Wolfson Centre for Young People's Mental Health and Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
Wolfson Centre for Young People's Mental Health and Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
Lancet. 2022 Aug 20;400(10352):617-631. doi: 10.1016/S0140-6736(22)01012-1. Epub 2022 Aug 5.
Depression rates in young people have risen sharply in the past decade, especially in females, which is of concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions. Adverse outcomes associated with depression in young people include depression recurrence; the onset of other psychiatric disorders; and wider, protracted impairments in interpersonal, social, educational, and occupational functioning. Thus, prevention and early intervention for depression in young people are priorities. Preventive and early intervention strategies typically target predisposing factors, antecedents, and symptoms of depression. Young people who have a family history of depression, exposure to social stressors (eg, bullying, discordant relationships, or stressful life events), and belong to certain subgroups (eg, having a chronic physical health problem or being a sexual minority) are at especially high risk of depression. Clinical antecedents include depressive symptoms, anxiety, and irritability. Evidence favours indicated prevention and targeted prevention to universal prevention. Emerging school-based and community-based social interventions show some promise. Depression is highly heterogeneous; therefore, a stepwise treatment approach is recommended, starting with brief psychosocial interventions, then a specific psychological therapy, and then an antidepressant medication.
在过去的十年中，年轻人的抑郁率急剧上升，尤其是女性，这令人担忧，因为青春期是一个快速的社会、情感和认知发展以及关键的生活转变时期。与年轻人抑郁相关的不良后果包括抑郁复发；其他精神障碍的发病；以及人际、社会、教育和职业功能的更广泛、长期受损。因此，预防和早期干预年轻人的抑郁症是当务之急。预防和早期干预策略通常针对易患因素、前兆和抑郁症状。有抑郁症家族史、接触社会压力源（例如欺凌、关系不和或压力生活事件）以及属于某些亚组（例如患有慢性身体健康问题或性少数群体）的年轻人患抑郁症的风险特别高。临床前兆包括抑郁症状、焦虑和易怒。有证据支持针对普遍性预防的有针对性预防和有针对性预防。新兴的基于学校和社区的社会干预措施显示出一些希望。抑郁症高度异质；因此，建议采用逐步治疗方法，首先是简短的心理社会干预，然后是特定的心理治疗，然后是抗抑郁药物治疗。
