Patton George C, Olsson Craig, Bond Lyndal, Toumbourou John W, Carlin John B, Hemphill Sheryl A, Catalano Richard F
Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Australia.
J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1424-32. doi: 10.1097/CHI.0b013e3181886ebe.
To prospectively examine the relation between pubertal stage and the onset and course of depressive symptoms.
The design was a three-wave longitudinal study of health and social development using statewide community samples in Washington, United States, and Victoria, Australia. Approximately 5,769 students initially ages 10 to 15 years were assessed for depressive symptoms with the Short Mood and Feelings Questionnaire. Pubertal status was assessed using a self-report version of the Pubertal Development Scale.
Advancing pubertal stage carried higher risks for depressive symptoms in female subjects in all of the three study waves. The pubertal rise in female depressive symptoms was due to both higher risk for incident cases and an even greater effect on risks for persistence of depressive symptoms. Report of poor emotional control 12 months earlier carried a twofold higher risk for incident depressive symptoms and largely explained the pubertal rise in female incident cases. High family conflict and severity of bullying also predicted persistence of depressive symptoms. Preexisting depressive symptoms were not associated with later increases in the rate of pubertal transition.
Advancing pubertal stage carries risks for both the onset and persistence of depressive symptoms in females. Social adversity around puberty predicts the persistence of symptoms but does not account for a pubertal rise in female depression. A report of poor emotional control may be a useful marker of girls at risk for depressive symptoms and as a target for preventive intervention.
前瞻性研究青春期阶段与抑郁症状的发作及病程之间的关系。
采用美国华盛顿州和澳大利亚维多利亚州的全州社区样本,进行一项关于健康与社会发展的三波纵向研究。最初对约5769名年龄在10至15岁的学生使用简版情绪与情感问卷评估抑郁症状。使用青春期发育量表的自我报告版本评估青春期状态。
在所有三个研究波次中,青春期进展在女性受试者中会带来更高的抑郁症状风险。女性抑郁症状在青春期的上升是由于新发病例风险增加以及对抑郁症状持续风险的影响更大。12个月前情绪控制差的报告使新发病例的抑郁症状风险增加两倍,并且在很大程度上解释了女性新发病例在青春期的上升情况。高家庭冲突和严重欺凌也预示着抑郁症状的持续。既往存在的抑郁症状与青春期过渡速率的后期增加无关。
青春期进展对女性抑郁症状的发作和持续都有风险。青春期周围的社会逆境预示着症状的持续,但不能解释女性抑郁症在青春期的上升。情绪控制差的报告可能是有抑郁症状风险女孩的有用标志,也是预防性干预的目标。