Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers
Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers
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DOI：
10.1186/1471-244x-12-90
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发表时间：
2012-07-27
期刊：
影响因子：
4.4
通讯作者：
von Knorring, Anne-Liis
中科院分区：
文献类型：
--
作者：
Bohman, Hannes;Jonsson, Ulf;von Knorring, Anne-Liis
背景：目前缺乏以人群为基础的关于心理健康状况和功能性身体/躯体症状的长期纵向研究。关于与躯体症状相关的长期心理健康结果或抑郁症与这些症状之间的时间关系，人们知之甚少。这项为期15年的研究随访青少年抑郁症和匹配的控制，筛选从人口为基础的样本，谁报告不同数量的躯体symptoms.Methods：总人口的16-17岁的青少年在乌普萨拉，瑞典，抑郁症在1991-1993年进行了筛选。筛选阳性的青少年和相同数量的健康对照组参加了半结构化的诊断面试。此外，还评估了21种不同的自测躯体症状。百分之六十四的青少年参加了后续结构化interview 15 years later.Results：无论青少年抑郁症的存在，青少年的躯体症状预测抑郁症和其他成人精神障碍。在青少年抑郁症患者中，功能性躯体症状的数量在剂量反应关系中预测自杀行为、双相发作、精神病发作以及慢性和复发性抑郁症。与预期相反，腹痛和出汗的躯体症状比所有DSM-IV抑郁症状更好地预测抑郁症。腹痛持续作为一个独立的强大的预测抑郁症和焦虑症，即使在控制其他重要的混杂因素。结论：在青春期的躯体症状可以预测严重的成人心理健康障碍。与青少年抑郁症并发的躯体症状的数量以逐步的方式与自杀企图、双相情感障碍、精神病性障碍以及复发性和慢性抑郁症相关。这些发现可能有助于为有躯体症状的患者制定治疗指南。
Background: There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms.Methods: The total population of 16-17-year-olds in Uppsala, Sweden, was screened for depression in 1991-1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later.Results: Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders.Conclusions: Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.