Subthreshold depressive disorder in adolescents: predictors of escalation to full-syndrome depressive disorders.
Subthreshold depressive disorder in adolescents: predictors of escalation to full-syndrome depressive disorders.
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DOI：
10.1097/chi.0b013e3181a56606
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发表时间：
2009-07
影响因子：
13.3
通讯作者：
Seeley JR
中科院分区：
文献类型：
--
作者：
Klein DN;Shankman SA;Lewinsohn PM;Seeley JR
阈下抑郁障碍是一个最好的建立风险因素的发病全综合征抑郁障碍。然而，许多患有阈下抑郁症的年轻人不会发展为完全综合征抑郁症。我们在一个社区样本中研究了225名患有阈下抑郁障碍的青少年升级为全综合征抑郁障碍的预测因素。阈下抑郁障碍的标准是持续至少1周的抑郁情绪或兴趣或快乐的丧失，以及其他7种DSM-IV相关症状中的至少2种。从青春期中期到30岁，使用半结构化诊断访谈对参与者进行了四次评估。升级为完全综合征抑郁障碍的估计风险为67%。五个变量解释了预测升级的独特方差：抑郁症状的严重程度，医疗条件/症状，自杀意念史，焦虑症史和抑郁症的家庭负荷。有三个或三个以上风险因素的青少年估计有90%的机会升级为完全综合征抑郁症，而风险因素少于三个的青少年则为47%。这些数据可能是有用的，在确定一个亚组的青年与阈下抑郁症谁是在特别高的风险升级到全综合征抑郁症。
Subthreshold depressive disorder is one of the best established risk factors for the onset of full-syndrome depressive disorders. However, many youths with subthreshold depressive disorder do not develop full-syndrome depression. We examined predictors of escalation to full-syndrome depressive disorders in a community sample of 225 adolescents with subthreshold depressive disorder. Criteria for subthreshold depressive disorder were an episode of depressed mood or loss of interest or pleasure lasting at least 1 week and at least two of the seven other DSM-IV-associated symptoms for major depression. Participants were assessed four times from mid-adolescence to age 30 years using semistructured diagnostic interviews. The estimated risk for escalation to full-syndrome depressive disorders was 67%. Five variables accounted for unique variance in predicting escalation: severity of depressive symptoms, medical conditions/symptoms, history of suicidal ideation, history of anxiety disorder, and familial loading for depression. Adolescents with three or more risk factors had an estimated 90% chance of escalating to full-syndrome depressive disorder, compared with 47% of adolescents with fewer than three risk factors. These data may be useful in identifying a subgroup of youths with subthreshold depressive disorder who are at especially high risk for escalating to full-syndrome depressive disorders.