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印度农村社区青少年中抑郁与焦虑障碍的关系。

ADad 7: Relationship between depression and Anxiety Disorders among adolescents in a rural community population in India.

机构信息

Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, 632 002, Tamil Nadu, South India,

出版信息

Indian J Pediatr. 2013 Nov;80 Suppl 2:S165-70. doi: 10.1007/s12098-013-1232-3. Epub 2013 Sep 24.

Abstract

OBJECTIVES

Anxiety Disorders (AD) often co-exist with the heterotypic co-morbidity of Major Depressive Disorder (MDD) and Dysthymia (DysD). This study documents the prevalence of concurrent Depressive Disorder and its subtypes among AD, relationship between specific AD and Depressive Disorders, influence of severity of Depressive Disorders (DD) on AD and vice-versa, as well as the effect of age and gender on this co-morbidity.

METHODS

In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders, Beck Depression Inventory and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version to collect the required data. Descriptive statistics, Independent t tests and Chi-square tests were done to evaluate the prevalence of concurrent Depressive Disorders among AD, relationship between specific AD and Depressive Disorders, severity of DD, and effect of age and gender on this co-morbidity.

RESULTS

Depressive Disorders were concurrently present in 23.7% of adolescents with AD, while 13.9% had concurrently only MDD, 8.3% had only DysD and 1.5% had both. More adolescents with AD had multiple mood disorders than otherwise. Twenty percent of adolescents with Panic Disorder, 12.1% with Generalised anxiety Disorder, 5.3% with Separation Anxiety Disorder and 12% with Social Anxiety Disorder had Depressive Disorders. Dysthymic disorder was statistically significantly more among those with PD (P = 0.009). Depressive Disorders were more severe among those with AD (P = 0.001) and the AD was more severe in those with DD (P = 0.01). As the severity of AD increased the severity of the DD also increased (P = 0.001). While DD were more prevalent among the late adolescence (P = 0.001), gender did not have any influence.

CONCLUSIONS

The two-way overlap between AD and DD is prevalent. Adolescents with Anxiety Disorders should be screened for Depressive Disorders, and when present should be treated.

摘要

目的

焦虑障碍(AD)常与异质共病,如重度抑郁障碍(MDD)和心境恶劣障碍(DysD)。本研究记录了 AD 中同时存在抑郁障碍及其亚型的患病率,以及特定 AD 与抑郁障碍之间的关系,抑郁障碍严重程度对 AD 的影响及其相互影响,以及年龄和性别对这种共病的影响。

方法

在一项对 500 名青少年的前瞻性社区调查中,独立评估者使用儿童焦虑相关情绪障碍筛查表、贝克抑郁量表和情感障碍和精神分裂症儿童/现病史和终身版来收集所需数据。采用描述性统计、独立 t 检验和卡方检验评估 AD 中同时存在抑郁障碍的患病率、特定 AD 与抑郁障碍的关系、DD 的严重程度,以及年龄和性别对这种共病的影响。

结果

AD 青少年中同时存在抑郁障碍的比例为 23.7%,其中 13.9%仅同时存在 MDD,8.3%仅存在 DysD,1.5%同时存在两者。AD 青少年中同时存在多种心境障碍的比例较高。惊恐障碍(PD)青少年中 20%、广泛性焦虑障碍(GAD)青少年中 12.1%、分离焦虑障碍(SAD)青少年中 5.3%和社交焦虑障碍(SAD)青少年中 12%存在抑郁障碍。Dysthymic disorder 在 PD 患者中更为常见(P = 0.009)。AD 患者的抑郁障碍更为严重(P = 0.001),AD 患者的抑郁障碍也更为严重(P = 0.01)。随着 AD 严重程度的增加,DD 的严重程度也随之增加(P = 0.001)。虽然 DD 在青春期后期更为常见(P = 0.001),但性别没有任何影响。

结论

AD 和 DD 之间的双向重叠很常见。患有焦虑障碍的青少年应接受抑郁障碍的筛查,当存在抑郁障碍时应进行治疗。

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