Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Age at Menarche and Depression into Adulthood

Pediatrics; ePub 2017 Dec 26; Mendle, et al

Early pubertal timing in girls is associated with elevated rates of depression and antisocial behavior into adulthood, a recent study found. The study used a nationally representative sample of 7,802 women managed prospectively from adolescence over a period of ∼14 years to examine associations of age at menarche with depressive symptoms and antisocial behaviors in adulthood. Among the findings:

  • Earlier ages at menarche were associated with higher rates of both depressive symptoms and antisocial behaviors in early-middle adulthood.
  • These higher rates were mainly due to difficulties that started in adolescence and did not diminish over time.
  • Adolescent health care providers should be attuned to early maturers’ elevated mental health risk and sensitive to the potential duration of changes in mental health that begin at puberty.


Mendle J, Ryan RM, McKone KMP. Age at menarche, depression, and antisocial behavior in adulthood. [Published online ahead of print December 26, 2017]. Pediatrics. doi:10.1542/peds.2017-1703.


It is well documented that early puberty in girls is associated with a higher prevalence and severity through late adolescence of depression, anxiety, disordered eating, delinquency, substance abuse and school failure.1 This study extends the duration of effect into adulthood. What should this mean to those of us who care for children? It means that early puberty identifies individuals who are at risk for mental health problems and while an intervention has not yet been studied, it makes sense to alert the families of these adolescents of this correlation in order to increase attention to the need for social support and increased discussion around the difficulties and challenges that early puberty presents for some young girls. — Neil Skolnik, MD

  1. Mendle J. Why puberty matters for psychopathology. Child Dev Perspect. 2014;8(4):218–222.