Is there an epidemic of child or adolescent depression?
Is there an epidemic of child or adolescent depression?
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DOI：
10.1111/j.1469-7610.2006.01682.x
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发表时间：
2006-12-01
影响因子：
7.6
通讯作者：
Angold, Adrian
中科院分区：
文献类型：
--
作者：
Costello, E. Jane;Erkanli, Alaattin;Angold, Adrian
背景：专业和普通媒体最近都发表了对儿童和青少年抑郁症“流行病”的担忧。这种担忧的原因包括：（1）抗抑郁药处方的增加，（2）连续出生的成年人队列的回顾性回忆，（3）1990年之前青少年自杀率的上升，以及（4）三个英国青少年队列中情绪问题增加的证据。研究方法：回顾了1965年至1996年出生的儿童的流行病学研究，并对所有使用结构化诊断访谈对18岁以下参与者的代表性人群样本进行正式抑郁症诊断的研究进行了荟萃分析。估计出生年份对患病率的影响，控制年龄，性别，样本量，分类（e。例如，在一个实施例中，DSM与ICD）、测量工具和访谈时间范围（当前、3个月、6个月、12个月）。结果如下：26项研究被确定，对1965年至1996年出生的儿童进行了近60，000次观察，这些儿童至少接受了一次能够对抑郁症进行正式诊断的结构化精神病学访谈。抑郁症发病率不受出生年份的影响。分类法、测量工具、访谈时间等因素对访谈结果影响不大。总体患病率估计为：13岁以下，2.8%（标准误（SE）.5%）; 13-18岁，5.6%（SE .3%）; 13-18岁女孩：5.9%（SE.3%）; 13-18岁男孩：4.6%（SE.3%）。结论：当使用同时评估而不是回顾性回忆时，没有证据表明过去30年中儿童或青少年抑郁症的患病率增加。公众对“流行病”的看法可能源于对临床医生长期诊断不足的疾病的高度认识。
Background: Both the professional and the general media have recently published concerns about an 'epidemic' of child and adolescent depression. Reasons for this concern include ( 1) increases in antidepressant prescriptions, ( 2) retrospective recall by successive birth cohorts of adults, ( 3) rising adolescent suicide rates until 1990, and ( 4) evidence of an increase in emotional problems across three cohorts of British adolescents. Methods: Epidemiologic studies of children born between 1965 and 1996 were reviewed and a meta-analysis conducted of all studies that used structured diagnostic interviews to make formal diagnoses of depression on representative population samples of participants up to age 18. The effect of year of birth on prevalence was estimated, controlling for age, sex, sample size, taxonomy ( e. g., DSM vs. ICD), measurement instrument, and time-frame of the interview ( current, 3 months, 6 months, 12 months). Results: Twenty-six studies were identified, generating close to 60,000 observations on children born between 1965 and 1996 who had received at least one structured psychiatric interview capable of making a formal diagnosis of depression. Rates of depression showed no effect of year of birth. There was little effect of taxonomy, measurement instrument, or time-frame of interview. The overall prevalence estimates were: under 13, 2.8% ( standard error ( SE) .5%); 13-18 5.6% (SE .3%); 13-18 girls: 5.9% (SE.3%); 13-18 boys: 4.6%( SE.3%). Conclusions: When concurrent assessment rather than retrospective recall is used, there is no evidence for an increased prevalence of child or adolescent depression over the past 30 years. Public perception of an 'epidemic' may arise from heightened awareness of a disorder that was long under-diagnosed by clinicians.