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儿童和青少年慢性躯体疾病与抑郁的关系:一项对 13326 名患者的回顾性研究。

Association between chronic somatic conditions and depression in children and adolescents: A retrospective study of 13,326 patients.

机构信息

Epidemiology, IQVIA, Darmstädter Landstraße 108, Frankfurt, 60598, Germany.

University Clinic of Marburg, Marburg, Germany.

出版信息

J Affect Disord. 2019 Feb 15;245:697-701. doi: 10.1016/j.jad.2018.11.014. Epub 2018 Nov 5.

Abstract

AIMS

The goal of this study was to analyze the association between chronic somatic conditions and depression diagnosis in children and adolescents.

METHODS

The present case-control study included 13,326 children and adolescents with depression as well as controls without depression followed in 243 pediatric practices between 2010 and 2015. Cases and controls were matched by age, gender, index year, and physician. The effect of several chronic disorders in terms of the risk of developing depression was estimated using logistic regression models.

RESULTS

Depression was diagnosed in 0.7% of the population. The prevalence of depression increased with age from 0.2% in individuals aged 7 years to 2.0% in those aged 15 years. Depression was significantly associated with anorexia nervosa (OR = 6.69), ADHD (OR = 2.32), chronic sinusitis (OR = 1.82), short stature due to endocrine disorder (OR = 1.70), obesity (OR = 1.57), disorders of the thyroid gland (OR = 1.53) and certain disorders involving the immune mechanism (OR = 1.42). The risk of a depression diagnosis also increased with the number of chronic conditions (one condition: OR = 1.69; two conditions: OR = 1.81; more than two conditions: OR = 2.03).

CONCLUSIONS

Depression was associated with several chronic disorders and the number of such conditions in pediatric practices in Germany. Therefore, depression should be regularly assessed in young patients affected by chronic disorders.

摘要

目的

本研究旨在分析儿童和青少年慢性躯体疾病与抑郁诊断之间的关联。

方法

本病例对照研究纳入了 2010 年至 2015 年期间在 243 家儿科诊所随访的 13326 例患有抑郁的儿童和青少年病例以及无抑郁的对照。病例和对照按年龄、性别、指数年和医生进行匹配。使用逻辑回归模型估计了几种慢性疾病对发生抑郁风险的影响。

结果

人群中诊断出的抑郁为 0.7%。抑郁的患病率随年龄增长而增加,从 7 岁人群的 0.2%增加到 15 岁人群的 2.0%。抑郁与神经性厌食症(OR=6.69)、注意缺陷多动障碍(OR=2.32)、慢性鼻窦炎(OR=1.82)、内分泌障碍引起的身材矮小(OR=1.70)、肥胖症(OR=1.57)、甲状腺疾病(OR=1.53)和某些涉及免疫机制的疾病(OR=1.42)显著相关。抑郁诊断的风险也随慢性疾病数量的增加而增加(一种疾病:OR=1.69;两种疾病:OR=1.81;超过两种疾病:OR=2.03)。

结论

在德国儿科实践中,抑郁与多种慢性疾病和此类疾病的数量有关。因此,应定期评估受慢性疾病影响的年轻患者的抑郁情况。

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