Mood disorders in children and adolescents: An epidemiologic perspective
Mood disorders in children and adolescents: An epidemiologic perspective
复制标题
DOI：
10.1016/s0006-3223(01)01129-5
复制
发表时间：
2001-06-15
影响因子：
10.6
通讯作者：
Merikangas, KR
中科院分区：
文献类型：
--
作者：
Kessler, RC;Avenevoli, S;Merikangas, KR
流行病学研究表明，重度抑郁症在儿童中相对罕见，但在青少年中很常见，青春期结束时终生患病率高达25%。躁狂症要少得多，青春期结束时终生患病率不超过2%。发育研究包括对青春期过渡期间的荷尔蒙变化和社会变化的评估，需要调查生物和环境的联合影响以及青春期抑郁的性别差异的出现。虽然阈值以下的情绪障碍症状很常见，但对其临床意义仍存在争议。从患者、教师和儿童获得的不一致症状报告的方法学不确定性，以及关于成人研究中关于发病年龄的回顾报告的普遍存在，使这一争议变得更加复杂。回顾报告显示，至少50%的患有严重抑郁症的青少年和9a%的躁狂症患者继续有成人复发。这些复发是由不利的角色转变引起的，例如教育程度缩短和青少年生育，这些通常发生在最初治疗之前，积极的根据地和旨在防止不良角色影响发生的早期治疗可能有助于降低儿童和青少年情绪障碍的持久性。需要长期的随访研究来解决目前关于病因学、方法学和长期治疗效果的不确定因素。还需要旨在更快地提供临时信息的创新流行病学研究设计，以促进对长期发展过程的了解。(C)2001年生物精神病学学会
Epidemiologic studies show that major depression is comparatively rare among children, but common among adolescents with up to a 25% lifetime prevalence by the end of adolescence. Mania is much less common, with no more than a 2% lifetime prevalence by the end of adolescence. Developmental studies that include assessments of both hormonal changes and social changes through the pubertal transition ai e needed to investigate joint biological and environmental influences an the emergence of the gender difference in depression in puberty. Although subthreshold mood disorder symptoms are common, controversy exists about their clinical significance. This controversy is made more complex by methodologic uncertainties regarding inconsistent symptom reports obtained from patients, teachers, and children and by the pervasive existence of comorbidity Retrospective reports about age of onset in adult studies suggest that at least 50% of youngsters with major depression and 9a% of those with mania continue to have adult recurrences. These recurrences are mediated by adverse role transitions, such as truncated educational attainment and teenage childbearing that typically occur before the time of initial treatment Aggressive entrench and early treatment aimed at preventing the occurrence of adverse role effects might help decrease the persistence of child and adolescent mood disorders. Long-term follow-up studies are needed to resolve current uncertainties regarding nosology, methodology, and long-term treatment effects. Innovative epidemiologic research designs aimed at more quickly providing provisional information are also needed to advance understanding of long-term developmental processes. (C) 2001 Society of Biological Psychiatry