Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum-KU Leuven, Leuven, Belgium.
Department of Sociology, Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, MI, United States of America.
J Affect Disord. 2024 Oct 15;363:206-213. doi: 10.1016/j.jad.2024.07.090. Epub 2024 Jul 25.
This study adopts individual and societal-level approaches to examine the contribution of childhood risk factors to major depressive episodes (MDE) in 2526 American young adults.
Nationally representative data from the 2017 U.S. Panel Study of Income Dynamics - Transition into Adulthood Supplement (PSID-TAS) were analyzed using multivariate methods to assess the impact of parental mental illness, childhood adversities, childhood mental disorders, and childhood physical conditions. Adjusted odds ratios and population attributable risk proportions (PARPs) are calculated to estimate the proportion of MDE cases related to risk factors.
The 12-month prevalence of positive screens for MDE was 25.4 %. Approximately 34 % of these were attributable to childhood mental disorders, 24 % to childhood physical conditions, 21 % to childhood adversities, and 16 % to parental mental illness. Childhood and parental depression were critical risk factors, both at the individual (odds ratio exceeding 2) and societal (PARP approximately 24 %) levels. Gender-specific risk factors were identified, with childhood physical abuse and childhood anxiety disorders constituting risk factors for females, and childhood externalizing disorders and childhood headaches as risk factors for males. Approximately 60 % of U.S. young adult MDE cases are attributable to risk factors before age 18.
Possible over reporting of MDE may have biased the associations between predictors and depression.
Exposure to depression at a young age-one's own or parental depression-is a robust risk factor for both genders. Policies and interventions focused at alleviating the societal burden of depression should value its generational transmission.
本研究采用个体和社会层面的方法,考察了儿童时期风险因素对 2526 名美国年轻成年人发生重度抑郁发作(MDE)的影响。
采用多变量方法对 2017 年美国收入动态面板研究-成年过渡期补充调查(PSID-TAS)的全国代表性数据进行分析,评估了父母精神疾病、儿童逆境、儿童期精神障碍和儿童期身体状况对 MDE 的影响。调整后的优势比和人群归因风险比例(PARP)用于估计与风险因素相关的 MDE 病例比例。
MDE 阳性筛查的 12 个月患病率为 25.4%。这些病例中约 34%归因于儿童期精神障碍,24%归因于儿童期身体状况,21%归因于儿童逆境,16%归因于父母精神疾病。儿童期和父母的抑郁症是关键的风险因素,在个体(优势比超过 2)和社会(PARP 约为 24%)层面均如此。还确定了性别特异性的风险因素,儿童期身体虐待和儿童期焦虑障碍是女性的风险因素,儿童期外化障碍和儿童期头痛是男性的风险因素。大约 60%的美国年轻成年人 MDE 病例归因于 18 岁之前的风险因素。
MDE 的可能过度报告可能会影响预测因素与抑郁之间的关联。
年轻时暴露于抑郁——自己或父母的抑郁——是两性的一个强有力的风险因素。以缓解社会抑郁负担为重点的政策和干预措施应重视其代际传递。