Longmore Avery, Anagnostou Evdokia, Georgiages Stelios, Jones Jessica, Kelley Elizabeth, Baribeau Danielle
Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Can J Psychiatry. 2024 Jul 25:7067437241259925. doi: 10.1177/07067437241259925.
The objective of this study was to identify longitudinal predictors of depressive symptoms in autistic children and youth.
Participants were youth with a diagnosis of autism who were part of the Province of Ontario Neurodevelopmental Disorders Network longitudinal substudy. Depressive symptoms were assessed using the child behaviour checklist (CBCL) affective problems subscale. Univariate and multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between clinical and demographic characteristics at baseline (T1) and clinically elevated depressive symptoms (CEDS) approximately 4 years later (T2).
The mean age of participants ( = 75) at T1 was 9.8 years ( = 2.7) and at T2 was 14.1 years ( = 2.8). A total of 37% and 35% of participants had CEDS at T1 and T2, respectively. Additionally, 24% of participants had CEDS at both T1 and T2. T1 characteristics associated with T2 CEDS were: loneliness (OR = 3.0, 95% CI, 1.1 to 8.8), self-harm (OR = 4.0, 95% CI, 1.1 to 16.9), suicidal ideation (OR = 3.9, 95% CI, 1.0 to 16.5), more social and adaptive skills (OR = 0.3, 95% CI, 0.1 to 0.9), elevated restricted and repetitive behaviours (OR = 3.8, 95% CI, 1.3 to 11.6), psychotropic medication use (OR = 3.0, 95% CI, 1.1 to 8.4), attention-deficient/hyperactivity disorder (OR = 2.8, 95% CI, 1.1 to 7.8), and T1 CEDS (OR = 8.8, 95% CI, 3.1 to 27.0) (uncorrected for multiple comparisons). Associations persisted after adjusting for age and intelligence quotient (IQ) differences. Age, sex, IQ, teasing/bullying on the CBCL, family psychiatric history and family income were not associated with T2 CEDS.
Our results highlight both high prevalence and high potential for the persistence of depressive symptoms in autism and emphasize the importance of early support to address loneliness and social participation.
本研究的目的是确定自闭症儿童和青少年抑郁症状的纵向预测因素。
参与者是被诊断为自闭症的青少年，他们是安大略省神经发育障碍网络纵向子研究的一部分。使用儿童行为检查表（CBCL）情感问题分量表评估抑郁症状。单变量和多变量逻辑回归模型用于估计基线时（T1）的临床和人口统计学特征与大约4年后（T2）临床抑郁症状升高（CEDS）之间关联的优势比（OR）和95%置信区间（CI）。
T1时参与者（n = 75）的平均年龄为9.8岁（标准差 = 2.7），T2时为14.1岁（标准差 = 2.8）。分别有37%和35%的参与者在T1和T2时有CEDS。此外，24%的参与者在T1和T2时均有CEDS。与T2时CEDS相关的T1特征包括：孤独感（OR = 3.0，95%CI，1.1至8.8）、自我伤害（OR = 4.0，95%CI，1.1至16.9）、自杀意念（OR = 3.9，95%CI，1.0至16.5）、更多的社交和适应技能（OR = 0.3，95%CI，0.1至0.9）、受限和重复行为增加（OR = 3.8，95%CI，1.3至11.6）、使用精神药物（OR = 3.0，95%CI，1.1至8.4）、注意力缺陷/多动障碍（OR = 2.8，95%CI，1.1至7.8）以及T1时的CEDS（OR = 8.8，95%CI，3.1至27.0）（未进行多重比较校正）。在调整年龄和智商（IQ）差异后，这些关联仍然存在。年龄、性别、IQ、CBCL上的取笑/欺凌、家族精神病史和家庭收入与T2时的CEDS无关。
我们的结果突出了自闭症中抑郁症状高发且持续存在的可能性，并强调了早期支持以解决孤独感和社会参与问题的重要性。
