Association of Interparental Violence and Maternal Depression With Depression Among Adolescents at the Population and Individual Level.
Association of Interparental Violence and Maternal Depression With Depression Among Adolescents at the Population and Individual Level.
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DOI：
10.1001/jamanetworkopen.2023.1175
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发表时间：
2023-03-01
影响因子：
13.8
通讯作者：
中科院分区：
文献类型：
--
作者：
在人群和个体水平上，儿童期暴露于父母亲密伴侣暴力（IPV）和/或母亲抑郁与18岁时的抑郁症相关吗？在这项队列研究中，对1991年至1992年出生于英格兰西南部埃文地区的5029名儿童进行了研究，儿童期暴露于IPV或母亲抑郁症与18岁时患严重抑郁症的风险增加24%至68%相关。仅仅根据父母的IPV或母亲的抑郁症的信息来估计一个人在青春期患上抑郁症是很差的。预防IPV和孕产妇抑郁症可以改善儿童的心理健康在人口水平;然而，筛查儿童的孕产妇抑郁症和IPV的目标干预措施，以防止青少年抑郁症不会确定许多儿童谁可能受益，并可能不必要地针对许多其他人谁不会发展抑郁症。这项队列研究探讨了在人口和个人层面上，12岁之前经历父母亲密伴侣暴力和/或母亲抑郁症与18岁时抑郁症的相关程度。父母亲密伴侣暴力（IPV）和母亲抑郁症与儿童抑郁症风险增加有关。然而，目前还不知道是否有关于这些经验的信息可以准确地识别出个别儿童患抑郁症的风险较高。研究在人群和个体水平上，12岁之前经历父母IPV和/或母亲抑郁与18岁时抑郁的相关程度。这项队列研究使用了来自雅芳父母和儿童纵向研究的数据，这是一项基于英国人口的出生队列研究，最初招募了1991年和1992年预计预产期的孕妇。本研究中使用的数据收集自1991年至2009年。数据分析于2022年2月至3月进行。母亲报告的父母IPV进行了8次评估（儿童年龄，1-11岁）。通过爱丁堡产后抑郁量表或母亲服用抑郁症药物（由母亲报告8次（儿童年龄，2-12岁））评估母亲抑郁症。当孩子18岁时，用简短的情绪和感觉问卷（SMFQ）和临床访谈计划修订版（CIS-R）测量抑郁症状。抑郁症病例的二元指标是SMFQ的11分或以上和CIS-R的12分或以上的截止点。该研究包括5029名18岁时出现抑郁症状的儿童（2862名女孩[56.9%]; 2167名男孩[43.1%]）。IPV仅与24%的（调整后的风险比，1.24; 95%CI，0.97-1.59）18岁时抑郁症的风险较高，仅暴露于母亲抑郁症与35%的（调整后的风险比，1.35; 95%CI，1.11-1.64）更高的风险，并暴露于IPV和母亲抑郁症与68%（调整后的风险比，1.68; 95% CI，1.34-2.10）风险较高。在个人水平上，受试者操作特征曲线下面积为0.58（95% CI，0.55-0.60）根据SMFQ的抑郁症和0.59（95% CI，0.55-0.62），表明58%-59%的概率（即，8%-9%以上的机会），一个随机参与者与抑郁症在18岁已暴露于IPV和/或母亲抑郁症相比，随机参与者谁没有抑郁症。在这项队列研究中，父母IPV和母亲抑郁症与青少年抑郁症在人口水平。然而，估计一个人在青春期发展抑郁症的基础上，只有IPV或母亲抑郁症的信息是穷人。筛查儿童的母亲抑郁症和IPV的目标干预措施，以防止青少年抑郁症将无法确定许多儿童谁可能受益，并可能不必要地针对许多其他人谁不发展抑郁症。
Is exposure to parental intimate partner violence (IPV) and/or maternal depression during childhood associated with depression at age 18 years at the population and individual level? In this cohort study of 5029 children born in 1991 to 1992 in the Avon region of southwest England, exposure to IPV or maternal depression in childhood was associated with 24% to 68% higher risk of having severe depressive symptoms at age 18 years. The estimation of an individual developing depression in adolescence based solely on information about parental IPV or maternal depression is poor. Prevention of IPV and maternal depression can improve children’s mental health at the population level; however, screening children for maternal depression and IPV to target interventions to prevent adolescent depression will not identify many children who might benefit and may unnecessarily target many others who will not develop depression. This cohort study examines the extent to which experiencing parental intimate partner violence and/or maternal depression before age 12 years is associated with depression at age 18 years at the population and individual level. Parental intimate partner violence (IPV) and maternal depression are associated with increased risk of depression in children at the population level. However, it is not known whether having information about these experiences can accurately identify individual children at higher risk of depression. To examine the extent to which experiencing parental IPV and/or maternal depression before age 12 years is associated with depression at age 18 years at the population and individual level. This cohort study used data from the Avon Longitudinal Study of Parents and Children, a UK population-based birth cohort, which initially recruited pregnant mothers with estimated due dates in 1991 and 1992. Data used in this study were collected from 1991 to 2009. Data analysis was performed from February to March 2022. Mother-reported parental IPV was assessed on 8 occasions (child age, 1-11 years). Maternal depression was assessed via the Edinburgh Postnatal Depression Scale or by the mother taking medication for depression, as reported by the mother on 8 occasions (child age, 2-12 years). Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) and Clinical Interview Schedule–Revised (CIS-R) when the child was aged 18 years. Binary indicators of a case of depression were derived the cutoff point of 11 points or above for the SMFQ and 12 points or above for the CIS-R. The study included 5029 children (2862 girls [56.9%]; 2167 boys [43.1%]) with a measure of depressive symptoms at age 18 years. IPV only was associated with a 24% (adjusted risk ratio, 1.24; 95% CI, 0.97-1.59) higher risk of depression at age 18 years, exposure to maternal depression only was associated with a 35% (adjusted risk ratio, 1.35; 95% CI, 1.11-1.64) higher risk, and exposure to both IPV and maternal depression was associated with a 68% (adjusted risk ratio, 1.68; 95% CI, 1.34-2.10) higher risk. At the individual level, the area under the receiver operating characteristic curve was 0.58 (95% CI, 0.55-0.60) for depression according to the SMFQ and 0.59 (95% CI, 0.55-0.62) for the CIS-R, indicating a 58% to 59% probability (ie, 8%-9% above chance) that a random participant with depression at age 18 years had been exposed to IPV and/or maternal depression compared with a random participant who did not have depression. In this cohort study, parental IPV and maternal depression were associated with depression in adolescence at the population level. However, estimation of an individual developing depression in adolescence based only on information about IPV or maternal depression is poor. Screening children for maternal depression and IPV to target interventions to prevent adolescent depression will fail to identify many children who might benefit and may unnecessarily target many others who do not develop depression.
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DOI：
10.1136/bmj.b2393
发表时间：
2009-06-29
期刊：
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影响因子：
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影响因子：
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