Childhood neurodevelopmental difficulties and risk of adolescent depression: the role of irritability
Childhood neurodevelopmental difficulties and risk of adolescent depression: the role of irritability
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DOI：
10.1111/jcpp.13053
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发表时间：
2019-08-01
影响因子：
7.6
通讯作者：
Thapar, Anita
中科院分区：
文献类型：
--
作者：
Eyre, Olga;Hughes, Rachael A.;Thapar, Anita
患有神经发育障碍的儿童患抑郁症的风险增加。在一般人群中，易怒预示着抑郁，在患有神经发育障碍的儿童中也很常见。因此，神经发育障碍儿童的易怒可能与后来的抑郁症有关。本研究旨在(a)检查儿童神经发育困难与青少年抑郁之间的关系，(b)测试易怒是否解释了这种联系。方法7-9岁有任何神经发育困难的儿童（n = 1697）和选择的无任何神经发育困难的对照组（n = 3177）从英国人群为基础的前瞻性队列——雅芳父母与儿童纵向研究中确定。神经发育障碍的定义是，在认知能力、沟通、自闭症谱系症状、注意力缺陷/多动症状、阅读或运动协调等至少一项测试中，在样本中得分最低的5%。发展和幸福评估测量了父母在7岁时报告的儿童易怒，父母在10岁和13岁时报告的青少年抑郁，以及15岁时自我报告的抑郁。综合抑郁措施，得出青春期重度抑郁症（MDD）的结果。逻辑回归检验了儿童神经发育困难和青少年重度抑郁症之间的关系，控制了性别。通径分析估计了由易怒引起的这种关联的比例。对个体神经发育问题进行重复分析。结果儿童期神经发育困难与青春期MDD相关（OR = 2.11, 95% CI = 1.24, 3.60, p = 0.006）。据统计，儿童易怒占这一关联的42%。在单独检查每一种神经发育困难时，自闭症、沟通和多动症问题都与抑郁有关，其中烦躁解释了29%-51%的联系。结论：儿童易怒似乎是儿童神经发育困难和青少年重度抑郁症之间联系的关键因素。患有自闭症和多动症的儿童的高易怒率可能解释了神经发育组抑郁率升高的原因。
Background Children with neurodevelopmental disorders are at increased risk of developing depression. Irritability predicts depression in the general population and is common in children with neurodevelopmental disorders. Thus, it is possible that irritability in children with neurodevelopmental disorders contributes to the link with later depression. This study aimed to (a) examine the association between childhood neurodevelopmental difficulties and adolescent depression and (b) test whether irritability explains this association. Methods Children with any neurodevelopmental difficulty at the age of 7-9 (n = 1,697) and a selected, comparison group without any neurodevelopmental difficulty (n = 3,177) were identified from a prospective, UK population-based cohort, the Avon Longitudinal Study of Parents and Children. Neurodevelopmental difficulties were defined as a score in the bottom 5% of the sample on at least one measure of cognitive ability, communication, autism spectrum symptoms, attention-deficit/hyperactivity symptoms, reading or motor coordination. The Development and Well-Being Assessment measured parent-reported child irritability at the age of 7, parent-reported adolescent depression at the age of 10 and 13, and self-reported depression at the age of 15. Depression measures were combined, deriving an outcome of major depressive disorder (MDD) in adolescence. Logistic regression examined the association between childhood neurodevelopmental difficulties and adolescent MDD, controlling for gender. Path analysis estimated the proportion of this association explained by irritability. Analyses were repeated for individual neurodevelopmental problems. Results Childhood neurodevelopmental difficulties were associated with adolescent MDD (OR = 2.11, 95% CI = 1.24, 3.60, p = .006). Childhood irritability statistically accounted for 42% of this association. On examining each neurodevelopmental difficulty separately, autistic, communication and ADHD problems were each associated with depression, with irritability explaining 29%-51% of these links. Conclusions Childhood irritability appears to be a key contributor to the link between childhood neurodevelopmental difficulties and adolescent MDD. High rates of irritability in children with autistic and ADHD difficulties may explain elevated rates of depression in the neurodevelopmental group.