Separation anxiety disorder in childhood as a risk factor for future mental illness
Separation anxiety disorder in childhood as a risk factor for future mental illness
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DOI：
10.1097/chi.0b013e31816765e7
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发表时间：
2008-05-01
影响因子：
13.3
通讯作者：
Joiner, Thomas E., Jr.
中科院分区：
文献类型：
--
作者：
Lewinsohn, Peter M.;Holm-Denoma, Jill M.;Joiner, Thomas E., Jr.
目的：探讨儿童分离焦虑障碍（SAD）对成年早期（19-30岁）精神病理发展的影响程度。方法：采用俄勒冈州青少年抑郁项目参与者的一个子集（n = 816）。受试者在16岁时提供终生精神疾病（包括SAD）和当前精神疾病的回顾性报告，然后进行前瞻性随访，直到30岁。诊断评估在青春期进行两次，在24岁和30岁时再次进行。根据儿童/青少年时期的诊断，将受试者分为四个正交组：SAD (n = 42)，其他焦虑症（n = 88），异质性精神障碍对照组（n = 389）和非精神疾病对照组（n = 297）。调整与群体状态显著相关的人口统计学变量和19岁前的共病性疾病，用分层多元逻辑回归分析结果。结果：SAD是青年期发生精神障碍的一个重要危险因素（78.6%）。主要的弱点是恐慌症和抑郁症。结论：由于SAD是青年期精神障碍的主要易感性，临床医生应该对SAD的存在保持敏感，患有SAD的儿童和青少年应该接受治疗。未来的研究应该评估在儿童/青少年时期成功治疗SAD和/或提供预防性干预是否能降低未来精神病理的风险。
Objective: To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30). Method: A Subset of the participants of the Oregon Adolescent Depression Project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and concurrent reports of current mental illness at age 16 and were then followed prospectively until age 30. Diagnostic assessments were conducted twice during adolescence and again at ages 24 and 30. Based on diagnosis during childhood/adolescence, the subjects were partitioned into four orthogonal groups: SAD (n = 42), other anxiety disorders (n = 88), a heterogeneous psychiatric disorders control group (n = 389), and a not mentally ill control group (n = 297). Adjusting for demographic variables that were significantly associated with group status and for comorbid disorders prior to age 19, the results were analyzed with hierarchical multiple logistic regression. Results: SAD was a strong (78.6%) risk factor for the development of mental disorders during young adulthood. The major vulnerabilities were for panic disorder and depression. Conclusions: Because SAD creates a major vulnerability for mental disorders during young adulthood, clinicians should be sensitive to the presence of SAD, and children and adolescents with SAD should be treated. Future research should evaluate whether successful treatment of SAD and/or the provision of a preventive intervention during childhood/adolescence reduce the risk for future psychopathology.