Greenlee Jessica L, Mosley Angela S, Shui Amy M, Veenstra-VanderWeele Jeremy, Gotham Katherine O
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia;
Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee;
Pediatrics. 2016 Feb;137 Suppl 2(Suppl 2):S105-14. doi: 10.1542/peds.2015-2851I.
Depression is commonly associated with autism spectrum disorder (ASD) across the life span. We sought to identify medical and behavioral problems associated with a history of a parent-reported diagnosis of depression in a large sample of school-aged children and adolescents with ASD.
A sample of 1272 participants (aged 6-17 years; mean [SD]: 9.56 [2.79] years) from the Autism Speaks Autism Treatment Network consortium were divided into "ever-depressed" (n = 89) and "nondepressed" (n = 1183) groups on the basis of caregiver endorsement of children's current or previous diagnoses of depression.
In total, 7.0% of children with ASD (4.8% of those aged 6-12 years and 20.2% of those aged 13-17 years) were reported to have a history of a depression diagnosis. Positive depression history was associated with greater chronological age, higher IQ, and Asperger disorder diagnosis. After controlling for age, IQ, and within-spectrum categorical diagnosis, the ever-depressed group exhibited significantly greater rates of seizure disorders (odds ratio = 2.64) and gastrointestinal problems (odds ratio = 2.59) and trend-level differences in aggression, somatic complaints, and social impairments. The groups did not differ in autism severity, repetitive behaviors, sleep problems, eating problems, self-injurious behavior, or current intervention use.
Co-occurring depression is a particularly common problem in higher-functioning older children within the Autism Treatment Network. Our findings indicate that children with ASD and a history of a depression diagnosis are more likely to also have co-occurring medical problems, although the presence and direction of causality is unclear.
在整个生命周期中，抑郁症常与自闭症谱系障碍（ASD）相关。我们试图在大量患有ASD的学龄儿童和青少年样本中，确定与父母报告的抑郁症诊断史相关的医学和行为问题。
来自自闭症之声自闭症治疗网络联盟的1272名参与者（年龄6 - 17岁；平均[标准差]：9.56 [2.79]岁），根据照顾者对儿童当前或既往抑郁症诊断的认可情况，分为“曾患抑郁症”组（n = 89）和“未患抑郁症”组（n = 1183）。
总体而言，据报告有7.0%的ASD儿童（6 - 12岁儿童中的4.8%以及13 - 17岁儿童中的20.2%）有抑郁症诊断史。抑郁症阳性病史与更大的实际年龄、更高的智商以及阿斯伯格障碍诊断相关。在控制了年龄、智商和谱系内分类诊断后，曾患抑郁症组的癫痫障碍发生率（优势比 = 2.64）和胃肠道问题发生率（优势比 = 2.59）显著更高，并且在攻击行为、躯体主诉和社交障碍方面存在趋势水平差异。两组在自闭症严重程度、重复行为、睡眠问题、饮食问题、自伤行为或当前干预使用方面没有差异。
共病抑郁症在自闭症治疗网络中功能较高的大龄儿童中是一个特别常见的问题。我们的研究结果表明，有抑郁症诊断史的ASD儿童更有可能同时患有其他医学问题，尽管因果关系的存在和方向尚不清楚。
