Williamson Douglas E, Birmaher Boris, Axelson David A, Ryan Neal D, Dahl Ronald E
Department of Child and Adolescent Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
J Am Acad Child Adolesc Psychiatry. 2004 Mar;43(3):291-7. doi: 10.1097/00004583-200403000-00010.
To examine the development of first-onset major depressive disorder (MDD) in children at high and low familial risk for depression in a prospective study.
High-risk children (n = 76) who were free of any lifetime affective disorder and had at least one first-degree and one second-degree relative with a lifetime history of childhood-onset, recurrent, bipolar, or psychotic depression were included. Low-risk children (n = 63) were included if they were free of any lifetime psychiatric disorder and had no first-degree relatives and fewer than 20% of their second-degree relatives with a lifetime affective disorder. Children and their parents were assessed in a prospective design using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version (K-SADS-E). The average interval between follow-up interviews was 18 months, and the average follow-up period was 6 years.
High-risk children had approximately a threefold increased risk of developing first-onset MDD compared with low-risk children (odds ratio = 3.21). The average age of new-onset MDD was 14.0 +/- 2.9 years (range 9.5-19.5 years). Above and beyond the familial loading for MDD, mother's lifetime anxiety disorder (odds ratio = 2.84) and lifetime behavioral disorder (odds ratio = 3.25) in the child significantly added to the risk of developing a first-onset MDD.
Having high familial loading for affective disorders, a mother with and anxiety disorder, and a behavioral disorder in the child all significantly contributed to the risk of developing depression.
在一项前瞻性研究中，考察抑郁症家族风险高和低的儿童首次发作重度抑郁症（MDD）的发展情况。
纳入高危儿童（n = 76），这些儿童既往无任何情感障碍，且至少有一位一级亲属和一位二级亲属有儿童期起病、复发性、双相或精神病性抑郁症的终生病史。低危儿童（n = 63）若既往无任何精神障碍，且无一级亲属，二级亲属中患情感障碍的比例低于20%，则纳入研究。采用学龄儿童情感障碍和精神分裂症量表-流行病学版（K-SADS-E），以前瞻性设计对儿童及其父母进行评估。随访访谈的平均间隔时间为18个月，平均随访期为6年。
与低危儿童相比，高危儿童首次发作MDD的风险增加了约三倍（优势比 = 3.21）。新发MDD的平均年龄为14.0±2.9岁（范围9.5 - 19.5岁）。除了MDD的家族负荷外，儿童母亲的终生焦虑障碍（优势比 = 2.84）和终生行为障碍（优势比 = 3.25）显著增加了首次发作MDD的风险。
情感障碍家族负荷高、母亲患有焦虑障碍以及儿童患有行为障碍均显著增加了患抑郁症的风险。
