School of Medicine, Yale University, New Haven, Connecticut, United States of America.
PLoS One. 2020 May 8;15(5):e0232373. doi: 10.1371/journal.pone.0232373. eCollection 2020.
Major depressive disorder is a common disease with high mortality and morbidity worldwide. Though peak onset is during late adolescence, the prevalence of major depressive disorder remains high throughout adulthood. Leveraging an association study design, this study screened a large number of variables in the 2017 National Survey on Drug Use and Health to characterize differences between adult and youth depression across a wide array of phenotypic measurements.
All dichotomous variables were manually identified from the survey for association screening. Association between each dichotomous variable and past-year major depressive episode (MDE) occurrence was calculated as an odds ratio for adults (≥18 years) and youth (12-17 years), and tested for significance with Fischer's exact test. Logarithm of the calculated odds ratios were plotted and fitted to a linear model to assess correlation between adult and youth risk factors.
Many of the screened variables showed similar association between past-year depressive episode occurrence in youth and adults; Lin's concordance correlation coefficient between adult and youth associations was 0.91 (95% CI 0.89-0.92). Differentially associated variables were identified, tracking: female sex, alcohol use, cigarette use, marijuana use, Medicaid/CHIP coverage, cognitive changes due to a mental, physical or emotional condition, and respondents' identification of a single depressive event as the worst experienced.
While some youth-specific correlates of major depressive episodes were identified through screening, including some novel associations, most examined variables showed similar association with youth and adult depression. Further study of results is warranted, especially concerning the finding of increased association between marijuana use and depressive episodes in youth.
重度抑郁症是一种全球性的高发病率和高死亡率的常见疾病。尽管发病高峰期在青少年晚期，但成年期重度抑郁症的患病率仍然很高。利用关联研究设计，本研究在 2017 年全国药物使用与健康调查中筛选了大量变量，以描述各种表型测量之间成人和青少年抑郁的差异。
从调查中手动识别所有二分类变量进行关联筛选。对于成年人（≥18 岁）和青少年（12-17 岁），计算每个二分类变量与过去一年重度抑郁发作（MDE）发生的关联，并通过 Fisher 精确检验检验其显著性。对数计算的优势比绘制并拟合线性模型，以评估成人和青少年危险因素之间的相关性。
许多筛选出的变量在青少年和成年人中过去一年抑郁发作的发生存在相似的关联；成人和青少年关联之间的 Lin 一致性相关系数为 0.91（95%CI 0.89-0.92）。确定了差异相关的变量，包括：女性、饮酒、吸烟、大麻使用、医疗补助/儿童健康保险计划（CHIP）覆盖、因精神、身体或情绪状况导致的认知变化，以及受访者将单次抑郁事件识别为经历过的最严重事件。
虽然通过筛选确定了一些与青少年重度抑郁发作相关的特定因素，包括一些新的关联，但大多数研究的变量与青少年和成人抑郁的关联相似。需要进一步研究结果，特别是关于大麻使用与青少年抑郁发作之间关联增加的发现。
