Wilson S, Hicks B M, Foster K T, McGue M, Iacono W G
Department of Psychology,University of Minnesota,Minneapolis, MN,USA.
Department of Psychiatry,University of Michigan,Ann Arbor, MI,USA.
Psychol Med. 2015 Feb;45(3):505-14. doi: 10.1017/S0033291714001640. Epub 2014 Jul 10.
Major depressive disorder (MDD) that onsets by adolescence is associated with various deficits in psychosocial functioning. However, adolescent-onset MDD often follows a recurrent course that may drive its associated impairment.
To tease apart these two clinical features, we examined the relative associations of age of onset (adolescent versus adult) and course (recurrent versus single episodes) of MDD with a broad range of psychosocial functioning outcomes assessed in early adulthood. Participants comprised a large, population-based sample of male and female twins from the Minnesota Twin Family Study (MTFS; n = 1252) assessed prospectively from ages 17 to 29 years.
A recurrent course of MDD predicted impairment in several psychosocial domains in adulthood, regardless of whether the onset was in adolescence or adulthood. By contrast, adolescent-onset MDD showed less evidence of impairment in adulthood after accounting for recurrence. Individuals with both an adolescent onset and recurrent episodes of MDD represented a particularly severe group with pervasive psychosocial impairment in adulthood.
The negative implications of adolescent-onset MDD for psychosocial functioning in adulthood seem to be due primarily to its frequently recurrent course, rather than its early onset, per se. The results highlight the importance of considering both age of onset and course for understanding MDD and its implications for functioning, and also in guiding targeted intervention efforts.
青春期起病的重度抑郁症（MDD）与心理社会功能的各种缺陷有关。然而，青春期起病的MDD通常呈复发病程，这可能导致其相关损害。
为了区分这两种临床特征，我们研究了MDD的起病年龄（青少年期与成年期）和病程（复发与单次发作）与成年早期评估的广泛心理社会功能结果之间的相对关联。参与者包括明尼苏达双生子家庭研究（MTFS；n = 1252）中一个基于人群的大型双生子样本，从17岁到29岁进行前瞻性评估。
MDD的复发病程预示成年期在几个心理社会领域存在损害，无论起病是在青少年期还是成年期。相比之下，在考虑复发因素后，青春期起病的MDD在成年期显示出较少的损害证据。青春期起病且有复发发作的MDD个体代表了一个特别严重的群体，在成年期存在普遍的心理社会损害。
青春期起病的MDD对成年期心理社会功能的负面影响似乎主要归因于其频繁复发的病程，而非起病早本身。结果强调了在理解MDD及其对功能的影响以及指导有针对性的干预措施时，同时考虑起病年龄和病程的重要性。
