Cognitive impairment as a mediator in the developmental pathway from infant malnutrition to adolescent depressive symptoms in Barbadian youth.
Cognitive impairment as a mediator in the developmental pathway from infant malnutrition to adolescent depressive symptoms in Barbadian youth.
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DOI：
10.1097/dbp.0b013e31820b7707
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发表时间：
2011-04
期刊：
影响因子：
--
通讯作者：
Galler JR
中科院分区：
文献类型：
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作者：
Waber DP;Eaglesfield D;Fitzmaurice GM;Bryce C;Harrison RH;Galler JR
抑郁症状在早年经历过严重营养不良的青少年中有所增加。早期营养不良也可能对认知功能产生重大影响，这可能是由于营养不良对非常年轻的大脑产生不利影响。在一个发展级联模型的背景下，我们测试的假设，早期营养不良和青少年抑郁症状之间的关联是介导的认知障碍，enveloped从营养不良。我们纵向评估了巴巴多斯青年（N=57）在生命的第一年因中度至重度蛋白质-能量营养不良住院，健康对照组（N=60）。主要假设通过多元回归模型进行检验。校正协变量后，早期营养不良可预测儿童期认知功能（智商，p<0.001;注意力问题，p<0.01;普通入学考试，p<0.01）和青少年抑郁症状（p<0.05）。儿童期认知功能介导了早期营养不良和青春期抑郁症状之间的关联（p<0.001）。母亲抑郁症状是青少年抑郁症状的独立预测因子（p<0.05）。儿童期认知障碍间接导致先前营养不良的青少年抑郁症状升高，与发展级联模型一致。营养不良和青春期抑郁症状之间的直接联系很小。
Depressive symptoms are elevated in adolescents who experienced significant malnutrition early in life. Early malnutrition can also have a significant impact on cognitive functioning, presumably due to the adverse impact of the malnutrition on the very young brain. In the context of a developmental cascade model, we tested the hypothesis that the association between early malnutrition and adolescent depressive symptoms is mediated by the cognitive impairment that ensues from the malnutrition. We evaluated Barbadian youth (N=57) hospitalized for moderate to severe protein-energy malnutrition in the first year of life and healthy controls (N=60) longitudinally. The primary hypothesis was tested by multiple regression models. After adjusting for covariates, early malnutrition predicted both cognitive functioning in childhood (IQ, p<0.001; attention problems, p<.01; Common Entrance Examination, p<0.01) and adolescent depressive symptoms (p<0.05). Childhood cognitive functioning mediated the association between early malnutrition and depressive symptoms in adolescence (p<0.001). Maternal depressive symptoms were a significant but independent predictor of adolescent depressive symptoms (p<0.05). Cognitive compromise in childhood accounts indirectly for elevated depressive symptoms in previously malnourished adolescents, consistent with a developmental cascade model. The direct link between malnutrition and depressive symptoms in adolescence is small.