Division of Psychological Medicine & Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics & Genomics Cardiff University, United Kingdom.
Division of Psychological Medicine & Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics & Genomics Cardiff University, United Kingdom.
J Affect Disord. 2019 Jan 15;243:175-181. doi: 10.1016/j.jad.2018.09.015. Epub 2018 Sep 11.
Depression is the leading global cause of disability and often begins in adolescence. The genetic architecture and treatment response profiles for adults and adolescents differ even though identical criteria are used to diagnose depression across different age groups. There is no clear consensus on how these groups differ in their symptom profiles.
Using data from a two-generation family study, we compared the presentation of DSM-IV depressive symptoms in adolescents and adults with MDD (Major Depressive Disorder). We also compared DSM-IV depressive symptom counts using latent class analysis.
Vegetative symptoms (appetite and weight change, loss of energy and insomnia) were more common in adolescent MDD than adult MDD. Anhedonia/loss of interest and concentration problems were more common in adults with MDD. When using latent class analysis to look at depressive symptoms, a vegetative symptom profile was also seen in adolescent depression only.
Adults and adolescents were recruited in different ways. Adolescent cases were more likely to be first-onset while adult cases were recurrences. It was not possible to examine how recurrence affected adolescent depression symptom profiles.
Differences in how depression presents in adolescents and adults may be consistent with different pathophysiological mechanisms. For adolescents, we found that vegetative/physical disturbances were common (loss of energy, changes in weight, appetite and sleep changes). For adults, anhedonia/loss of interest and concentration difficulties were more common.
抑郁症是全球首要致残原因，且通常始于青少年时期。尽管在不同年龄组中使用相同的标准来诊断抑郁症，但成人和青少年的遗传结构和治疗反应特征存在差异。对于这两个群体在症状特征上存在哪些差异，目前尚无明确共识。
我们使用来自两代人家族研究的数据，比较了患有 MDD（重度抑郁症）的青少年和成年人的 DSM-IV 抑郁症状表现。我们还使用潜在类别分析比较了 DSM-IV 抑郁症状计数。
与成年 MDD 相比，青少年 MDD 中更常见植物性症状（食欲和体重变化、精力丧失和失眠）。快感缺失/兴趣丧失和注意力问题在成年 MDD 中更为常见。当使用潜在类别分析来观察抑郁症状时，仅在青少年抑郁症中也可以看到植物性症状特征。
招募青少年和成年人的方式不同。青少年病例更有可能是首发病例，而成年病例则是复发病例。无法检查复发如何影响青少年抑郁症状特征。
青少年和成年人中抑郁表现的差异可能与不同的病理生理机制一致。对于青少年，我们发现植物性/身体紊乱很常见（精力丧失、体重、食欲和睡眠变化）。对于成年人，快感缺失/兴趣丧失和注意力困难更为常见。
