Depression and role impairment among adolescents in primary care clinics
Depression and role impairment among adolescents in primary care clinics
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DOI：
10.1016/j.jadohealth.2004.11.123
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发表时间：
2005-12-01
影响因子：
7.6
通讯作者：
Wells, KB
中科院分区：
文献类型：
--
作者：
Asarnow, JR;Jaycox, LH;Wells, KB
目的：为了评估抑郁症和角色障碍之间的关联，在初级保健样本，控制和不控制的影响，一般的医疗conditions.Methods：横断面调查连续初级保健患者，年龄13-21岁（n 3471），从6个网站，包括公共卫生，管理式医疗，和学术健康中心诊所。我们评估了可能的抑郁症，抑郁症状，和常见的医疗问题，使用青年自我报告的一份简短的筛选问卷。主要结果测量是两个角色损害的指标：（a）生产力/角色活动的减少，定义为不在学校或全职工作;和（B）低教育程度，定义为在学校落后超过2年或20岁，未能完成高中学业。可能的抑郁障碍筛查阳性的青少年的生产力/角色活动下降率升高（19% vs. 13%; OR 1.69; 95%置信区间[CI] 1.39-2.06; p < 0.001）和低教育程度（20% vs. 15%; OR 1.47; 95% CI 1.21-1.78; p < 0.001）。可能的抑郁症作出了独特的贡献，这些损害指标的预测调整后的eft'ect有一个一般的医疗条件控制抑郁症，一般的医疗条件的存在并没有贡献的角色impairment.Conclusions：青少年初级保健患者筛选抑郁症阳性的风险增加损害的学校/工作生产力和教育程度。这些发现强调了初级保健临床医生对抑郁症和角色限制的关注的重要性。(c)2005年，为青少年医学会。All rights reserved.
Purpose: To evaluate the association between depression and role impairment in a primary care sample, with and without controlling for the effects of general medical conditions.Methods: Cross-sectional survey of consecutive primary care patients, ages 13-21 years (n 3471), drawn from six sites including public health, managed care, and academic health center clinics. We assessed probable depressive disorder, depressive symptoms, and common medical problems Using youth self-report on a brief screening questionnaire. Main Outcome measures were two indicators of role impairment: (a) decrement in productivity/role activity, defined as not in school or working full time; and (b) low educational attainment, defined as more than 2 years behind in school or 20 years of age and failed to complete high school.Results: Adolescents screening positive for probable depressive disorder had elevated rates of productivity/role activity decrements (19% vs. 13%; OR 1.69; 95% confidence interval [CI] 1.39-2.06; p < 0.001) and low educational attainment (20% vs. 15%; OR 1.47; 95% CI 1.21-1.78; p < 0.001). Probable depressive disorder made a unique contribution to the prediction of these impairment indicators after adjusting for the eft'ect of having a general medical conditions controlling for depression, the presence of a general medical condition did not contribute to role impairment.Conclusions: Adolescent primary care patients screening positive for depression are at increased risk for impairment in school/work productivity and educational attainment. These findings ernphasize the importance of primary care clinicians' attention to depression and role limitations. (c) 2005 Society for Adolescent Medicine. All rights reserved.