Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder.
Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder.
复制标题
DOI：
10.1177/1362361320945540
复制
发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Cable N
中科院分区：
文献类型：
--
作者：
Hosozawa M;Sacker A;Cable N
这项探索性研究旨在探讨青少年抑郁和自我伤害行为之间的联系以及自闭症谱系障碍的诊断时间。我们分析了来自英国千年队列研究的11，320名14岁奥尔兹的数据，其中包括396名自闭症谱系障碍儿童。暴露是在5岁、7岁、11岁和14岁时由父母报告确认的自闭症谱系障碍的诊断时间。结果是通过简短的情绪和感觉问卷（得分为12分）和自我伤害行为的自我报告来测量抑郁症，两者都在14岁时进行评估。采用多变量回归分析对数据进行分析。91%的自闭症谱系障碍组具有典型范围内的认知能力。在调整了儿童和家庭混杂因素后，诊断年龄和抑郁症之间存在正线性趋势，7岁至11岁之间的儿童和11岁后诊断的儿童表现出症状增加（比值比分别为2.21和3.58）。在自残行为方面也观察到类似的趋势，11岁以后诊断的儿童表现出最强的相关性（比值比= 3.16）。这些结果表明，早期诊断在预防这一人群的继发性心理健康问题方面的重要性，特别是在那些没有认知延迟的人群中。进一步的研究在更广泛的知识范围内复制并澄清潜在的机制是必要的。患有自闭症谱系障碍的儿童患抑郁症和自残行为的风险增加。自闭症谱系障碍的诊断时间是否与青春期的这些后果有关的问题尚未得到研究。这项探索性研究的目的是探讨抑郁症和自我伤害行为在青春期和父母报告的时间诊断自闭症谱系障碍使用一个大的人口为基础的队列在英国之间的关联。在我们的研究中，大多数自闭症谱系障碍儿童具有典型范围内的认知能力。我们发现自闭症谱系障碍诊断的时间与青少年的抑郁和自我伤害行为之间存在线性关联;自闭症谱系障碍的后期诊断，特别是青少年的诊断，与自闭症谱系障碍儿童青少年自我报告的抑郁症状和自我伤害行为的风险增加有关。我们的研究结果，尽管是观察性的，但表明针对自闭症谱系障碍早期诊断的干预措施和改善人与环境适应的方法可能有助于预防这一人群的继发性心理健康问题，特别是那些没有认知延迟和诊断较晚的人群。进一步的研究在更广泛的知识范围内复制并澄清潜在的机制是必要的。
This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the timing of diagnosis for autism spectrum disorder. We analysed data on 11,320 14 year olds, including 396 children with autism spectrum disorder, from the UK Millennium Cohort Study. Exposures were the timing of diagnosis for autism spectrum disorder confirmed by parental report at ages 5, 7, 11 and 14. Outcomes were depression measured by the Short Mood and Feelings Questionnaire (scores ⩾12) and self-report of self-harming behaviour, both assessed at age 14. Data were analysed using multivariable regression analysis. 91% of the autism spectrum disorder group had within-typical-range cognitive ability. After adjusting for child and family confounders, there was a positive linear trend between diagnostic age and depression, with children diagnosed between ages 7 and 11 and children diagnosed after age 11 showing increased symptoms (odds ratio = 2.21 and 3.58, respectively). A similar trend was observed for self-harming behaviour, with children diagnosed after age 11 showing the strongest association (odds ratio = 3.16). These results suggest the importance of earlier diagnosis in preventing secondary mental health problems in this population, particularly among those without cognitive delays. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted. Children with autism spectrum disorder are at increased risk of depression and self-harming behaviours. The question of whether timing of diagnosis of autism spectrum disorder is associated with these consequences in adolescence has not yet been studied. This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the parent-reported timing of diagnosis for autism spectrum disorder using a large population-based cohort in the United Kingdom. Most of the children with autism spectrum disorder in our study had within-typical-range cognitive ability. We found a linear association between timing of autism spectrum disorder diagnosis and depression and self-harming behaviour in adolescence; later diagnosis of autism spectrum disorder, particularly diagnosis in adolescence, was associated with the increased risk of self-reported depressive symptoms and self-harming behaviour in adolescence among children with autism spectrum disorder. Our findings, albeit observational, suggest that interventions targeting the earlier diagnosis of autism spectrum disorder and approaches to improve person–environment fit may help prevent secondary mental health problems in this population, particularly among those without cognitive delays and those diagnosed late. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted.
登录
查看更多内容
影响因子：
6.2
作者：
Moseley, R. L.;Gregory, N. J.;Baron-Cohen, S.
通讯作者：
Baron-Cohen, S.
影响因子：
3.9
作者：
Licence L;Oliver C;Moss J;Richards C
通讯作者：
Richards C
影响因子：
7.2
作者：
Madley-Dowd, Paul;Hughes, Rachael;Heron, Jon
通讯作者：
Heron, Jon
影响因子：
25.8
作者：
Rai, Dheeraj;Culpin, Iryna;Pearson, Rebecca M.
通讯作者：
Pearson, Rebecca M.
影响因子：
7.4
作者：
Hedley, Darren;Uljarevic, Mirko;Trollor, Julian
通讯作者：
Trollor, Julian