Association Between Changes in Caregiver Depressive Symptoms and Child Attention-Deficit/Hyperactivity Disorder Symptoms.
Association Between Changes in Caregiver Depressive Symptoms and Child Attention-Deficit/Hyperactivity Disorder Symptoms.
复制标题
照顾者抑郁症状的变化与儿童注意力缺陷/多动症症状之间的关联。
DOI：
10.1097/dbp.0000000000000562
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Silverstein,Michael
中科院分区：
文献类型：
--
作者：
Walls,Morgan;Cabral,Howard;Feinberg,Emily;Silverstein,Michael
目的：注意力缺陷多动障碍（ADHD）儿童的照顾者中抑郁症的患病率很高。我们研究了照顾者抑郁症状轨迹和儿童ADHD symptoms.Methods的变化之间的关联：我们分析了2 ADHD护理管理系统的6至12岁的儿童和他们的照顾者（n= 156二分）的随机试验的数据。儿童ADHD症状使用Swanson，Nolan和Pelham评定量表（SNAP-IV）进行测量。使用抑郁症状快速量表（QIDS）测量照顾者的抑郁症状。在基线、6个月和12个月时评估测量结果。我们使用多变量模型来检验照顾者抑郁症状变化与儿童ADHD症状变化之间的相关性。结果：从基线到12个月，与抑郁症状没有改变（变化分数：-0.97）或恶化（变化分数：-0.23，p= 0.003）的儿童相比，抑郁症状改善的照顾者的儿童SNAP-IV评分（变化分数：-1.43）显著降低。在调整后的模型中，改善的照顾者抑郁症状与12个月内SNAP-IV评分的大幅降低相关。与那些抑郁症状恶化的儿童相比，那些抑郁症状没有显着变化的儿童有-0.78分（95%置信区间[CI]：-1.40至-0.17）SNAP-IV评分的下降幅度更大，而那些照顾者抑郁症状改善的儿童SNAP-IV评分的下降幅度更大-1.31分（95% CI：-1.97至-0.66）。考虑到照顾者抑郁症状和儿童ADHD症状轨迹之间的纵向关联，针对家庭单位行为健康需求的干预措施可能为城市ADHD儿童提供希望。
Objective:Depression is highly prevalent among caregivers of children with attention-deficit/hyperactivity disorder (ADHD). We examined the association between caregiver depressive symptom trajectories and changes in child ADHD symptoms.Methods:We analyzed data from a randomized trial of 2 ADHD care management systems for children aged 6 to 12 years and their caregivers (n= 156 dyads). Child ADHD symptoms were measured using the Swanson, Nolan, and Pelham rating scale (SNAP-IV). Caregiver depressive symptoms were measured using the Quick Inventory of Depressive Symptomatology (QIDS). Measures were assessed at baseline, 6 months, and 12 months. We used multivariable models to examine associations between changes in caregiver depressive symptoms and changes in child ADHD symptoms.Results:From baseline to 12 months, children of caregivers with improved depressive symptoms had significantly greater reductions in SNAP-IV scores (change score:− 1.43) compared with those whose depressive symptoms did not change (change score:− 0.97) or worsened (change score:− 0.23, p= 0.003). In adjusted models, improved caregiver depressive symptoms were associated with greater reductions in SNAP-IV scores over the 12-month period. Compared with those with worsening caregiver depressive symptoms, children whose caregivers showed no significant changes in depressive symptoms had a− 0.78 point (95% confidence interval [CI]:− 1.40 to− 0.17) greater reduction in the SNAP-IV score, and those children whose caregiver depressive symptoms improved had a− 1.31 point greater reduction in the SNAP-IV score (95% CI:− 1.97 to− 0.66).Conclusion:Given the longitudinal association between caregiver depressive symptom and child ADHD symptom trajectories, interventions that address the behavioral health needs of the family unit may offer promise for urban children with ADHD.