Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.
Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.
J Affect Disord. 2021 Mar 1;282:1132-1142. doi: 10.1016/j.jad.2020.12.179. Epub 2021 Jan 3.
To determine social and sex differences in psychosocial functioning and psychiatric comorbidity among adolescents with depression.
A cohort-based study in Stockholm, Sweden. Adolescents who turned 13 years during 2001-2007, were followed in registers until they turned 18 in 2005-2011, (n = 169,262). In the current study, those with depression at age 13-17 were included (n = 6,439).
Adolescents with parents with low (OR=1.5, CI 1.1-2.2) education were more likely to have low psychosocial functioning. Those with parents with low education and low household income were more likely to have comorbid internalizing (OR=1.3, CI 1.0-1.7/1.3, CI 1.0-1.7) and externalizing disorders (OR=2.5, CI 1.5-4.0/2.4, CI 1.4-4.2). Adolescents with parents born outside the Nordic countries were more likely to have comorbid externalizing disorders (OR=1.6, CI 1.1-2.4). No social differences were evident in relation to family receipt of unemployment benefits. Social differences were found for both girls and boys in relation to psychosocial functioning and comorbidity but the magnitude of social differences in depression with comorbidity was overall larger for boys than girls.
The findings of the current study can only be generalized to adolescents that have sought care for and been diagnosed with depression, within a setting similar to this study, e.g. with free access to care.
Adolescents with depression and with more disadvantaged social circumstances in the childhood run a higher risk of psychiatric comorbidity and low psychosocial functioning, which can indicate a lengthy clinical course and poorer response to treatment. Both boys and girls follow this path but partly in different kinds of psychiatric comorbidity.
确定患有抑郁症的青少年在心理社会功能和精神共病方面的社会和性别差异。
这是一项在瑞典斯德哥尔摩进行的基于队列的研究。2001-2007 年期间年满 13 岁的青少年在登记册中进行随访，直到 2005-2011 年年满 18 岁（n=169262）。在本研究中，纳入了 13-17 岁时患有抑郁症的患者（n=6439）。
父母受教育程度低（OR=1.5，CI 1.1-2.2）的青少年更有可能出现心理社会功能低下。父母受教育程度低且家庭收入低的青少年更有可能患有共患的内化障碍（OR=1.3，CI 1.0-1.7/1.3，CI 1.0-1.7）和外化障碍（OR=2.5，CI 1.5-4.0/2.4，CI 1.4-4.2）。父母出生在北欧国家以外的青少年更有可能患有共患的外化障碍（OR=1.6，CI 1.1-2.4）。在家庭领取失业救济金方面，没有发现社会差异。在心理社会功能和共病方面，女孩和男孩都存在社会差异，但在伴有共病的抑郁症方面，男孩的社会差异总体上大于女孩。
本研究的结果只能推广到在类似本研究的环境中寻求治疗并被诊断为抑郁症的青少年，例如，他们可以免费获得治疗。
患有抑郁症且在儿童时期社会处境较为不利的青少年，更有可能出现精神共病和心理社会功能低下，这可能表明其临床病程较长，对治疗的反应较差。男孩和女孩都遵循这条道路，但在某种程度上是不同类型的精神共病。
