Gong C, Fang J, Wan Y H, Duan X N, Su P Y, Tao F B, Sun Y
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Jul 6;54(7):747-752. doi: 10.3760/cma.j.cn112150-20190717-00573.
To examine the prospective association of pubertal timing and tempo with depressive symptoms in adolescents. Since 2013, 2 084 students in grade 1-3 were selected from two primary schools in Bengbu, Anhui Province were selected by using convenience sampling method to establish the adolescence pubertal development cohort. Followed up for 6 years, physical examination, secondary sexual development evaluation (testicular volume for boys and breast development for girls) and depressive symptoms were evaluated biennially. Non-linear growth model was used to estimate pubertal timing and tempo for boys and girls respectively. Depressive symptoms were interviewed by using the Short Mood & Feeling Questionnaire (SMFQ) at baseline and Mood & Feeling Questionnaire (MFQ) during follow-up for students in grade 1-2. Children Depression Inventory (CDI) was used for students in grade 3 at baseline and during follow-up. Depressive symptom scores were standardized by using the -score method. Multivariate linear regression model was used to analyze the predictive effects of modeling pubertal timing and tempo on depressive symptoms of adolescence boys and girls. There were 1 909 students with complete questionnaire and puberty development information, including 1 052 boys (59.19%) and 857 girls (43.81%), with average age about (13.94±0.87) years and 91.60 percent follow-up rate. The average modeling pubertal timing of girls (11.25 years) was earlier than that of boys (12.70 years), and the average pubertal tempo of girls about 1.47 Tanner stage/year was faster than that of boys about 1.28 Tanner stage/year. After controlling for depressive symptoms, maternal education and adverse childhood experiences at baseline and age, body mass index (BMI) classification and sleep time during follow-up, this predictive effect of pubertal timing and tempo on depressive symptoms was only significant among girls. Compared with girls with on time pubertal timing, girls in the delay timing group had a lower level of depressive symptoms (β=-0.19, 95% :-0.34,-0.01). Compared with girls in average pubertal tempo group, the fast tempo group associated with an increasing risk of depressive symptoms (β0.23, 95%: 0.05, 0.40), while the slow tempo group associated with an decreasing risk of depressive symptoms (β-0.21, 95%:-0.39,-0.03). Insignificant effects were found in puberty timing and tempo on depressive symptoms of boys (>0.05). Fast pubertal tempo increases the risk of development of depressive symptoms of adolescent girls. There is no predictive effect of pubertal timing and tempo on depression symptoms of adolescent boys.
探讨青春期启动时间和进程与青少年抑郁症状之间的前瞻性关联。自2013年起,采用便利抽样法从安徽省蚌埠市的两所小学选取1 - 3年级的2084名学生,建立青少年青春期发育队列。随访6年,每两年进行一次体格检查、第二性征发育评估(男孩为睾丸容积,女孩为乳房发育)以及抑郁症状评估。分别采用非线性生长模型估计男孩和女孩的青春期启动时间和进程。对1 - 2年级学生在基线时使用简版情绪与感受问卷(SMFQ),随访期间使用情绪与感受问卷(MFQ)进行抑郁症状访谈。对3年级学生在基线和随访期间使用儿童抑郁量表(CDI)。抑郁症状得分采用z分数法进行标准化。采用多变量线性回归模型分析青春期启动时间和进程模型对青少年男孩和女孩抑郁症状的预测作用。共有1909名学生拥有完整的问卷和青春期发育信息,其中男孩1052名(59.19%),女孩857名(43.81%),平均年龄约(13.94±0.87)岁,随访率为91.60%。女孩的平均青春期启动时间模型(11.25岁)早于男孩(12.70岁),女孩的平均青春期进程约为1.47 Tanner分期/年,快于男孩的约1.28 Tanner分期/年。在控制了基线时的抑郁症状、母亲教育程度和不良童年经历以及年龄、随访期间的体重指数(BMI)分类和睡眠时间后,青春期启动时间和进程对抑郁症状的这种预测作用仅在女孩中显著。与青春期启动时间正常的女孩相比,启动时间延迟组的女孩抑郁症状水平较低(β=-0.19,95%置信区间:-0.34,-0.01)。与青春期进程平均组的女孩相比,进程快的组抑郁症状风险增加(β=0.23,95%置信区间:0.05,0.40),而进程慢的组抑郁症状风险降低(β=-0.21,95%置信区间:-0.39,-0.03)。青春期启动时间和进程对男孩抑郁症状的影响不显著(P>0.05)。青春期进程快会增加青少年女孩出现抑郁症状的风险。青春期启动时间和进程对青少年男孩的抑郁症状没有预测作用。