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青少年期抑郁症状轨迹的异质性:预测青年期结局

Heterogeneity of Depressive Symptom Trajectories through Adolescence: Predicting Outcomes in Young Adulthood.

作者信息

Chaiton Michael, Contreras Gisèle, Brunet Jennifer, Sabiston Catherine M, O'Loughlin Erin, Low Nancy C P, Karp Igor, Barnett Tracie A, O'Loughlin Jennifer

机构信息

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario ; Ontario Tobacco Research Unit, Toronto, Ontario.

出版信息

J Can Acad Child Adolesc Psychiatry. 2013 May;22(2):96-105.

Abstract

OBJECTIVE

This study describes developmental trajectories of depressive symptoms in adolescents and examines the association between trajectory group and mental health outcomes in young adulthood.

METHODS

Depressive symptoms were self-reported every three months from grade seven through grade 11 by 1293 adolescents in the Nicotine Dependence in Teens (NDIT) study and followed in young adulthood (average age 20.4, SD=0.7, n=865). Semi-parametric growth modeling was used to identify sex-specific trajectories of depressive symptoms.

RESULTS

THREE DISTINCT TRAJECTORY GROUPS WERE IDENTIFIED: 50% of boys and 29% of girls exhibited low, decreasing levels of depressive symptoms; 14% of boys and 28% of girls exhibited high and increasing levels; and 36% of boys and 43% of girls exhibited moderate levels with linear increase. Trajectory group was a statistically significant independent predictor of depression, stress, and self-rated mental health in young adulthood in boys and girls. Boys, but not girls, in the high trajectory group had a statistically significant increase in the likelihood of seeking psychiatric care.

CONCLUSIONS

Substantial heterogeneity in changes in depressive symptoms over time was found. Because early depressive symptoms predict mental health problems in young adulthood, monitoring adolescents for depressive symptoms may help identify those most at risk and in need of intervention.

摘要

目的

本研究描述青少年抑郁症状的发展轨迹,并探讨轨迹组与青年期心理健康结果之间的关联。

方法

在青少年尼古丁依赖(NDIT)研究中,1293名青少年从七年级到十一年级每三个月自我报告一次抑郁症状,并在青年期进行随访(平均年龄20.4岁,标准差=0.7,n=865)。采用半参数生长模型来确定抑郁症状的性别特异性轨迹。

结果

确定了三个不同的轨迹组:50%的男孩和29%的女孩表现出低水平且逐渐下降的抑郁症状;14%的男孩和28%的女孩表现出高水平且逐渐上升的抑郁症状;36%的男孩和43%的女孩表现出中等水平且呈线性上升。轨迹组是男孩和女孩青年期抑郁、压力和自评心理健康的统计学显著独立预测因素。高轨迹组中的男孩(而非女孩)寻求精神科护理的可能性有统计学显著增加。

结论

发现抑郁症状随时间变化存在显著异质性。由于早期抑郁症状可预测青年期的心理健康问题,监测青少年的抑郁症状可能有助于识别那些风险最高且需要干预的人群。

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