对患有抑郁症及有抑郁症风险的青少年进行前瞻性随访：青少年早期识别抑郁症风险分层队列纵向评估的方案与方法
Prospective Follow-Up of Adolescents With and at Risk for Depression: Protocol and Methods of the Identifying Depression Early in Adolescence Risk Stratified Cohort Longitudinal Assessments.
作者信息
Piccin Jader, Viduani Anna, Buchweitz Claudia, Pereira Rivka B, Zimerman Aline, Amando Guilherme R, Cosenza Victor, Ferreira Leonardo Z, McMahon Natália A G, Melo Ramásio F, Richter Danyella, Reckziegel Frederico D S, Rohrsetzer Fernanda, Souza Laila, Tonon André C, Costa-Valle Marina Tuerlinckx, Zajkowska Zuzanna, Araújo Ricardo Matsumura, Hauser Tobias U, van Heerden Alastair, Hidalgo Maria Paz, Kohrt Brandon A, Mondelli Valeria, Swartz Johnna R, Fisher Helen L, Kieling Christian
机构信息
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
出版信息
JAACAP Open. 2024 Jun;2(2):145-159. doi: 10.1016/j.jaacop.2023.11.002.
OBJECTIVE
To present the protocol and methods for the prospective longitudinal assessments-including clinical and digital phenotyping approaches-of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study, which comprises Brazilian adolescents stratified at baseline by risk of developing depression or presence of depression.
METHOD
Of 7,720 screened adolescents aged 14 to 16 years, we recruited 150 participants (75 boys, 75 girls) based on a composite risk score: 50 with low risk for developing depression (LR), 50 with high risk for developing depression (HR), and 50 with an active untreated major depressive episode (MDD). Three annual follow-up assessments were conducted, involving clinical measures (parent- and adolescent-reported questionnaires and psychiatrist assessments), active and passive data sensing via smartphones, and neurobiological measures (neuroimaging and biological material samples). Retention rates were 96% (Wave 1), 94% (Wave 2), and 88% (Wave 3), with no significant differences by sex or group ( > .05). Participants highlighted their familiarity with the research team and assessment process as a motivator for sustained engagement.
DISCUSSION
This protocol relied on novel aspects, such as the use of a WhatsApp bot, which is particularly pertinent for low- to-middle-income countries, and the collection of information from diverse sources in a longitudinal design, encompassing clinical data, self-reports, parental reports, Global Positioning System (GPS) data, and ecological momentary assessments. The study engaged adolescents over an extensive period and demonstrated the feasibility of conducting a prospective follow-up study with a risk-enriched cohort of adolescents in a middle-income country, integrating mobile technology with traditional methodologies to enhance longitudinal data collection.
目的
介绍青少年抑郁早期识别风险分层队列（IDEA-RiSCo）研究的前瞻性纵向评估方案和方法，包括临床和数字表型分析方法，该研究纳入了在基线时根据患抑郁症风险或抑郁症存在情况进行分层的巴西青少年。
方法
在7720名接受筛查的14至16岁青少年中，我们根据综合风险评分招募了150名参与者（75名男孩，75名女孩）：50名患抑郁症风险低（LR），50名患抑郁症风险高（HR），50名患有未经治疗的活动性重度抑郁发作（MDD）。进行了三次年度随访评估，包括临床测量（家长和青少年报告的问卷以及精神科医生评估）、通过智能手机进行的主动和被动数据感知以及神经生物学测量（神经影像学和生物材料样本）。保留率分别为96%（第1波）、94%（第2波）和88%（第3波），按性别或组无显著差异（>0.05）。参与者强调他们对研究团队和评估过程的熟悉程度是持续参与的动力。
讨论
该方案依赖于新颖的方面，例如使用WhatsApp机器人，这对低收入和中等收入国家尤为相关，以及在纵向设计中从不同来源收集信息，包括临床数据、自我报告、家长报告、全球定位系统（GPS）数据和生态瞬时评估。该研究在很长一段时间内让青少年参与其中，并证明了在中等收入国家对一组风险较高的青少年进行前瞻性随访研究的可行性，将移动技术与传统方法相结合以加强纵向数据收集。
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