Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: evidence of distinct subgroups at risk.
Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: evidence of distinct subgroups at risk.
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DOI：
10.1016/j.jad.2014.02.011
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发表时间：
2014-04
影响因子：
6.6
通讯作者：
Klein, Daniel N.
中科院分区：
文献类型：
--
作者：
Hill, Ryan M.;Pettit, Jeremy W.;Lewinsohn, Peter M.;Seeley, John R.;Klein, Daniel N.
在青春期出现亚阈值抑郁症状(Subd)与发展成严重抑郁障碍(MDD)的高风险相关。对于预测从Subd升级到MDD的变量，我们知之甚少。这项研究在青少年社区样本中使用了纵向前瞻性设计，以确定预测从Subd升级到MDD的危险因素组合。使用分类树分析来确定危险因素的组合，这些组合提高了在424名终生Subd病史的青少年中预测MDD发病的敏感性和特异性。在424名患者中，144名患者在随访期内发生了MDD。发现了多个亚组的证据：在朋友支持较差的青少年中，升级的风险最高的是有终生焦虑史或药物使用障碍的参与者。在朋友支持程度较高的青少年中，那些在过去一年中报告多次重大生活事件或有焦虑症病史的青少年升级的风险最高。研究结果可能不会为成年后首次发展为subd的人提供预防措施。这项研究没有检查从Subd到MDD升级过程中涉及的预测因素的时间顺序。有Subd病史的青少年在朋友支持不足、焦虑或药物使用障碍、或有更好的朋友支持、多次重大生活事件和焦虑症时，升级为MDD的风险最高。这些发现可能会为青少年抑郁症预防计划的病例识别方法提供参考。
The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: Among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs.
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DOI：
10.1097/chi.0b013e3181a56606
发表时间：
2009-07
影响因子：
13.3
作者：
Klein DN;Shankman SA;Lewinsohn PM;Seeley JR
通讯作者：
Seeley JR
影响因子：
2.3
作者：
ANDREWS, JA;LEWINSOHN, PM;ROBERTS, RE
通讯作者：
ROBERTS, RE
影响因子：
6.9
作者：
Lewinsohn, PM;Shankman, SA;Klein, DN
通讯作者：
Klein, DN
影响因子：
4.1
作者：
JAYCOX, LH;REIVICH, KJ;SELIGMAN, MEP
通讯作者：
SELIGMAN, MEP
影响因子：
4.4
作者：
Merikangas, KR;Mehta, RL;Kessler, RC
通讯作者：
Kessler, RC