Psychogiou Lamprini, Navarro Marie C, Orri Massimiliano, Côté Sylvana M, Ahun Marilyn N
Mood Disorders Centre, University of Exeter, Exeter, United Kingdom.
Department of Public Health, Bordeaux Population Health Research Centre, Institut National de la Santé et de la Recherche Médicale U1219, Bordeaux, France.
JAMA Netw Open. 2024 Aug 1;7(8):e2425987. doi: 10.1001/jamanetworkopen.2024.25987.
Depression is a leading cause of disability. The timing and persistence of depression may be differentially associated with long-term mental health and psychosocial outcomes.
To examine if depression symptoms during early and middle childhood and adolescence and persistent depression symptoms are associated with impaired young adult outcomes independent of early risk factors.
DESIGN, SETTING, AND PARTICIPANTS: Data for this prospective, longitudinal cohort study were from the Québec Longitudinal Study of Child Development, a representative population-based Canadian birth cohort. The cohort consists of infants born from October 1, 1997, to July 31, 1998. This is an ongoing study; data are collected annually or every 2 years and include those ages 5 months to 21 years. The end date for the data in this study was June 30, 2019, and data analyses were performed from October 4, 2022, to January 3, 2024.
Depression symptoms were assessed using maternal reports in early childhood (ages 1.5 to 6 years) from 1999 to 2004, teacher reports in middle childhood (ages 7 to 12 years) from 2005 to 2010, and self-reports in adolescence (ages 13 to 17 years) from 2011 to 2015.
The primary outcome was depression symptoms at age 20 years, and secondary outcomes were indicators of psychosocial functioning (binge drinking; perceived stress; not being in education, employment, or training; social support; and experiencing online harrasment) at age 21 years. All outcomes were self-reported. Adult outcomes were reported by participants at ages 20 and 21 years from 2017 to 2019. Risk factors assessed when children were aged 5 months old were considered as covariates to assess the independent associations of childhood and adolescent depression symptoms with adult outcomes.
The cohort consisted of 2120 infants. The analytic sample size varied from 1118 to 1254 participants across outcomes (56.85% to 57.96% female). Concerning the primary outcome, adjusting for early risk factors and multiple testing, depression symptoms during adolescence were associated with higher levels of depression symptoms (β, 1.08 [95% CI, 0.84-1.32]; P < .001 unadjusted and Bonferroni adjusted) in young adulthood. Concerning the secondary outcomes, depression symptoms in adolescence were only associated with perceived stress (β, 3.63 [95% CI, 2.66-4.60]; P < .001 unadjusted and Bonferroni adjusted), while both middle-childhood (β, -1.58 [95% CI, -2.65 to -0.51]; P = .003 unadjusted and P < .001 Bonferroni adjusted) and adolescent (β, -1.97 [95% CI, -2.53 to -1.41]; P < .001 unadjusted and Bonferroni adjusted) depression symptoms were associated with lower levels of social support. There were no associations for binge drinking; not being in education, employment, or training; or experiencing online harrasment.
In this cohort study of Canadian children and adolescents, childhood and adolescent depression symptoms were associated with impaired adult psychosocial functioning. Interventions should aim to screen and monitor children and adolescents for depression to inform policymaking regarding young adult mental health and psychosocial outcomes.
抑郁症是导致残疾的主要原因。抑郁症的发作时间和持续时间可能与长期心理健康及社会心理结果存在不同程度的关联。
探讨儿童早期、中期和青少年时期的抑郁症状以及持续性抑郁症状是否与青年成人期的不良后果相关，且独立于早期风险因素。
设计、地点和参与者：这项前瞻性纵向队列研究的数据来自魁北克儿童发展纵向研究，这是一项基于加拿大具有代表性的出生队列研究。该队列由1997年10月1日至1998年7月31日出生的婴儿组成。这是一项正在进行的研究；数据每年或每两年收集一次，涵盖5个月至21岁的人群。本研究数据的截止日期为2019年6月30日，数据分析于2022年10月4日至2024年1月3日进行。
抑郁症状通过以下方式评估：1999年至2004年使用母亲报告评估儿童早期（1.5至6岁）的情况，2005年至2010年使用教师报告评估儿童中期（7至12岁）的情况，2011年至2015年使用自我报告评估青少年（13至17岁）的情况。
主要结局是20岁时的抑郁症状，次要结局是21岁时社会心理功能的指标（酗酒；感知压力；未接受教育、就业或培训；社会支持；以及遭受网络骚扰）。所有结局均为自我报告。成人结局由参与者在2017年至2019年20岁和21岁时报告。将儿童5个月大时评估的风险因素视为协变量，以评估儿童期和青少年期抑郁症状与成人结局的独立关联。
该队列由2120名婴儿组成。各结局的分析样本量在1118至1254名参与者之间（女性占56.85%至57.96%）。关于主要结局，在调整早期风险因素和多次检验后，青少年期的抑郁症状与青年成人期较高水平的抑郁症状相关（β，1.08 [95%置信区间，0.84 - 1.32]；未调整和Bonferroni调整后的P <.001）。关于次要结局，青少年期的抑郁症状仅与感知压力相关（β，3.63 [95%置信区间，2.66 - 4.60]；未调整和Bonferroni调整后的P <.001），而儿童中期（β， - 1.58 [95%置信区间， - 2.65至 - 0.51]；未调整的P = 0.003，Bonferroni调整后的P <.001）和青少年期（β， - 1.97 [95%置信区间， - 2.53至 - 1.41]；未调整和Bonferroni调整后的P <.001）的抑郁症状均与较低水平的社会支持相关。在酗酒、未接受教育、就业或培训、或遭受网络骚扰方面未发现关联。
在这项针对加拿大儿童和青少年的队列研究中，儿童期和青少年期的抑郁症状与成人社会心理功能受损相关。干预措施应旨在筛查和监测儿童及青少年的抑郁症，为有关青年成人心理健康和社会心理结果的政策制定提供信息。
