Portogallo H J, Skvarc D R, Shore L A, Toumbourou J W
School of Psychology, Deakin University, Geelong, Australia.
School of Psychology, Deakin University, Geelong, Australia.
J Affect Disord. 2024 Oct 15;363:643-652. doi: 10.1016/j.jad.2024.07.056. Epub 2024 Jul 28.
Group differences in longitudinal patterns of child and adolescent depressive symptoms are commonly observed. However, the implications for adult mental health are unclear. This study presents a systematic review of child and adolescent depressive symptom trajectory research and meta-analysis of their longitudinal effects on adult depressive symptoms and disorders.
A systematic search identified 12 longitudinal studies (12 cohorts, N = 35,058) that were harmonized to identify common symptom trajectories prior to age 18 years. Examination of follow-up in the same groups was made (at average age 20.5 years) to estimate longitudinal associations with adult depressive symptoms (Sx) and disorders (Dx), using random effects meta-analyses.
The included studies identified Low (70.3 %), Moderate (17.9 %), High (9.5 %), Increasing (9.5 %) and Decreasing (5.1 %) symptom trajectories. These trajectories were found to predict variation in symptoms and disorders in adulthood: Low, Dx = 4.5 %, 95 % Confidence Interval [CI] 2.7-6.8 %, Sx [Mean] = 8.33, Standard Deviation [SD] = 6.30; Moderate, Dx = 20.9 %, CI 11.9-31.5 % - Sx = 18.13, SD = 3.38; High, Dx = 34.4 % CI 17.2-54.0 % - Sx = 38.80, SD = 7.75; Increasing, Dx = 38.3 %, CI 12.7-67.5 % - Sx = 24.73, SD = 18.64; Decreasing, Dx = 15.4 %, CI 10.5-20.9 % - Sx = 17.00, SD = 12.18.
Confidence intervals are wide for some trajectory effects. There was significant between-cohort heterogeneity in predictive effects for High trajectories, suggesting the need for further research to identify characteristics influencing variation.
Low symptom trajectories forecast lower adult depression symptoms and disorders. Programs effectively targeting reductions in Moderate, High, Increasing and Decreasing trajectories will likely prevent problems in early adulthood.
儿童和青少年抑郁症状的纵向模式存在群体差异，这一点已普遍得到观察。然而，其对成人心理健康的影响尚不清楚。本研究对儿童和青少年抑郁症状轨迹研究进行了系统综述，并对其对成人抑郁症状和障碍的纵向影响进行了荟萃分析。
通过系统检索，确定了12项纵向研究（12个队列，N = 35058），这些研究经过协调，以确定18岁之前的常见症状轨迹。对同一组人群进行随访检查（平均年龄20.5岁），使用随机效应荟萃分析来估计与成人抑郁症状（Sx）和障碍（Dx）的纵向关联。
纳入的研究确定了低（70.3%）、中（17.9%）、高（9.5%）、上升（9.5%）和下降（5.1%）的症状轨迹。发现这些轨迹可预测成年期症状和障碍的变化：低轨迹，Dx = 4.5%，95%置信区间[CI] 2.7 - 6.8%，Sx[均值]= 8.33，标准差[SD]= 6.30；中轨迹，Dx = 20.9%，CI 11.9 - 31.5% - Sx = 18.13，SD = 3.38；高轨迹，Dx = 34.4%，CI 17.2 - 54.0% - Sx = 38.80，SD = 7.75；上升轨迹，Dx = 38.3%，CI 12.7 - 67.5% - Sx = 24.73，SD = 18.64；下降轨迹，Dx = 15.4%，CI 10.5 - 20.9% - Sx = 17.00，SD = 12.18。
部分轨迹效应的置信区间较宽。高轨迹的预测效应在队列间存在显著异质性，这表明需要进一步研究以确定影响变异的特征。
低症状轨迹预示着成人抑郁症状和障碍的发生率较低。有效针对降低中、高、上升和下降轨迹的项目可能会预防成年早期出现的问题。
