Department of Psychiatry & Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, United States; Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA, United States.
Department of Psychiatry & Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, United States.
J Affect Disord. 2021 Mar 15;283:20-29. doi: 10.1016/j.jad.2021.01.036. Epub 2021 Jan 14.
First onsets of depression are especially common in adolescent females and often develop into chronic/recurrent illness. Surprisingly few studies have comprehensively evaluated multiple domains of etiologically-informative risk factors for first onset in adolescents from the community. We investigated whether clinical, cognitive, personality, interpersonal, and biological risk factors prospectively predict a first onset of depressive disorder (DD), and of DD with a chronic/recurrent course, in a community sample of adolescent girls.
479 girls (13.5-15.5 years) with no history of DD completed baseline assessments of risk factors and five diagnostic assessments over 3 years. Baseline measures were analyzed separately and jointly to prospectively predict first-onset DD and first-onset chronic/recurrent DD.
Most risk factors predicted first-onset DD (n = 93), including depressive symptoms, anxiety disorders, rumination, personality traits, blunted neural response (late positive potential [LPP]) to unpleasant pictures, peer victimization, parental criticism, and parental mood disorder. Depressive symptoms, rumination, parental mood disorder, and parental criticism were independently associated with first onsets. Nearly all measures, including a blunted neural response to rewards (reward positivity [RewP]), also predicted first-onset chronic/recurrent DD (n = 52), with depressive symptoms, low extraversion, poor peer relationships, and blunted RewP emerging as independent risk factors.
This study focused on adolescent females and therefore does not provide information on males.
Multiple domains of risk factors in early adolescence are prospectively associated with first-onset DD and chronic/recurrent DD. A smaller subset of risk factors uniquely contributing to first onsets may represent core vulnerabilities for adolescent-onset depression and promising prevention targets.
青少年女性首次出现抑郁症状的情况尤其常见，且往往发展为慢性/复发性疾病。令人惊讶的是，很少有研究全面评估过来自社区的青少年患者中与发病机制相关的、具有启示意义的多种风险因素。我们旨在调查在社区青少年女性样本中，临床、认知、人格、人际和生物学风险因素是否能前瞻性地预测首次出现抑郁障碍（DD），以及首次出现慢性/复发性 DD。
479 名（13.5-15.5 岁）无 DD 病史的女孩完成了风险因素的基线评估和 3 年内的 5 次诊断评估。基线测量值被分别和联合进行分析，以前瞻性地预测首次发作 DD 和首次发作慢性/复发性 DD。
大多数风险因素预测了首次发作 DD（n=93），包括抑郁症状、焦虑障碍、反刍思维、人格特质、不愉快图片刺激下的大脑反应迟钝（晚期正波电位[LPP]）、同伴受欺负、父母批评和父母心境障碍。抑郁症状、反刍思维、父母心境障碍和父母批评与首次发作独立相关。几乎所有的测量指标，包括对奖励的大脑反应迟钝（奖励正波[RewP]），也预测了首次发作慢性/复发性 DD（n=52），其中抑郁症状、低外向性、较差的同伴关系和 RewP 迟钝是独立的风险因素。
本研究侧重于青少年女性，因此不提供男性相关信息。
青少年早期的多个风险因素与首次发作 DD 和慢性/复发性 DD 具有前瞻性相关性。一小部分独特地促成首次发作的风险因素可能代表青少年发病抑郁的核心脆弱性，是有前途的预防目标。
