Comorbid Anxiety and Depressive Symptoms in Children and Adolescents: A Systematic Review and Analysis.
Comorbid Anxiety and Depressive Symptoms in Children and Adolescents: A Systematic Review and Analysis.
复制标题
儿童和青少年的合并焦虑和抑郁症状：系统评价和分析。
DOI：
10.1097/pra.0000000000000132
复制
发表时间：
2016-03
影响因子：
1.9
通讯作者：
McClintock SM
中科院分区：
文献类型：
--
作者：
Melton TH;Croarkin PE;Strawn JR;McClintock SM
一大批广泛的研究考察了成年人的焦虑和抑郁共病。儿童和青少年也经常出现焦虑和抑郁的共病；然而，研究和治疗需要儿童独特的环境和神经发育考虑。因此，我们对儿童和青少年共患焦虑和抑郁的理解是有限的。这项系统性综述的目的是检查目前有关儿童和青少年焦虑和抑郁共病的文献。综述包括理论概念化以及诊断、神经生物学、预防和治疗方面的考虑。此外，还提出了一种治疗儿童/青少年共病焦虑和抑郁的算法。这项系统的文献综述包括在Ovid SP Medline、精神病信息和Pubmed上的三个独立搜索。这篇综述包括并综合了1987至2015年间发表的115篇文章。现有证据表明，焦虑和抑郁在儿童和青少年的临床人群中很常见，而儿童和青少年的共病可能被低估。与单独患有任何一种疾病的儿童和青少年相比，患有焦虑和抑郁的儿童和青少年具有独特的表现、更严重的症状和治疗阻力。对于这一人群的诊断策略和治疗的未来发展，一个维度的方法可能是必要的。新的神经成像研究表明，焦虑和抑郁各自代表着一种不同的神经生物学表型。目前可用的文献表明，焦虑和抑郁并存是儿童和青少年的常见表现。这张诊断性图片强调了综合维度评估和多模式循证方法的重要性，因为疾病严重程度很高。这些常见临床疾病的神经生物学和治疗方面的未来研究是有必要的。
A large and extensive body of research has examined comorbid anxiety and depression in adults. Children and adolescents also frequently present with comorbid anxiety and depression; however, research and treatment require unique environmental and neurodevelopmental considerations in children. As a result, our understanding of comorbid anxiety and depression in children and adolescents is limited. The goal of this systematic review was to examine current literature focused on comorbid anxiety and depression in children and adolescents. The review included theoretical conceptualizations as well as diagnostic, neurobiologic, prevention, and treatment considerations. In addition, a proposed algorithm for the treatment of comorbid anxiety and depression in children/adolescents is provided. This systematic literature review included three discrete searches in Ovid SP Medline, PsychInfo, and Pubmed. The review included and synthesized 115 articles published between 1987 and 2015. The available evidence suggests that anxiety and depression are common in clinical populations of children and adolescents, and that comorbidity is likely underestimated in children and adolescents. Children and adolescents with comorbid anxiety and depression have unique presentations, greater symptom severity, and treatment resistance compared with those who have either disease in isolation. A dimensional approach may be necessary for the future development of diagnostic strategies and treatments for this population. Nascent neuroimaging work suggests that anxiety and depression each represents a distinct neurobiological phenotype. The literature that is currently available suggests that comorbid anxiety and depression is a common presentation in children and adolescents. This diagnostic picture underscores the importance of comprehensive dimensional assessments and multimodal evidence-based approaches given high disease severity. Future research on the neurobiology and treatment of these common clinical conditions is warranted.