Child-, adolescent- and young adult-onset depressions: differential risk factors in development?
Child-, adolescent- and young adult-onset depressions: differential risk factors in development?
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DOI：
10.1017/s0033291711000675
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发表时间：
2011-11
影响因子：
6.9
通讯作者：
Angold, A.
中科院分区：
文献类型：
--
作者：
Shanahan, L.;Copeland, W. E.;Costello, E. J.;Angold, A.
此前的研究报告称，童年逆境可以预测青少年抑郁症，但不能预测成人抑郁症，但研究混淆了逆境中潜在的真实差异与经历逆境的最近时间的差异。在测试儿童、青少年和青壮年抑郁症之间的差异时，这篇论文考虑了风险的新近。来自大烟山研究的两个队列(N=1004)的每个受试者使用了多达九波数据，涵盖了社区中9-16岁、19岁和21岁的儿童。9-16岁的青少年和他们的一位父母接受了儿童和青少年精神病学评估的访问；这些年轻人在19岁和21岁时接受了青年成人精神病学评估的访问。评估了抑郁症最常见的心理社会危险因素：贫困、生活事件、父母的精神病理、虐待和家庭功能障碍。与以前的研究一致，大多数儿童时期的心理社会危险因素与儿童发病的关系比与青少年/成人起病的抑郁症更密切。当抑郁发病组之间潜在的真实风险差异从近期风险差异中解脱出来时，儿童和年轻人发病的抑郁症不再彼此不同。青春期起病的抑郁症与很少的心理社会危险因素有关。当考虑到风险的近期时，儿童和青壮年起病的抑郁症之间的假定危险因素没有差异。青春期起病的抑郁症与很少的心理社会危险因素有关。有可能一些青春期起病的抑郁症病例在风险方面与儿童和青壮年起病的抑郁症不同。
Previous research reported that childhood adversity predicts juvenile- but not adult-onset depression, but studies confounded potentially genuine differences in adversity with differences in the recency with which adversity was experienced. This paper took into account the recency of risk when testing for differences among child-, adolescent-, and young-adult-onset depressions. Up to nine waves of data were used per subject from two cohorts of the Great Smoky Mountains Study (N = 1,004), covering children in the community ages 9–16, 19, and 21 years. Youth and one of their parents were interviewed using the Child and Adolescent Psychiatric Assessment between ages 9–16; these same youth were interviewed using the Young Adult Psychiatric Assessment at ages 19 and 21. The most common psychosocial risk factors for depression were assessed: poverty, life events, parental psychopathology, maltreatment, and family dysfunction. Consistent with previous research, most childhood psychosocial risk factors were more strongly associated with child-onset than with adolescent-/adult-onset depression. When potentially genuine risk differences among the depression-onset groups were disentangled from differences due to the recency of risk, child- and young adult-onset depression were no longer different from one another. Adolescent-onset depression was associated with few psychosocial risk factors. There were no differences in putative risk factors between child- and young adult-onset depression when the recency of risk was taken into account. Adolescent-onset depression was associated with few psychosocial risk factors. It is possible that some adolescent-onset depression cases differ in terms of risk from child- and young adult-onset depression.