Methodological complexities in the diagnosis of major depression in youth: An analysis of mother and youth self-reports
Methodological complexities in the diagnosis of major depression in youth: An analysis of mother and youth self-reports
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DOI：
10.1089/104454601317261573
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发表时间：
2001-12-01
影响因子：
1.9
通讯作者：
Faraone, SV
中科院分区：
文献类型：
--
作者：
Braaten, EB;Biederman, J;Faraone, SV
目的：考虑到青年和父母报告之间关于重性抑郁症（MDD）诊断的一致性水平较低，临床研究中不一致的青年和父母报告的信息性仍然存在不确定性。为此，我们评估是否发病率和功能相关的诊断，抑郁症在青年中的不同informant source.Methods：样本包括186对独立评估的母亲和青年自我报告的诊断，抑郁症的结构化诊断访谈中确定的一个大型研究，青年和没有注意缺陷多动障碍的两种性别。受试者也进行了评估的措施，人际关系，学校和家庭功能，以及以前的治疗history.Results：MDD的诊断认可的青年自我报告，只有当与母亲的报告相比，其特点是显着：发作持续时间较短，发病年龄较晚，抑郁相关损害较轻，人际功能损害较少，合并症发生率较低，并且降低了接受任何抑郁症治疗的可能性。与MDD相关的发病率和功能障碍因信息来源而异，并且遵循剂量-反应关联，其中与青年和母亲同时报告相关的发病率最高，其次是母亲单独报告，当仅由青年认可时发病率和功能障碍最少。这些研究结果表明，完全依赖于青少年自我报告可能会发现一种轻度的抑郁症与有限的发病率和残疾相比，由父母的报告。
Objective: Considering the well-documented low level of agreement between youth and parent reports on the diagnosis of major depressive disorder (MDD), uncertainties remain as to the informativeness of discrepant youth and parent reports in clinical studies. To this end we evaluated whether morbidity and functional correlates on the diagnosis of MDD in youth vary by informant source.Methods: The sample consisted of 186 pairs of independently assessed mother and youth self-reports on the diagnosis of MDD using structured diagnostic interviews ascertained in a large study of youth with and without attention deficit hyperactivity disorder of both genders. Subjects were also assessed on measures of interpersonal, school, and family functioning as well as prior treatment history.Results: The diagnosis of MDD endorsed by youth self-report only when compared with that reported by the mother was characterized by significantly: shorter duration episode, later age at onset, milder depression-associated impairment, less impairment in interpersonal functioning, lower rates of comorbid disorders, and decreased likelihood to receive any course of treatment for depression. The morbidity and dysfunction associated with MDD varied significantly by informant source, and followed a dose-response association with the highest morbidity associated with the concurrent reports of the youth and the mothers, followed by mother report alone, with the least morbidity and dysfunction when endorsed by youth alone.Conclusions: These findings suggest that exclusive reliance on youth self-reports may identify a mild form of depression associated with limited morbidity and disability compared with that identified by parental reports.