Adolescent depression is linked to adult ill-health and functional impairment, but recent research suggests that individual/contextual factors might account for this association. This study aimed to test whether the clinical heterogeneity of adolescent depression is related to marginalization from the labor market across early to middle adulthood. Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort initially assessed with structured clinical interviews at age 16–17. The cohort (n = 321 depressed; n = 218 nondepressed) was followed up after 2+ decades through linkage to nationwide population-based registries. Outcomes included consecutive annual data on unemployment, work disability, social welfare recipiency, and a composite marginalization measure, spanning from age 21 to 40. Longitudinal associations were examined using logistic regression analysis in a generalized estimating equations modeling framework. Subsequent depressive episodes and educational attainment in early adulthood were explored as potential pathways. The results showed that adolescent depression was associated with adult marginalization outcomes, but the strength of association varied across depressed subgroups. Adolescents with persistent depressive disorder had higher odds of all outcomes, including the composite marginalization measure (adjusted OR = 2.0, 95% CI = 1.4–2.7, p < 0.001), and this was partially (31%) mediated by subsequent depressive episodes in early adulthood. Exploratory moderation analysis revealed that entry into tertiary education mitigated the association with later marginalization, but only for adolescents with episodic major depression. In conclusion, the risk for future labor market marginalization is elevated among depressed adolescents, particularly those presenting with persistent depressive disorder. Targeted interventions seem crucial to mitigate the long-lasting impact of early-onset depression.

青少年抑郁症与成人健康不良和功能障碍有关，但最近的研究表明，个人/背景因素可能是这种关联的原因。本研究旨在检验青少年抑郁症的临床异质性是否与成年早期到中期劳动力市场的边缘化有关。数据来自乌普萨拉青少年抑郁症纵向研究，这是一项基于社区的队列研究，最初在 16-17 岁时通过结构化临床访谈进行评估。队列（n  = 321 抑郁；n = 218 名非抑郁症患者）在 2 多年后通过与全国人口登记处的联系进行了随访。结果包括从 21 岁到 40 岁的失业、工作残疾、社会福利接受者和综合边缘化措施的连续年度数据。在广义估计方程建模框架中使用逻辑回归分析检查纵向关联。随后的抑郁发作和成年早期的教育程度被探索为潜在的途径。结果表明，青少年抑郁症与成人边缘化结果相关，但相关强度因抑郁亚组而异。患有持续性抑郁症的青少年在所有结果中都有更高的几率，包括综合边缘化指标（调整后的 OR = 2.0，95% CI = 1。p  < 0.001)，这部分 (31%) 是由成年早期随后的抑郁发作介导的。探索性调节分析表明，进入高等教育减轻了与后来边缘化的关联，但仅适用于患有偶发性重度抑郁症的青少年。总之，抑郁症青少年未来劳动力市场边缘化的风险增加，尤其是那些患有持续性抑郁症的青少年。有针对性的干预措施似乎对于减轻早发性抑郁症的长期影响至关重要。