Clinical presentation and course of depression in youth: Does onset in childhood differ from onset in adolescence?
Clinical presentation and course of depression in youth: Does onset in childhood differ from onset in adolescence?
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DOI：
10.1097/00004583-200401000-00015
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发表时间：
2004-01-01
影响因子：
13.3
通讯作者：
Ryan, ND
中科院分区：
文献类型：
--
作者：
Birmaher, B;Williamson, DE;Ryan, ND
目的：同时前瞻性地比较重度抑郁症儿童和青少年的临床表现、病程和父母精神病史。方法：通过结构化访谈对一组青春期前儿童 (n = 46) 和青春期后青少年 (n = 22) 进行精神病理学和父母精神病史评估，并每 2 年随访一次，持续约 5 年。结果：除了青少年有更多的抑郁性忧郁症状外，两组都有相似的抑郁症状、持续时间（平均 17 个月）、发作的严重程度、恢复率（85%）和复发率（40%）、合并症和父母精神病史。女性、内疚感增加、既往抑郁症发作以及父母的精神病理学与较差的纵向病程相关。结论：总体而言，重度抑郁症在儿童和青少年中的表现相似，且两组患者的临床病程均较长且家庭精神疾病负担较高。
Objective: To simultaneously and prospectively compare the clinical presentation, course, and parental psychiatric history between children and adolescents with major depressive disorder. Method: A group of prepubertal children (n = 46) and postpubertal adolescents (n = 22) were assessed with structured interviews for psychopathology and parental psychiatric history and followed once every 2 years for approximately 5 years. Results: With the exception of more depressive melancholic symptoms in the adolescents, both groups had similar depressive symptomatology, duration (average 17 months), severity of the index episode, rates of recovery (85%) and recurrence (40%), comorbid disorders, and parental psychiatric history. Female sex, increased guilt, prior episodes of depression, and parental psychopathology were associated with worse longitudinal course. Conclusions: In general, major depressive disorder is manifested similarly in children and adolescents, and both groups have a protracted clinical course and high family loading for psychiatric disorders.