School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
PLoS One. 2013 Oct 11;8(10):e78323. doi: 10.1371/journal.pone.0078323. eCollection 2013.
Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies.
青春期是研究抑郁症发展的关键时期，欧洲和北美的研究表明，风险呈上升趋势，始于青少年早期，并随着青少年年龄的增长而持续增加。很少有研究调查过中低收入国家青少年抑郁症的发病过程和相关风险因素。这项纵向队列研究在智利的一个社会经济弱势群体青少年样本中研究了抑郁症状轨迹和风险因素（n=2508）。数据是在一项针对 12 至 18 岁中学生的临床试验期间收集的，时间跨度为 18 个月（中位数年龄为 14 岁）。在基线时，该样本中就存在临床水平的抑郁症状（女生为 35%，男生为 28%）；然而，症状轨迹的潜在增长模型显示出随着时间的推移症状逐渐减轻的模式。对于女生来说，存在焦虑-抑郁的发展途径，最初的焦虑水平预示着以后会出现更严重的抑郁后果。解决问题能力差与最初的抑郁水平有关，但不能预测抑郁症状的发展过程。至关重要的是，症状轨迹的下降提出了关于纵向研究中重复评估效果的重要方法学问题。
