier pubic hair development was associated with depressive symptoms (RRR = 1.32, 95% CI: 1.07-1.63) and clinically diagnosed depression (RR = 1.66, 95% CI: 1.10-2.50). Earlier voice break was associated with depressive symptoms (RRR = 1.35, 95% CI: 1.11-1.63), and earlier first ejaculation was associated with clinically diagnosed depression (RR = 1.51, 95% CI: 1.16-1.98). Overall, pubertal timing was more strongly associated with adolescent depression than pubertal tempo.
Why it matters
This study shows that earlier pubertal maturation is a risk factor for both depressive symptoms and clinical depression in adolescent boys and girls, with timing showing stronger associations than tempo.
Limits
Pubertal milestones were self-reported rather than objectively assessed by clinical examination. Hospital registry records capture only clinically diagnosed cases in secondary or specialized care, potentially missing cases managed in primary care. Depressive symptoms were evaluated only at age 18, and residual confounding cannot be ruled out.