Ndjatou Tatiana, Qiu Yuqing, Gerber Linda M, Chang Jane
Department of Pediatrics, Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, NY.
Department of Population Health Sciences, Division of Biostatistics, Weill Cornell Medicine, New York, NY.
J Pediatr Clin Pract. 2024 Apr 26;13:200113. doi: 10.1016/j.jpedcp.2024.200113. eCollection 2024 Sep.
To compare adolescent and caregiver reports of adolescent adverse childhood experiences (ACEs) and their relationship with current adolescent depression and to analyze the relationship between ACEs and depression.
We recruited 46 adolescent-caregiver dyads from a large, inner-city medical center's adolescent medicine clinic. Adolescents and caregivers completed the Center for Youth Wellness ACE questionnaire, encompassing traditional ACEs (eg, abuse, neglect, household dysfunction) and nontraditional ACEs (eg, foster care, parental death, exposure to community violence). Adolescents also completed the Patient Health Questionnaire-9A (PHQ-9A) depression screening tool.
Among adolescents, 14 (30%) reported no traditional ACEs, 11 (24%) reported 1, and 21 (46%) reported more than 1. Regarding nontraditional ACEs, 16 (35%) reported none, 11 (24%) reported 1, and 19 (41%) reported more than 1. Caregiver reports consistently indicated lower ACEs compared with adolescent self-reports ( < .005). For the PHQ-9A scores, 26 (57%) of adolescents showed no or minimal depression, 14 (30%) mild, and 6 (13%) moderate depression. A moderate positive correlation emerged between PHQ-9A scores and self-reported traditional ACEs (r = 0.5, < .001) and nontraditional ACEs (r = 0.49, < .001). In addition, a positive correlation was observed between the absolute differences in adolescent and caregiver reports of traditional ACEs and PHQ-9A scores (n = 46, ρ = 0.51, < .001).
As the differences in ACE reports between adolescents and caregivers increased, there was a corresponding increase in adolescent depression scores. It is essential to incorporate comprehensive ACE screening and encourage open communication between adolescents and caregivers, which may improve mental health outcomes.
比较青少年及其照顾者报告的青少年童年不良经历（ACEs），以及它们与当前青少年抑郁症的关系，并分析ACEs与抑郁症之间的关系。
我们从一家大型市中心医疗中心的青少年医学诊所招募了46对青少年-照顾者二元组。青少年和照顾者完成了青少年健康中心ACE问卷，该问卷涵盖了传统的ACEs（如虐待、忽视、家庭功能障碍）和非传统的ACEs（如寄养、父母死亡、接触社区暴力）。青少年还完成了患者健康问卷-9A（PHQ-9A）抑郁筛查工具。
在青少年中，14人（30%）报告没有传统的ACEs，11人（24%）报告有1次，21人（46%）报告有不止1次。关于非传统的ACEs，16人（35%）报告没有，11人（24%）报告有1次，19人（41%）报告有不止1次。与青少年自我报告相比，照顾者报告始终显示ACEs较低（P <.005）。对于PHQ-9A得分，26名（57%）青少年没有或仅有轻微抑郁，14名（30%）有轻度抑郁，6名（13%）有中度抑郁。PHQ-9A得分与自我报告的传统ACEs（r = 0.5，P <.00）和非传统ACEs（r = 0.49，P <.001）之间出现了中度正相关。此外，观察到青少年和照顾者报告的传统ACEs的绝对差异与PHQ-9A得分之间存在正相关（n = 46，ρ = 0.51，P <.001）。
随着青少年和照顾者报告的ACEs差异增加，青少年抑郁得分相应增加。纳入全面的ACE筛查并鼓励青少年与照顾者之间的开放沟通至关重要，这可能会改善心理健康结果。
