Association of Autistic Traits With Depression From Childhood to Age 18 Years
Association of Autistic Traits With Depression From Childhood to Age 18 Years
复制标题
DOI：
10.1001/jamapsychiatry.2018.1323
复制
发表时间：
2018-08-01
期刊：
影响因子：
25.8
通讯作者：
Pearson, Rebecca M.
中科院分区：
文献类型：
--
作者：
Rai, Dheeraj;Culpin, Iryna;Pearson, Rebecca M.
自闭症谱系障碍（ASD）从童年到成年早期的抑郁轨迹的人群为基础的研究是罕见的。遗传混杂和潜在的环境中介（如欺凌）在任何关联中的作用尚不清楚。为了比较患有或不患有ASD和自闭症特征的儿童从10岁到18岁的抑郁症状的轨迹，以评估ASD和自闭症特征与国际疾病统计分类之间的关联，第10次修订版（ICD-10）在18岁时诊断抑郁症，并探讨遗传混杂和欺凌的重要性。设计、环境和参与者对英国布里斯托尔的埃文父母和儿童出生队列纵向研究的参与者进行的纵向研究，随访至18岁。布里斯托。数据分析时间为2017年1月至11月。主要结果和指标采用简明心境和情感问卷（SMFQ）在10至18岁的6个时间点评估抑郁症状。根据ICD-10抑郁症诊断标准，年龄为18岁的患者采用临床访谈时间表修订版进行诊断。暴露是ASD诊断和4个二分法自闭症特征（社交沟通，连贯性，重复行为和社交能力）。使用精神病学基因组学联盟自闭症发现全基因组关联研究总结数据得出自闭症多基因风险评分。欺负在8岁，10岁，13 years.Results的最大样本完整的数据是6091轨迹分析（48.8%的男性）和3168岁的抑郁症诊断分析（44.4%的男性）。在10岁时，患有ASD和自闭症特征的儿童的平均SMFQ抑郁症状评分高于普通人群（例如，社交沟通5.55 [95% CI，5.16-5.95] vs 3.73 [95% CI，3.61-3.85]，ASD 7.31 [95% CI，6.22-8.40] vs 3.94 [95% CI，3.83-4.05]，在18岁之前保持上升趋势（例如，社交7.65 [95% CI，6.92-8.37] vs 6.50 [95% CI，6.29-6.71]，ASD 7.66 [95% CI，5.96-9.35] vs 6.62 [95% CI，6.43-6.81]）。社交障碍与18岁时的抑郁症相关（调整后的相对风险，1.68; 95%CI，1.05-2.70），欺凌解释了这种风险的很大一部分。没有证据表明自闭症多基因风险评分存在混杂因素。在更大的样本分析，使用多重插补导致类似的，但更精确的results.CONCLUSIONS和RELEVANCE ASD和ASD特征的儿童有更高的抑郁症状评分比一般人群的年龄10岁，坚持到18岁，特别是在欺凌的背景下。社交障碍是自闭症患者与抑郁症相关的一个重要特征。欺凌作为一种环境媒介，可以成为干预的目标。
IMPORTANCE Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear.OBJECTIVES To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying.DESIGN, SETTING, AND PARTICIPANTS Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017.MAIN OUTCOMES AND MEASURES Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years.RESULTS The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6.92-8.37] vs 6.50 [95% CI, 6.29-6.71], for ASD 7.66 [95% CI, 5.96-9.35] vs 6.62 [95% CI, 6.43-6.81]). Social communication impairments were associated with depression at age 18 years (adjusted relative risk, 1.68; 95% CI, 1.05-2.70), and bullying explained a substantial proportion of this risk. There was no evidence of confounding by the autism polygenic risk score. Analysis in larger samples using multiple imputation led to similar but more precise results.CONCLUSIONS AND RELEVANCE Children with ASD and ASD traits have higher depressive symptom scores than the general population by age 10 years, which persist to age 18 years, particularly in the context of bullying. Social communication impairments are an important autistic trait in relation to depression. Bullying, as an environmental intermediary, could be a target for interventions.