Hammerton Gemma, Mahedy Liam, Mars Becky, Harold Gordon T, Thapar Anita, Zammit Stanley, Collishaw Stephan
Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom.
Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom.
PLoS One. 2015 Jul 7;10(7):e0131885. doi: 10.1371/journal.pone.0131885. eCollection 2015.
Depression is common, especially in women of child-bearing age; prevalence estimates for this group range from 8% to 12%, and there is robust evidence that maternal depression is associated with mental health problems in offspring. Suicidal behaviour is a growing concern amongst young people and those exposed to maternal depression are likely to be especially at high risk. The aim of this study was to utilise a large, prospective population cohort to examine the relationship between depression symptom trajectories in mothers over the first eleven years of their child's life and subsequent adolescent suicidal ideation. An additional aim was to test if associations were explained by maternal suicide attempt and offspring depressive disorder. Data were utilised from a population-based birth cohort: the Avon Longitudinal Study of Parents and Children. Maternal depression symptoms were assessed repeatedly from pregnancy to child age 11 years. Offspring suicidal ideation was assessed at age 16 years. Using multiple imputation, data for 10,559 families were analysed. Using latent class growth analysis, five distinct classes of maternal depression symptoms were identified (minimal, mild, increasing, sub-threshold, chronic-severe). The prevalence of past-year suicidal ideation at age 16 years was 15% (95% CI: 14-17%). Compared to offspring of mothers with minimal symptoms, the greatest risk of suicidal ideation was found for offspring of mothers with chronic-severe symptoms [OR 3.04 (95% CI 2.19, 4.21)], with evidence for smaller increases in risk of suicidal ideation in offspring of mothers with sub-threshold, increasing and mild symptoms. These associations were not fully accounted for by maternal suicide attempt or offspring depression diagnosis. Twenty-six percent of non-depressed offspring of mothers with chronic-severe depression symptoms reported suicidal ideation. Risk for suicidal ideation should be considered in young people whose mothers have a history of sustained high levels of depression symptoms, even when the offspring themselves do not have a depression diagnosis.
抑郁症很常见,尤其是在育龄女性中;该群体的患病率估计在8%至12%之间,并且有充分的证据表明母亲患抑郁症与后代的心理健康问题有关。自杀行为在年轻人中越来越受到关注,而那些母亲患有抑郁症的人可能尤其处于高风险之中。本研究的目的是利用一个大型的前瞻性人群队列,来研究孩子出生后的头十一年里母亲的抑郁症状轨迹与随后青少年自杀意念之间的关系。另一个目的是检验这些关联是否可以由母亲的自杀未遂和后代的抑郁症来解释。数据来自一个基于人群的出生队列:雅芳亲子纵向研究。从怀孕到孩子11岁,对母亲的抑郁症状进行了多次评估。在孩子16岁时评估其自杀意念。使用多重填补法,对10559个家庭的数据进行了分析。通过潜在类别增长分析,确定了母亲抑郁症状的五个不同类别(轻微、轻度、上升、亚阈值、慢性重度)。16岁时过去一年自杀意念的患病率为15%(95%置信区间:14-17%)。与症状轻微的母亲的后代相比,慢性重度症状母亲的后代出现自杀意念的风险最高[比值比3.04(95%置信区间2.19, 4.21)],有证据表明亚阈值、上升和轻度症状母亲的后代出现自杀意念的风险有较小程度的增加。这些关联不能完全由母亲的自杀未遂或后代的抑郁症诊断来解释。26%患有慢性重度抑郁症状的母亲的非抑郁后代报告有自杀意念。对于那些母亲有持续高水平抑郁症状病史的年轻人,即使其后代本身没有抑郁症诊断,也应考虑其自杀意念的风险。