Lewinsohn Peter M, Holm-Denoma Jill M, Small Jason W, Seeley John R, Joiner Thomas E
Drs. Lewinsohn and Seeley and Mr. Small are with the Oregon Research Institute; Dr. Holm-Denoma is with the University of Vermont; and Dr. Joiner is with Florida State University..
Drs. Lewinsohn and Seeley and Mr. Small are with the Oregon Research Institute; Dr. Holm-Denoma is with the University of Vermont; and Dr. Joiner is with Florida State University.
J Am Acad Child Adolesc Psychiatry. 2008 May;47(5):548-555. doi: 10.1097/CHI.0b013e31816765e7.
To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30).
A subset of the participants of the Oregon Adolescent Depression Project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and concurrent reports of current mental illness at age 16 and were then followed prospectively until age 30. Diagnostic assessments were conducted twice during adolescence and again at ages 24 and 30. Based on diagnosis during childhood/adolescence, the subjects were partitioned into four orthogonal groups: SAD (n = 42), other anxiety disorders (n = 88), a heterogeneous psychiatric disorders control group (n = 389), and a not mentally ill control group (n = 297). Adjusting for demographic variables that were significantly associated with group status and for comorbid disorders prior to age 19, the results were analyzed with hierarchical multiple logistic regression.
SAD was a strong (78.6%) risk factor for the development of mental disorders during young adulthood. The major vulnerabilities were for panic disorder and depression.
Because SAD creates a major vulnerability for mental disorders during young adulthood, clinicians should be sensitive to the presence of SAD, and children and adolescents with SAD should be treated. Future research should evaluate whether successful treatment of SAD and/or the provision of a preventive intervention during childhood/adolescence reduce the risk for future psychopathology.
确定儿童期分离焦虑障碍(SAD)在青年期(19 - 30岁)发展为精神病理学的风险程度。
使用俄勒冈青少年抑郁项目的一部分参与者(n = 816)。受试者提供了终生精神疾病(包括SAD)的回顾性报告以及16岁时当前精神疾病的同期报告,然后进行前瞻性随访直至30岁。在青少年期进行了两次诊断评估,在24岁和30岁时再次进行评估。根据儿童期/青少年期的诊断,将受试者分为四个正交组:SAD组(n = 42)、其他焦虑障碍组(n = 88)、异质性精神障碍对照组(n = 389)和非精神疾病对照组(n = 297)。在调整与组状态显著相关的人口统计学变量以及19岁之前的共病障碍后,采用分层多元逻辑回归分析结果。
SAD是青年期发生精神障碍的一个强有力的(78.6%)风险因素。主要易患的疾病是惊恐障碍和抑郁症。
由于SAD在青年期会造成患精神障碍的主要易感性,临床医生应对SAD的存在保持敏感,患有SAD的儿童和青少年应接受治疗。未来的研究应评估对SAD的成功治疗和/或在儿童期/青少年期提供预防性干预是否会降低未来发生精神病理学的风险。