Parental 'affectionless control' in adolescent depressive disorder
Parental 'affectionless control' in adolescent depressive disorder
复制标题
DOI：
10.1007/s001270170011
复制
发表时间：
2001-10-01
影响因子：
4.4
通讯作者：
Wolfe, R
中科院分区：
文献类型：
--
作者：
Patton, GC;Coffey, C;Wolfe, R
背景：患有抑郁症的成年人报告儿童期产妇护理次优率很高。尽管在生命早期与父母的关系更为突出，但在青少年发病障碍中，父母教养方式的关系尚未得到系统研究。方法：对2032名澳大利亚中学生进行了为期3年的青少年健康研究，为开展早发性抑郁症的两阶段研究提供了机会。在第2波到第6波之间，使用自我管理的计算机形式的修订临床访谈表（CIS-R）来生成ICD-10抑郁发作的第一阶段诊断。每个有CIS-R定义的抑郁发作的受试者与每个学校的两名CIS-R非病例受试者一起被选中进行第二阶段评估。第二阶段的评估包括使用综合国际诊断访谈（CIDI）的抑郁和轻躁模块的第二次诊断评估和使用父母结合工具的父亲和母亲风格评估。结果：2032名受试者中有1947名（95.8%）至少参加过一次队列研究（第一阶段）；435名入选受试者中有406名（94%）完成了第二阶段的评估。119名受试者在CIS-R的一个或多个波中符合抑郁发作的标准。在30个月的研究期间，69名受试者（10名男性，59名女性）在同一波同时满足CIS-R和CIDI对抑郁症的定义，并被归类为“明确的抑郁症”。母亲和父亲的低护理与抑郁症的两种定义都有独立的联系，在报告护理最低的四分位数中，影响最明显。在调整了低父母照顾后，高父母控制与抑郁之间的关联很小。结论：次优养育方式与青少年抑郁障碍相关。母亲和父亲的照顾不足与抑郁症的发病率高出两到三倍有关。这些发现与次优养育方式对发病的影响而不是对疾病病程的影响是一致的。不理想的养育方式是否与青少年以外的抑郁发病风险有关还有待澄清。
Background: Adults with depressive disorder report high rates of sub-optimal maternal care in childhood. Despite the greater salience of relationships with parents earlier in life, associations with parenting style have not yet been systematically studied in adolescent onset disorder. Methods: A six-wave, 3-year study of adolescent health in 2032 Australian secondary school students provided an opportunity to undertake a two-phase study of early onset depression. Between waves 2 to 6, a self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used to generate a first phase diagnosis of ICD-10 depressive episode. Each subject with a CIS-R-defined depressive episode was selected for second phase assessment together with two subjects from the CIS-R non-cases in each school. Second phase assessment included a second diagnostic assessment using the depression and hypomania modules of the Composite International Diagnostic Interview (CIDI) and assessment of paternal and maternal style using the Parental Bonding Instrument. Results: A total of 1947 out of 2032 subjects in the sampling frame (95.8%) participated in the cohort study (phase 1) at least once; 406 (94%) of the 435 selected subjects completed second phase assessment. One hundred and nineteen subjects fulfilled criteria for depressive episode on the CIS-R at one or more waves. Over the 30-month study period, 69 subjects (10 male, 59 female) fulfilled both CIS-R and CIDI definitions of depression at the same wave and were classified as 'definite depressive disorder'. Low maternal and paternal care held independent associations with both definitions of depression, with the effects clearest in those in the lowest quartile of reported care. After adjusting for low parental care, the associations between high parental control and depression were small. Conclusions: Sub-optimal parenting is associated with depressive disorder in adolescents. Low maternal and paternal care are each associated with a two- to three-fold higher rate of depressive disorder. These findings are consistent with an effect of sub-optimal parenting on the onset rather than course of disorder. Whether sub-optimal parenting is associated with a risk for the onset of depression outside the adolescent years has yet to be clarified.