National Comorbidity Survey - Replication (NCS-R)

全国合并症调查 - 复制 (NCS-R)

• 批准号: 8556940
• 负责人: kathleen r merikangas
• 金额: $ 8.59万
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8556940
• 关键词: Address; Adolescent; Adult; Adverse event; Age; American; Biological; Cardiovascular Diseases; Childhood; Comorbidity; DSM-IV; Desire for food; Diagnostic and Statistical Manual; Disease; Early treatment; Etiology; Fatigue; Future; Heterogeneity; Household; Knowledge; Link; Major Depressive Disorder; Mental Depression; Mental Health; Mental disorders; Migraine; Mood Disorders; Outcome; Pathway interactions; Pattern; Prevalence; Prevention; Probability; Psyche structure; Psychopathology; Public Health; Research; Risk Factors; Sampling; Severities; Sleep; Source; Structure; Surveys; Symptoms; Weight; Youth; comparative; depressive symptoms; disease classification; disorder subtype; hypomania; insight; neglect; novel; population based; programs; social; treatment response; young adult

During the past year, we have investigated the structure of depression observed in adults (NCS-R) and adolescents (NCS-A) and found highly similar classes and probabilities across adults and youth, with greater complexity in structure among adults than in adolescents. The subtypes identified in these analyses suggest that both symptom patterns and severity of depressive symptoms are sources of heterogeneity in major depressive disorder. We have also examined the associations between both maternal and paternal psychopathology and subtypes of neglect, assessed the associations between subtypes of neglect subtypes and lifetime DSM-IV disorders in adults, and evaluated the independent associations between neglect and psychopathology after adjustment for parental psychopathology, other adverse experiences, recall bias, and social and demographic correlates. We found that childhood supervisory neglect is associated with negative mental health outcomes among exposed youth, independent of other demographic and familial risk factors. Furthermore, both paternal and maternal psychopathology demonstrated significant associations with neglect subtypes. These findings highlight the importance of neglect in characterizing childhood adversity, and demonstrate the importance of a broader conceptualization of childhood risk factors for adult psychopathology (Heaton et al, under review). Public Health Impact: These findings have provided novel knowledge on comparability of the structure of major depressive disorder in adults and adolescents. The central importance of symptoms that are somatic in quality (such as changes in appetite, weight, sleep and fatigue) in discriminating depressive subtypes has major implications for our understanding of the biologic pathways, treatment and opportunities for prevention of the consequences of this major public health problem in American youth. The findings have also made contribution to the nosology of depression, and provided support for retention of atypical specifier in the new DSM-5 by demonstrating its distinct biological correlates and treatment response. The strong links we found between neglect and long standing psychiatric disorders have provided insights on importance of early intervention. Expansion of empirical inquiry into the associations between paternal, as well as maternal, risk factors and neglect in population based samples may provide advancements in both etiology and prevention. Future Plans: Our efforts on the NCS-R as an independent project have been significantly reduced over the past year, since the analyses of the most relevant topics to our research programs have been completed. However, we plan to keep using this rich nationally representative sample to conduct comparative analyses of symptom patterns, correlates and consequences of disorders shown in our parallel adolescent sample.

在过去的一年里，我们调查了在成年人(NCS-R)和青少年(NCS-A)中观察到的抑郁症的结构，发现成年人和青少年的抑郁类别和概率非常相似，成年人的结构比青少年的结构更复杂。这些分析中确定的亚型表明，症状模式和抑郁症状的严重程度都是严重抑郁障碍的异质性的来源。我们还检查了母亲和父亲的精神病理与忽视亚型之间的联系，评估了成人忽视亚型与终生DSM-IV障碍之间的联系，并在调整了父母的精神病理学、其他不良经历、回忆偏差以及社会和人口相关因素后，评估了忽视与精神病理学之间的独立联系。我们发现，在暴露的青少年中，童年监督忽视与消极的心理健康结果有关，与其他人口统计学和家庭危险因素无关。此外，父亲和母亲的精神病理学都显示出与忽视亚型的显著关联。这些发现突出了忽视在表征儿童逆境方面的重要性，并证明了对儿童风险因素进行更广泛的概念化对成人精神病理学的重要性(Heaton等人，正在审查中)。 公共卫生影响： 这些发现为成人和青少年主要抑郁障碍的结构可比性提供了新的知识。躯体症状(如食欲、体重、睡眠和疲劳的变化)在区分抑郁亚型方面的核心重要性，对于我们理解这一重大公共卫生问题在美国青年中的生物途径、治疗和预防后果的机会具有重要意义。这些发现也为抑郁症的病因学做出了贡献，并通过展示其独特的生物学相关性和治疗反应，为在新的DSM-5中保留非典型说明符提供了支持。我们发现忽视与长期存在的精神障碍之间存在着强烈的联系，这为早期干预的重要性提供了见解。在以人群为基础的样本中，扩大对父亲和母亲风险因素与忽视之间关系的实证调查，可能会在病因和预防方面提供进展。 未来计划： 在过去的一年里，我们在作为一个独立项目的NCS-R上的努力已经大大减少，因为对与我们研究计划最相关的主题的分析已经完成。然而，我们计划继续使用这个丰富的具有全国代表性的样本来对我们平行的青少年样本中显示的障碍的症状模式、相关性和后果进行比较分析。