Shi Jiali, Tao Yiran, Yan Caiying, Zhao Xudong, Wu Xueqing, Zhang Tingting, Zhong Cheng, Sun Jinhua, Hu Manji
Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Department of General Medicine, Zhoupu Health Service Center, Shanghai, China.
Front Psychiatry. 2023 Jan 24;13:1025168. doi: 10.3389/fpsyt.2022.1025168. eCollection 2022.
To evaluate the relationship between systemic family dynamics and adolescent depression.
An offline survey was distributed to 4,109 students in grades 6-12, with the final analysis including 3,014 students (1,524 boys and 1,490 girls) aged 10-18 years. The questionnaire included the Self-Rating Scale of Systemic Family Dynamics (SSFD), the Self-Rating Depression Scale (SDS), and demographic characteristics.
Family dynamics were negatively correlated with depressive symptoms, with better family dynamics (high scores) associated with lower levels of depression based on the SDS score. After adjusting for sociodemographic characteristics, an ordinal multiclass logistic regression analysis identified family atmosphere (OR = 0.952, 95% CI: 0.948-0.956, < 0.001) as the most important protective family dynamic against depression, followed by individuality (OR = 0.964, 95% CI: 0.960-0.968, < 0.001). Latent class analysis (LCA) created the low family dynamic and high family dynamic groups. There were significant differences in the mean SDS scores between the two groups (45.52 ± 10.57 vs. 53.78 ± 11.88; < 0.001) that persisted after propensity matching. Family atmosphere and individuation had a favorable diagnostic value for depression, with AUCs of 0.778 (95% CI: 0.760-0.796) and 0.710 (95% CI: 0.690-0.730), respectively. The diagnostic models for depression performed well.
Poor family dynamics may be responsible for adolescent depression. A variety of early intervention strategies focused on the family may potentially avoid adolescent depression.
评估家庭系统动力学与青少年抑郁症之间的关系。
对4109名6至12年级的学生进行了线下调查,最终分析纳入了3014名年龄在10至18岁的学生(1524名男生和1490名女生)。问卷包括家庭系统动力学自评量表(SSFD)、抑郁自评量表(SDS)以及人口统计学特征。
家庭动力学与抑郁症状呈负相关,基于SDS评分,较好的家庭动力学(高分)与较低的抑郁水平相关。在对社会人口学特征进行调整后,有序多分类逻辑回归分析确定家庭氛围(OR = 0.952,95% CI:0.948 - 0.956,< 0.001)是预防抑郁症最重要的保护性家庭动力学因素,其次是个性(OR = 0.964,95% CI:0.960 - 0.968,< 0.001)。潜在类别分析(LCA)创建了低家庭动力学组和高家庭动力学组。两组之间的平均SDS评分存在显著差异(45.52 ± 10.57 vs. 53.78 ± 11.88;< 0.001),倾向得分匹配后差异仍然存在。家庭氛围和个性化对抑郁症具有良好的诊断价值,AUC分别为0.778(95% CI:0.760 - 0.796)和0.710(95% CI:0.690 - 0.730)。抑郁症诊断模型表现良好。
不良的家庭动力学可能是青少年抑郁症的原因。多种以家庭为重点的早期干预策略可能有助于预防青少年抑郁症。