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中国青少年时期父母抑郁与晚年认知发展的关联:一项基于人群的队列研究。

Associations of parental depression during adolescence with cognitive development in later life in China: A population-based cohort study.

机构信息

Vanke School of Public Health, Tsinghua University, Beijing, China.

Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America.

出版信息

PLoS Med. 2021 Jan 11;18(1):e1003464. doi: 10.1371/journal.pmed.1003464. eCollection 2021 Jan.

Abstract

BACKGROUND

Prior research has underscored negative impacts of perinatal parental depression on offspring cognitive performance in early childhood. However, little is known about the effects of parental depression during adolescence on offspring cognitive development.

METHODS AND FINDINGS

This study used longitudinal data from the nationally representative China Family Panel Studies (CFPS). The sample included 2,281 adolescents aged 10-15 years (the median age was 13 years with an interquartile range between 11 and 14 years) in 2012 when their parents were surveyed for depression symptoms with the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). The sample was approximately balanced by sex, with 1,088 females (47.7%). We examined the associations of parental depression in 2012 with offspring cognitive performance (measured by mathematics, vocabulary, immediate word recall, delayed word recall, and number series tests) in subsequent years (i.e., 2014, 2016, and 2018) using linear regression models, adjusting for various offspring (i.e., age, sex, and birth order), parent (i.e., parents' education level, age, whether living with the offspring, and employment status), and household characteristics (i.e., place of residence, household income, and the number of offspring). We found parental depression during adolescence to be significantly associated with worse cognitive performance in subsequent years, in both crude and adjusted models. For example, in the crude models, adolescents whose mothers had depression symptoms in 2012 scored 1.0 point lower (95% confidence interval [CI]: -1.2 to -0.8, p < 0.001) in mathematics in 2014 compared to those whose mothers did not have depression symptoms; after covariate adjustment, this difference marginally reduced to 0.8 points (95% CI: -1.0 to -0.5, p < 0.001); the associations remained robust after further adjusting for offspring earlier cognitive ability in toddlerhood (-1.2, 95% CI: -1.6, -0.9, p < 0.001), offspring cognitive ability in 2012 (-0.6, 95% CI: -0.8, -0.3, p < 0.001), offspring depression status (-0.7, 95% CI: -1.0, -0.5, p < 0.001), and parents' cognitive ability (-0.8, 95% CI: -1.2, -0.3, p < 0.001). In line with the neuroplasticity theory, we observed stronger associations between maternal depression and mathematical/vocabulary scores among the younger adolescents (i.e., 10-11 years) than the older ones (i.e., 12-15 years). For example, the association between maternal depression and 2014 vocabulary scores was estimated to be -2.1 (95% CI: -2.6, -1.6, p < 0.001) in those aged 10-11 years, compared to -1.2 (95% CI: -1.6, -0.8, p < 0.001) in those aged 12-15 years with a difference of 0.9 (95% CI: 0.2, 1.6, p = 0.010). We also observed a stronger association of greater depression severity with worse mathematical scores. The primary limitations of this study were the relatively high attrition rate and residual confounding.

CONCLUSIONS

In this study, we observed that parental depression during adolescence was associated with adverse offspring cognitive development assessed up to 6 years later. These findings highlight the intergenerational association between depression in parents and cognitive development across the early life course into adolescence.

摘要

背景

先前的研究强调了围产期父母抑郁对幼儿认知表现的负面影响。然而,关于青少年时期父母抑郁对后代认知发展的影响知之甚少。

方法和发现

本研究使用了具有全国代表性的中国家庭追踪调查(CFPS)的纵向数据。该样本包括 2012 年接受父母抑郁症状调查的 2281 名 10-15 岁的青少年(中位数年龄为 13 岁,四分位距在 11 至 14 岁之间)。2012 年使用 20 项流行病学研究中心抑郁量表(CES-D)对父母的抑郁症状进行了评估。样本在性别上大致平衡,女性 1088 人(47.7%)。我们使用线性回归模型,调整了后代(即年龄、性别和出生顺序)、父母(即父母的教育水平、年龄、是否与后代同住和就业状况)和家庭特征(即居住地、家庭收入和子女人数)等各种因素后,考察了青少年时期父母抑郁与随后几年(即 2014 年、2016 年和 2018 年)子女认知表现(通过数学、词汇、即时单词回忆、延迟单词回忆和数字序列测试衡量)之间的关联。我们发现,青少年时期父母抑郁与随后几年认知表现较差显著相关,无论是在未调整还是调整后的模型中均是如此。例如,在未调整模型中,与母亲没有抑郁症状的青少年相比,2012 年母亲有抑郁症状的青少年在 2014 年的数学成绩低 1.0 分(95%置信区间 [CI]:-1.2 至-0.8,p<0.001);在调整了协变量后,这一差异略有缩小至 0.8 分(95%CI:-1.0 至-0.5,p<0.001);在进一步调整了幼儿期早期认知能力(-1.2,95%CI:-1.6,-0.9,p<0.001)、2012 年子女的认知能力(-0.6,95%CI:-0.8,-0.3,p<0.001)、子女抑郁状况(-0.7,95%CI:-1.0,-0.5,p<0.001)和父母认知能力(-0.8,95%CI:-1.2,-0.3,p<0.001)后,这种关联仍然稳健。根据神经可塑性理论,我们观察到母亲抑郁与数学/词汇成绩之间的关联在较年轻的青少年(即 10-11 岁)中比在年龄较大的青少年(即 12-15 岁)中更强。例如,与年龄较大的青少年(即 12-15 岁)相比,母亲抑郁与 2014 年词汇成绩的关联在年龄较小的青少年(即 10-11 岁)中估计为-2.1(95%CI:-2.6,-1.6,p<0.001),而在年龄较大的青少年中为-1.2(95%CI:-1.6,-0.8,p<0.001),两者相差 0.9(95%CI:0.2,1.6,p=0.010)。我们还观察到抑郁严重程度与数学成绩较差之间的关联更强。本研究的主要局限性是相对较高的流失率和残留混杂。

结论

在这项研究中,我们观察到青少年时期父母抑郁与随后 6 年的子女认知发展不良有关。这些发现突出了父母抑郁与整个生命早期至青少年期的认知发展之间的代际关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11a8/7799791/3b2715d2869f/pmed.1003464.g001.jpg

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