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复发性抑郁症成人患者的纵向症状病程:对其后代功能损害及精神病理学风险的影响。

Longitudinal symptom course in adults with recurrent depression: Impact on impairment and risk of psychopathology in offspring.

作者信息

Mars Becky, Collishaw Stephan, Hammerton Gemma, Rice Frances, Harold Gordon T, Smith Daniel, Bevan Jones Rhys, Sellers Ruth, Potter Robert, Craddock Nicolas, Thapar Ajay K, Heron Jon, Thapar Anita

机构信息

School of Social and Community Medicine, University of Bristol, UK.

Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK.

出版信息

J Affect Disord. 2015 Aug 15;182:32-8. doi: 10.1016/j.jad.2015.04.018. Epub 2015 Apr 17.

Abstract

BACKGROUND

Major depressive disorder (MDD) is common and is associated with an increased risk of psychopathology in offspring. However, depression shows considerable heterogeneity in its course over time. The aim of this study is to examine the relationship between parent depression symptom trajectories and (i) quality of life and social impairment and (ii) psychiatric disorder and depression symptoms in their offspring.

METHOD

Participants were from a longitudinal study of 337 parents with recurrent MDD and their adolescent offspring. Families were assessed on three occasions over four years. Parent depressive symptoms and current MDD diagnosis were assessed using the Schedules for Clinical Assessment in Neuropsychiatry. Adult quality of life and social impairment were derived from the EuroQol and current employment status. Psychiatric outcomes in offspring were assessed using the Child and Adolescent Psychiatric Assessment.

RESULTS

Using latent class growth analysis, three distinct classes of parental depression symptoms were identified (asymptomatic, mild, and chronic high). Parent depression classes were associated with their own quality of life and social impairment, and with psychiatric disorder and depression symptoms in their offspring.

LIMITATIONS

(i) We were unable to test associations with specific offspring disorders, (ii) we did not address the direction of effects underlying associations, and (iii) the sample consisted primarily of mothers and findings may not generalise to depressed fathers.

CONCLUSION

Longitudinal assessments of depressive symptoms in parents could help to identify families who are most in need of early intervention.

摘要

背景

重度抑郁症(MDD)很常见,且与后代精神病理学风险增加有关。然而,抑郁症在病程上表现出相当大的异质性。本研究的目的是探讨父母抑郁症状轨迹与(i)生活质量和社会功能损害以及(ii)其后代的精神障碍和抑郁症状之间的关系。

方法

参与者来自一项对337名患有复发性MDD的父母及其青少年后代的纵向研究。在四年内对这些家庭进行了三次评估。使用神经精神病学临床评估量表评估父母的抑郁症状和当前的MDD诊断。成人的生活质量和社会功能损害来自欧洲生活质量量表和当前就业状况。使用儿童和青少年精神病学评估来评估后代的精神科结局。

结果

通过潜在类别增长分析,确定了三类不同的父母抑郁症状(无症状、轻度和慢性重度)。父母抑郁类别与其自身的生活质量和社会功能损害以及其后代的精神障碍和抑郁症状相关。

局限性

(i)我们无法测试与特定后代疾病的关联,(ii)我们没有探讨关联背后的效应方向,(iii)样本主要由母亲组成,研究结果可能不适用于患有抑郁症的父亲。

结论

对父母抑郁症状进行纵向评估有助于识别最需要早期干预的家庭。

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