Lee Tsung-Han, Liu Hui-Ching, Huang Yu-Hsin, Sun Fang-Ju, Liu Shen-Ing
Department of Child and Adolescent Psychiatry, MacKay Memorial Hospital, Taipei City, Taiwan.
Department of Medical Research, MacKay Memorial Hospital, Taipei City, Taiwan.
Psychol Res Behav Manag. 2023 Dec 7;16:4959-4970. doi: 10.2147/PRBM.S429923. eCollection 2023.
Some risk/protective factors of adolescent depression have been proposed but have not been comprehensively studied. Recent advances in neuroimaging techniques have provided greater insight into the underlying neuropsychiatric mechanisms of depression-related factors such as impulsivity, substance use, gender difference and social support. However, how these factors are interconnected and how they affect depression in the real world is poorly understood. This study aimed to explore the relationships between adolescent depression with trait impulsivity, substance use and gender. We also tested the hypothesis that social support may play a buffering role in preventing depression. By expanding the diathesis-stress model.
The adolescents enrolled in this study were grade 1 senior high school students from northern Taiwan (N = 5879), and they were assessed for depression, trait impulsivity, and tobacco/alcohol use. Hierarchical multiple linear regression was performed to control possible confounders, including other depression-related diathesis and sociodemographic variables. Gender differences were also analyzed by separately examining variables significantly associated with depression.
A higher level of depression was associated with female gender, trait impulsivity, low self-esteem, negative attitude towards the future, tobacco use, alcohol use, family discord and difficulty in basic family needs. Good parental health, living with their biological family and social support were protective factors. Trait impulsivity was significantly associated with depression after controlling for the confounding factors. Gender-specific analysis showed that trait impulsivity and tobacco use had a significant synergistic interaction on female depression. Social support from parents/peers was significantly associated with depression, but social support from other family members/teachers was not.
The current study advances the understanding of adolescent depression and highlights that trait impulsivity, addictive substance use, social support and their interaction may play an influential role in the emergence of adolescent depression. Gender-specific research and treatment approach are also crucial, and more investigations are necessary.
虽然已经提出了一些青少年抑郁症的风险/保护因素，但尚未进行全面研究。神经影像学技术的最新进展使人们对与抑郁症相关因素（如冲动性、物质使用、性别差异和社会支持）的潜在神经精神机制有了更深入的了解。然而，这些因素如何相互关联以及它们在现实世界中如何影响抑郁症，人们知之甚少。本研究旨在探讨青少年抑郁症与特质冲动性、物质使用和性别的关系。我们还检验了社会支持可能在预防抑郁症中起缓冲作用的假设。通过扩展素质-应激模型。
本研究纳入的青少年是来自台湾北部的高一学生（N = 5879），他们接受了抑郁症、特质冲动性和烟草/酒精使用的评估。进行分层多元线性回归以控制可能的混杂因素，包括其他与抑郁症相关的素质和社会人口学变量。还通过分别检查与抑郁症显著相关的变量来分析性别差异。
较高水平的抑郁症与女性性别、特质冲动性、低自尊、对未来的消极态度、烟草使用、酒精使用、家庭不和以及基本家庭需求困难有关。父母健康状况良好、与亲生家庭同住和社会支持是保护因素。在控制混杂因素后，特质冲动性与抑郁症显著相关。性别特异性分析表明，特质冲动性和烟草使用对女性抑郁症有显著的协同相互作用。来自父母/同伴的社会支持与抑郁症显著相关，但来自其他家庭成员/教师的社会支持则不然。
本研究增进了对青少年抑郁症的理解，并强调特质冲动性、成瘾物质使用、社会支持及其相互作用可能在青少年抑郁症的发生中发挥重要作用。性别特异性研究和治疗方法也至关重要，还需要更多的调查。
