Lundervold Astri J, Hinshaw Stephen P, Sørensen Lin, Posserud Maj-Britt
Department of Biological and Medical Psychology, Jonas Lies vei 91, Bergen, Norway.
Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research, Bergen, 5002, Norway.
BMC Psychiatry. 2016 Feb 25;16:46. doi: 10.1186/s12888-016-0739-3.
Depression is common in adolescents, with a gender bias towards girls. Symptoms associated with attention deficit hyperactivity disorder (ADHD) tend to co-occur in depressed adolescents. This may be related to common features between the two symptom domains, but co-occurring ADHD symptoms may also inflate the severity of depression. The present study investigates the frequency and influence of ADHD symptoms co-occurring with depression in a gender balanced population-based sample of Norwegian adolescents.
A sample of 9614 adolescents (16-19 years) completed a questionnaire including the short version of the Mood and Feelings Questionnaire (sMFQ) and the Adult ADHD Self-Report Scale (ASRS), with items reflecting symptoms associated with depression and ADHD, respectively. The sMFQ sum score was used as a proxy for severity of depression, and adolescents with a score equal to or above the 90th percentile were defined as depressed. A high response on any of the ASRS items was used to define the presence of an ADHD symptom, and the number of high scores was used to indicate severity.
ADHD symptoms were frequently reported by the adolescents, with a higher frequency in girls than in boys. The gender differences were, however, minor when the analysis was restricted to the adolescents defined as depressed. Each severe symptom reported on the ASRS contributed significantly to increase the sum score on the sMFQ, and more than 20 % of the adolescents defined as depressed reported six or more symptoms within the ASRS inattention subscale.
The results emphasize the importance of screening for symptoms associated with ADHD when assessing adolescents presenting symptoms indicating depression. Although girls reported higher frequency of symptoms within both domains, the gender bias was dependent on the overall symptom severity. Awareness of co-occurrence of symptoms and gender biases are of importance for both clinical work and future research on mental health and service use in adolescence.
抑郁症在青少年中很常见，且存在女性偏多的性别差异。注意缺陷多动障碍（ADHD）相关症状往往与抑郁的青少年同时出现。这可能与两个症状领域的共同特征有关，但同时出现的ADHD症状也可能夸大抑郁症的严重程度。本研究调查了挪威青少年基于人群的性别均衡样本中，ADHD症状与抑郁症同时出现的频率及其影响。
9614名青少年（16 - 19岁）的样本完成了一份问卷，其中包括情绪与感受问卷简版（sMFQ）和成人ADHD自陈量表（ASRS），这些项目分别反映了与抑郁症和ADHD相关的症状。sMFQ总分用作抑郁症严重程度的指标，得分等于或高于第90百分位数的青少年被定义为抑郁。ASRS任何一项的高分用于定义ADHD症状的存在，高分数量用于表示严重程度。
青少年频繁报告ADHD症状，女孩报告的频率高于男孩。然而，当分析仅限于被定义为抑郁的青少年时，性别差异较小。ASRS上报告的每一项严重症状都显著增加了sMFQ的总分，超过20%被定义为抑郁的青少年在ASRS注意力不集中子量表中报告了六种或更多症状。
结果强调了在评估出现抑郁症状的青少年时，筛查与ADHD相关症状的重要性。尽管女孩在两个领域报告的症状频率都较高，但性别差异取决于总体症状严重程度。认识到症状的共现和性别差异对于青少年心理健康及服务利用的临床工作和未来研究都很重要。
