Birmaher Boris, Bridge Jeffrey A, Williamson Douglas E, Brent David A, Dahl Ronald E, Axelson David A, Dorn Lorah D, Ryan Neal D
Department of Child Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh PA 15213, USA.
J Am Acad Child Adolesc Psychiatry. 2004 Jul;43(7):839-46. doi: 10.1097/01.chi.0000128787.88201.1b.
To compare the psychosocial functioning of children and adolescents at high risk of major depressive disorder with youths with acute major depressive disorder and healthy controls.
High-risk (n = 57), major depressive disorder (n = 71), and healthy control (n = 48) youths and their families were recruited from 1987 to 1996 and assessed for psychopathology using standardized instruments. Except for 16 children who had disruptive disorders, the high-risk children were free of psychopathology. A parent completed the Psychosocial Schedule to evaluate the mother-child, father-child, marital relationships, and child-friend relationships and the child's school performance.
Overall, high-risk and healthy controls had similar psychosocial functioning. Marital relationships were worse in the high-risk children with psychopathology. Youths with major depressive disorder had significantly more psychosocial problems and school difficulties than those at high risk and healthy controls in most domains measured. Controlling for age, pubertal stage, race, sex, family composition, current and lifetime parental depression, and current and lifetime parental nonmood psychopathology yielded similar results.
The family and peer interactions of high-risk youths were similar to the interactions of healthy controls. Although family dysfunctional patterns seem to mainly depend on the child's depressive symptoms, longitudinal studies are needed to establish causality.
比较有重度抑郁症高风险的儿童和青少年与患有急性重度抑郁症的青少年以及健康对照组在心理社会功能方面的差异。
1987年至1996年招募了高风险组（n = 57）、重度抑郁症组（n = 71）和健康对照组（n = 48）的青少年及其家庭，并使用标准化工具对其心理病理学进行评估。除16名患有破坏性行为障碍的儿童外，高风险儿童均无心理病理学问题。由一位家长完成心理社会状况调查表，以评估母子、父子、婚姻关系以及孩子与朋友的关系和孩子的学业表现。
总体而言，高风险组和健康对照组的心理社会功能相似。有心理病理学问题的高风险儿童的婚姻关系较差。在大多数测量领域，患有重度抑郁症的青少年比高风险组和健康对照组有更多的心理社会问题和学业困难。控制年龄、青春期阶段、种族、性别、家庭构成、父母目前及一生的抑郁情况以及父母目前及一生的非情绪性心理病理学情况后，结果相似。
高风险青少年的家庭和同伴互动与健康对照组的互动相似。尽管家庭功能失调模式似乎主要取决于孩子的抑郁症状，但仍需要纵向研究来确定因果关系。
