Judge Baker Children's Center, Harvard Medical School, Boston, MA 02120, USA.
J Child Psychol Psychiatry. 2010 Jul;51(7):789-98. doi: 10.1111/j.1469-7610.2010.02208.x. Epub 2010 Mar 10.
We examined the prevalence of depressive symptoms in Barbadian youth with histories of infantile malnutrition and in a healthy comparison group and the extent to which the effect of malnutrition was mediated/moderated by maternal depression.
Depressive symptoms were assessed using a 20-item scale administered to youths (11-17 years of age) who had experienced an episode of protein-energy malnutrition (marasmus or kwashiorkor) during the first year of life and in a comparison group of healthy youths without a history of malnutrition. Their mothers completed the same questionnaire on the same test on three occasions when their children were 5-17 years of age at 2-5-year intervals.
The prevalence of depressive symptoms was elevated among previously malnourished youth relative to healthy comparison children (p < .001). When youth depression scores were subjected to a longitudinal multiple regression analysis, adjusting for the effect of maternal depressive symptoms, significant effects due to the history of early childhood malnutrition remained and were not discernibly attenuated from an unadjusted analysis. We also found significant independent effects of maternal depressive symptoms on youth depressive symptoms.
Early childhood malnutrition contributed independently to depressive symptoms in youths who experienced a significant episode of malnutrition in the first year of life. This relationship was not mediated or moderated by the effects of maternal depression. Whether the later vulnerability to depression is a direct effect of the episode of malnutrition and related conditions early in life or whether it is mediated by the more proximal neurobehavioral effects of the malnutrition remains to be determined.
我们研究了有婴儿期营养不良史的巴巴多斯青少年和健康对照组中抑郁症状的患病率，以及营养不良对母亲抑郁的影响程度是如何被中介/调节的。
使用 20 项量表评估青少年（11-17 岁）的抑郁症状，这些青少年在生命的第一年经历过蛋白质能量营养不良（消瘦症或夸希奥科病），并在没有营养不良史的健康对照组中进行评估。他们的母亲在孩子 5-17 岁时，在 2-5 年的间隔内，三次完成了相同的问卷。
与健康对照组儿童相比，以前营养不良的青少年抑郁症状的患病率较高（p<0.001）。当青少年抑郁评分进行纵向多回归分析，调整母亲抑郁症状的影响时，由于早期儿童营养不良的历史，仍存在显著的影响，并且与未经调整的分析相比，没有明显减弱。我们还发现母亲抑郁症状对青少年抑郁症状有显著的独立影响。
儿童早期营养不良对经历过生命第一年严重营养不良的青少年的抑郁症状有独立的影响。这种关系不受母亲抑郁影响的中介或调节。以后易患抑郁症是生命早期营养不良和相关情况的直接影响，还是由营养不良的更接近的神经行为影响介导的，还有待确定。
