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波多黎各有抑郁症状史青少年慢性化的相关因素及预测因素

Correlates and Predictors of Chronicity among Adolescents Living in Puerto Rico With a History of Depressive Symptoms.

作者信息

Cumba-Avilés Eduardo, Meléndez Marieli Piñero, Luiggi-Hernández José G, Feliciano-López Vidalina

机构信息

Institute for Psychological Research, University of Puerto Rico, Río Piedras Campus.

Albizu University, San Juan Campus.

出版信息

Rev Puertorriquena Psicol. 2021 Jul-Dec;32(2):190-206. Epub 2022 Jan 16.

Abstract

Chronic depression (CD) among Hispanic/Latina(o) youths has been understudied, although chronicity is the biggest risk factor for treatment-resistant depression. We examined CD correlates and predictors among 291 youths (aged 12-18 years) living in Puerto Rico with a history of depressive symptoms. They completed the Children's Depression Inventory (CDI), the Depressive Symptoms Spectrum Assessment Inventory (DSSAI), and the Brief Structured Diagnostic Measure for Depression. We explored CD correlates using Odds Ratios adjusted for CDI-Total scores. With multiple logistic regression, we identified optimal predictors of a history of chronic depressive symptoms (HCDS) or any chronic depressive disorder (HACDD). Living zone (rural), history of depressive disorder, household size (< 4), age of onset of symptoms (< 13 years), death/suicidal thoughts at the first episode, antidepressants use, and scores ≥ 84 percentile in the DSSAI-Anhedonia subscale, accounted for 37% of HCDS variance. The latter five variables and socioeconomic status (lower-middle/low) best distinguished HACDD and episodic disorders ( = .331). Identifying factors that distinguish chronic and episodic depression among Hispanic/Latina(o) youths may help to improve their diagnosis, access to and quality of care, as well as treatment selection, tailoring, and outcomes.

摘要

尽管慢性病程是难治性抑郁症的最大风险因素,但西班牙裔/拉丁裔青少年中的慢性抑郁症(CD)一直未得到充分研究。我们调查了291名居住在波多黎各且有抑郁症状史的青少年(年龄在12 - 18岁之间)中与慢性抑郁症相关的因素及预测指标。他们完成了儿童抑郁量表(CDI)、抑郁症状谱评估量表(DSSAI)和抑郁症简短结构化诊断量表。我们使用根据CDI总分调整后的优势比来探究与慢性抑郁症相关的因素。通过多元逻辑回归,我们确定了慢性抑郁症状史(HCDS)或任何慢性抑郁症(HACDD)的最佳预测指标。居住区域(农村)、抑郁症病史、家庭规模(< 4人)、症状发作年龄(< 13岁)、首次发作时的死亡/自杀念头、使用抗抑郁药以及在DSSAI快感缺乏分量表中得分≥第84百分位数,解释了HCDS变异的37%。后五个变量和社会经济地位(中低/低)最能区分HACDD和发作性疾病( = 0.331)。确定西班牙裔/拉丁裔青少年中区分慢性和发作性抑郁症的因素可能有助于改善他们的诊断、获得的护理及护理质量,以及治疗选择、调整和治疗效果。

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