Institute for Mental Health, School of Psychology, University of Birmingham, UK.
Early Intervention Service, Birmingham Women's and Children's NHS Trust, Birmingham, UK.
Br J Psychiatry. 2023 May;222(5):212-220. doi: 10.1192/bjp.2023.23.
Little is still known about the long-term impact of childhood and adolescent persistent depression and anxiety in adulthood.
To investigate the impact of persistent anxiety, depression, and comorbid anxiety and depression across childhood and adolescence on the development of multiple adverse outcomes in young adulthood.
This study used data from 8122 participants in the Avon Longitudinal Study of Parents and Children cohort. The Development and Well-Being Assessment (DAWBA) examined child anxiety and depression symptomatology. The DAWBA generalised anxiety and mood subscales at 8, 10 and 13 years were selected, and a measure of comorbid anxiety and depression symptoms was created at each time point. Further, several mental and physical health, substance misuse and education/employment problems were assessed at 24 years. Latent class growth analyses were used to detect trajectories of anxiety, depression and comorbid anxiety and depression; and logistic regression to examine how persistent anxiety, depression or both were associated with adverse outcomes at 24 years.
All three classes with persistent anxiety, depression or both were significantly associated with presenting with any mental health problems and any education/employment problem. Persistent high levels of depression and high levels of comorbid anxiety and depression, but not persistent high anxiety, were significantly associated with any physical health problem. High levels of comorbid anxiety and depression was the only DAWBA domain significantly associated with substance misuse; and overall, this was the domain that exerted the greatest negative impact, as it presented the highest odd ratio values.
Children and adolescents with comorbid anxiety and depression are at the highest risk for having more adverse outcomes at 24 years.
关于儿童和青少年时期持续性抑郁和焦虑对成年后长期影响的了解甚少。
探究儿童和青少年时期持续性焦虑、抑郁以及共病性焦虑和抑郁对年轻人多种不良结局的发展的影响。
本研究使用了来自阿冯纵向研究父母与子女队列的 8122 名参与者的数据。发展与健康评估(DAWBA)检查了儿童的焦虑和抑郁症状。选择了 DAWBA 广泛性焦虑和情绪分量表在 8、10 和 13 岁时的数据,并在每个时间点创建了共病性焦虑和抑郁症状的衡量标准。此外,在 24 岁时还评估了多种心理健康和身体健康、物质滥用和教育/就业问题。潜类别增长分析用于检测焦虑、抑郁和共病性焦虑和抑郁的轨迹;逻辑回归用于检查持续性焦虑、抑郁或两者与 24 岁时的不良结局之间的关系。
所有具有持续性焦虑、抑郁或两者的三个类别都与出现任何心理健康问题和任何教育/就业问题显著相关。持续性高水平的抑郁和高水平的共病性焦虑和抑郁,但不是持续性高水平的焦虑,与任何身体健康问题显著相关。高水平的共病性焦虑和抑郁是 DAWBA 领域中唯一与物质滥用显著相关的领域;总的来说,这是对产生最大负面影响的领域,因为它表现出了最高的比值比。
患有共病性焦虑和抑郁的儿童和青少年在 24 岁时出现更多不良结局的风险最高。