Stringaris Argyris, Lewis Glyn, Maughan Barbara
Argyris Stringaris, MD, PhD, MRCPsych, Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, London; Glyn Lewis, PhD, Division of Psychiatry, University College London; Barbara Maughan, PhD, MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, Institute of Psychiatry, London, UK.
Br J Psychiatry. 2014 Jul;205(1):17-23. doi: 10.1192/bjp.bp.113.134221. Epub 2014 Apr 24.
Pathways from early-life conduct problems to young adult depression remain poorly understood.
To test developmental pathways from early-life conduct problems to depression at age 18.
Data (n = 3542) came from the Avon Longitudinal Study of Parents and Children (ALSPAC). Previously derived conduct problem trajectories (ages 4-13 years) were used to examine associations with depression from ages 10 to 18 years, and the role of early childhood factors as potential confounders.
Over 43% of young adults with depression in the ALSPAC cohort had a history of child or adolescent conduct problems, yielding a population attributable fraction of 0.15 (95% CI 0.08-0.22). The association between conduct problems and depression at age 18 was considerable even after adjusting for prior depression (odds ratio 1.55, 95% CI 1.24-1.94). Early-onset persistent conduct problems carried the highest risk for later depression. Irritability characterised depression for those with a history of conduct problems.
Early-life conduct problems are robustly associated with later depressive disorder and may be useful targets for early intervention.
从儿童期行为问题到青年期抑郁症的发展路径仍未得到充分理解。
检验从儿童期行为问题到18岁时抑郁症的发展路径。
数据(n = 3542)来自阿冯父母与儿童纵向研究(ALSPAC)。先前得出的行为问题轨迹(4至13岁)用于检验与10至18岁抑郁症的关联,以及幼儿期因素作为潜在混杂因素的作用。
在ALSPAC队列中,超过43%的患有抑郁症的青年成年人有儿童或青少年行为问题史,人群归因分数为0.15(95%置信区间0.08 - 0.22)。即使在调整了先前的抑郁症后,18岁时行为问题与抑郁症之间的关联仍然相当显著(优势比1.55,95%置信区间1.24 - 1.94)。早发性持续性行为问题导致后期抑郁症的风险最高。易怒是有行为问题史者抑郁症的特征。
儿童期行为问题与后期抑郁症密切相关,可能是早期干预的有用靶点。