Major depressive disorder in adolescents exposed to a friend's suicide
Major depressive disorder in adolescents exposed to a friend's suicide
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DOI：
10.1097/01.chi.0000084830.67701.9
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发表时间：
2003-11-01
影响因子：
13.3
通讯作者：
Brent, DA
中科院分区：
文献类型：
--
作者：
Bridge, JA;Day, NL;Brent, DA
目的：评估在青少年接触朋友自杀后的6个月内，DSM-III重性抑郁症（MDD）的风险是否一致，并检查可能影响新发MDD风险的潜在调节或中介过程。方法：比较1988年12月至1991年3月期间129名接触过朋友自杀的青少年和145名年龄相仿、未接触过自杀的社区对照者的一个月MDD发病率。临床、家庭和社会因素作为自杀后1个月内新发重度抑郁症的预测因素进行了检查。结果：暴露的青少年发生新发重度抑郁症的风险明显增加，这种风险仅限于暴露后1个月内的较短时间内。相比之下，两组在第2至6个月间的重度抑郁症发病率没有差异。过去的酒精滥用史增加了接触自杀的风险，这随后增加了接触后1个月内新发重度抑郁症的风险。有MDD家族史和对死亡负有责任的暴露青少年患新发MDD的风险显著增加。结论：面对朋友自杀的青少年，死亡事件与MDD家族史的相互作用会大大增加新发MDD的风险。
Objective: To evaluate whether the risk of DSM-III major depressive disorder (MDD) is uniform across the 6 months after adolescent exposure to a friend's suicide, and to examine potential moderating or mediating processes that may influence the risk of new-onset MDD. Method: One-month incidence rates of MDD were compared between 129 adolescents who were exposed to a friend's suicide between December 1988 and March 1991 and 145 similar-aged, unexposed community controls participating in the Youth Exposed to Suicide study. Clinical, family, and social factors that antedated the exposure were examined as predictors of new-onset MDD within 1 month of the suicide. Results: Exposed adolescents had a markedly increased risk of developing new-onset MDD that was restricted to a narrow period of time, within 1 month after exposure. In contrast, there were no differences in the incidence of MDD between the groups in months 2 to 6. Past history of alcohol abuse increased the risk of exposure to suicide, which subsequently increased the risk of new-onset MDD within 1 month of exposure. Exposed youths who had both a family history of MDD and feelings of accountability for the death were at considerably increased risk of new-onset MDD. Conclusions: For adolescents exposed to a friend's suicide, events surrounding the death interact with family history of MDD to greatly increase the risk for new-onset MDD.