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社论:影响成年期的儿童抑郁症的“剂量”、时机和治疗方法是什么?

Editorial: What are the "Doses," Timing, and Treatment of Childhood Depression That Impact Adulthood?

机构信息

Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis.

出版信息

J Am Acad Child Adolesc Psychiatry. 2021 May;60(5):570-572. doi: 10.1016/j.jaac.2020.12.015. Epub 2020 Dec 21.

Abstract

Depression creates more burden globally than nearly any other physical or mental disorder, yet surprisingly, little is known about what can be done to prevent its onset and, as Duarte et al., in this issue of JAACAP, address, what the long-term outcomes of youth depression are. The existing medical literature on outcomes of child and adolescent depression is large enough for 2 recent reviews, which point out the key gaps in our understanding. Does childhood depression actually worsen adult outcomes, or is the driver really all the associated childhood adversity and comorbidity? Although we know women suffer disproportionately from depression, are childhood predictors specific to girls or boys? Is it worse to have many episodes of depression in one's youth than a few? Do subthreshold depressive symptoms impact adulthood too? Finally, is it important, in adulthood, whether depression began in childhood or adolescence?

摘要

抑郁症在全球造成的负担超过几乎任何其他身体或精神障碍,但令人惊讶的是,对于如何预防其发作,以及正如 Duarte 等人在本期 JAACAP 中所讨论的,青少年抑郁症的长期后果是什么,人们知之甚少。关于儿童和青少年抑郁症结局的现有医学文献数量庞大,足以进行 2 项最近的综述,这些综述指出了我们理解中的关键差距。儿童期抑郁症实际上确实会恶化成年期的结局,还是真正的驱动因素是所有相关的儿童期逆境和共病?尽管我们知道女性受抑郁症的影响不成比例,但儿童期的预测因素是否对女孩或男孩有特异性?在青少年时期经历多次抑郁发作比几次更糟糕吗?亚临床抑郁症状是否也会影响成年期?最后,在成年期,抑郁症是从儿童期还是青春期开始,这重要吗?

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