Natural course of adolescent major depressive disorder in a community sample: Predictors of recurrence in young adults
Natural course of adolescent major depressive disorder in a community sample: Predictors of recurrence in young adults
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DOI：
10.1176/appi.ajp.157.10.1584
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发表时间：
2000-10-01
影响因子：
17.7
通讯作者：
Gotlib, LH
中科院分区：
文献类型：
--
作者：
Lewinsohn, PM;Rohde, P;Gotlib, LH
目的：主要目的是确定复发的抑郁症在年轻的成年期（19-23岁），在社区样本的前抑郁adolescents.Method：共274名参与者进行了评估两次，在青春期和24岁生日后再次抑郁症复发的相关因素。从他们的一级亲属那里获得了终身精神病学信息。青少年预测变量包括人口统计学特征、心理社会变量、青少年重性抑郁障碍特征、共病、重性抑郁障碍和非心境障碍家族史、反社会和边缘型人格障碍症状。低水平的过度情感依赖，青少年时期的单一重度抑郁症发作，复发性重度抑郁症的家庭成员比例低，低水平的反社会和边缘型人格障碍症状，以及积极的归因方式（仅限配偶）独立预测了哪些以前抑郁的青少年将保持未来的精神病理学。女性、青春期多次重度抑郁症发作、复发性重度抑郁症家庭成员比例较高、边缘型人格障碍症状升高以及与父母的冲突（仅女性）独立预测复发性重度抑郁症。青少年期焦虑和物质使用障碍共病以及反社会人格障碍症状升高可独立区分与非心境障碍共病的复发性重性抑郁障碍青少年和单纯重性抑郁障碍青少年。在这项研究中确定的危险因素的前抑郁症青少年在成年早期复发重性抑郁症的风险增加，因此，持续监测和预防性或预防性治疗。
Objective: The primary purpose was to identify factors related to the recurrence of major depressive disorder during young adulthood (19-23 years of age) in a community sample of formerly depressed adolescents.Method: A total of 274 participants with adolescent-onset major depressive disorder were assessed twice during adolescence and again after their 24th birthday. Lifetime psychiatric information was obtained from their first-degree relatives. Adolescent predictor variables included demographic characteristics, psychosocial variables, characteristics of adolescent major depressive disorder, comorbidity, family history of major depressive disorder and nonmood disorder, and antisocial and borderline personality disorder symptoms.Results: Low levels of excessive emotional reliance, a single episode of major depressive disorder in adolescence, low proportion of family members with recurrent major depressive disorder, low levels of antisocial and borderline personality disorder symptoms, and a positive attributional style (mates only) independently predicted which formerly depressed adolescents would remain free of future psychopathology. Female gender, multiple major depressive disorder episodes in adolescence, higher proportion of family members with recurrent major depressive disorder, elevated borderline personality disorder symptoms, and conflict with parents (females only) independently predicted recurrent major depressive disorder. Comorbid anxiety and substance use disorders in adolescence and elevated antisocial personality disorder symptoms independently distinguished adolescents who developed recurrent major depressive disorder comorbid with nonmood disorder from those who developed pure major depressive disorder.Conclusions: Formerly depressed adolescents with the risk factors identified in this study are at elevated risk for recurrence of major depressive disorder during young adulthood and therefore warrant continued monitoring and preventive or prophylactic treatment.