Orchard Faith, Pass Laura, Marshall Tamsin, Reynolds Shirley
School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights Road, Reading, RG6 6AL, UK.
Berkshire Healthcare NHS Foundation Trust, Bracknell, UK.
Child Adolesc Ment Health. 2017 May;22(2):61-68. doi: 10.1111/camh.12178. Epub 2016 Jul 15.
Adolescence is a period of increased risk for the development of depression. Epidemiological and clinical studies suggest that the phenomenology of depression may differ during childhood and adolescence. However, participants in these studies may not reflect depressed young people referred to routine clinical services. The aim of this paper was to describe referrals for depression to a UK routine public healthcare service for children and adolescents with mental health difficulties.
This paper describes a consecutive series of adolescents (N = 100, aged 12-17 years), referred for depression to a routine public healthcare child and adolescent mental health service, in the south of England. Young people and their caregivers completed a structured diagnostic interview and self-report measures of anxiety and depression.
Fewer than half of young people referred for depression met diagnostic criteria for a depressive disorder. The key symptoms reported by those with depression were low mood or irritability, cognitive disturbances, sleep disturbances and negative self-perceptions. Suicidal ideation was common and was considerably higher than reported in other studies. Caregiver and young person's accounts of adolescent symptoms of depression and anxiety were uncorrelated. Caregivers also reported fewer symptoms of depression in their child than adolescents themselves.
These data have direct relevance to the design and delivery of public mental health services for children and adolescents. However, we do not know how representative this sample is of other clinical populations in the UK or in other countries. There is a need to collect routine data from other services to assess the needs of this group of high-risk adolescents.
青春期是抑郁症发病风险增加的时期。流行病学和临床研究表明，儿童期和青春期抑郁症的表现可能有所不同。然而，这些研究的参与者可能无法反映转介至常规临床服务机构的抑郁青少年的情况。本文旨在描述英国一家针对有心理健康问题的儿童和青少年的常规公共医疗服务机构中抑郁症的转诊情况。
本文描述了一系列连续转诊至英格兰南部一家常规公共医疗儿童和青少年心理健康服务机构的青少年（N = 100，年龄在12至17岁之间），这些青少年因抑郁症前来就诊。青少年及其照顾者完成了结构化诊断访谈以及焦虑和抑郁的自我报告测量。
被转诊至抑郁症治疗的青少年中，不到一半符合抑郁症诊断标准。抑郁症患者报告的关键症状为情绪低落或易怒、认知障碍、睡眠障碍和负面自我认知。自杀意念很常见，且远高于其他研究报告的比例。照顾者和青少年对青少年抑郁和焦虑症状的描述不相关。照顾者报告其孩子出现的抑郁症状也比青少年自己报告的少。
这些数据与儿童和青少年公共心理健康服务的设计和提供直接相关。然而，我们不知道这个样本在英国或其他国家的其他临床人群中具有多大代表性。有必要从其他服务机构收集常规数据，以评估这一高危青少年群体的需求。
