Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Department of Psychiatry, University of Oxford, Oxford, UK.
Soc Psychiatry Psychiatr Epidemiol. 2019 Feb;54(2):191-200. doi: 10.1007/s00127-018-1612-0. Epub 2018 Oct 24.
To (1) determine the association between exposure to maternal depressive symptoms in childhood and offspring suicide-related thoughts (SRT) and attempts (SA) in youth and young adults and (2) identify effect measure modifiers (offspring sex, family structure, maternal perceived social support, and social cohesion) of the association in 1.
A cohort was constructed by linking all cycles from the National Longitudinal Survey of Children and Youth, a Canadian nationally representative survey, from 1994 to 2009 in 16,903 subjects 0 to 25 years. Exposure to maternal-reported depressive symptoms was measured when offspring were between 0 and 10 years. Offspring self-reported incident and recurrent SRT and SA were measured between 11 and 25 years. Time-to-event models under a counting process framework were used to estimate adjusted hazard ratios (HR) and relative rates (RR) and 95% confidence intervals (CI). Effect measure modifiers were examined across adjusted stratum-specific estimates.
In offspring exposed to maternal depressive symptoms, the adjusted rates of incident SRT and SA (HR: 1.67, 95% CI 1.37, 2.08; HR: 1.93, 95% CI 1.43, 2.50) and of recurrent SRT and SA (RR: 1.61, 95% CI 1.33, 1.96; RR: 1.87, 95% CI 1.40, 2.36) were significantly elevated compared to non-exposed offspring. The stratum-specific rates of incident and recurrent SRT and SA were significantly elevated in females but not in males.
Girls exposed to maternal depressive symptoms in childhood are a target group for childhood suicide preventive strategies. Family-based preventions, and strategies to identify and effectively treat maternal depressive episodes could be beneficial for suicide prevention in offspring.
（1）确定儿童时期母亲抑郁症状暴露与青少年和青年期后代自杀相关想法（SRT）和自杀企图（SA）之间的关联，（2）确定关联的效应量修饰因子（后代性别、家庭结构、母亲感知的社会支持和社会凝聚力）。
通过链接 1994 年至 2009 年加拿大全国代表性的儿童和青少年纵向调查的所有周期，构建了一个队列，该队列共纳入了 16903 名 0 至 25 岁的受试者。当后代年龄在 0 至 10 岁时，测量母亲报告的抑郁症状的暴露情况。在 11 至 25 岁期间，后代自我报告的偶发性和复发性 SRT 和 SA。采用计数过程框架下的时间事件模型，估计调整后的危险比（HR）和相对率（RR）及 95%置信区间（CI）。在调整后的分层特异性估计中，检查了效应量修饰因子。
在暴露于母亲抑郁症状的后代中，偶发性 SRT 和 SA 的调整发病率（HR：1.67，95%CI：1.37，2.08；HR：1.93，95%CI：1.43，2.50）和复发性 SRT 和 SA 的调整发病率（RR：1.61，95%CI：1.33，1.96；RR：1.87，95%CI：1.40，2.36）明显高于未暴露的后代。女性的偶发性和复发性 SRT 和 SA 的分层特异性发病率明显高于男性，但男性则不然。
儿童时期暴露于母亲抑郁症状的女孩是儿童期预防自杀策略的目标人群。基于家庭的预防措施以及识别和有效治疗母亲抑郁发作的策略，可能有益于预防后代自杀。
