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儿童和青少年抑郁症发生的预测因素:一项临床研究。

Predictive factors for the development of depression in children and adolescents: a clinical study.

作者信息

Zhang Hong, Yu Peilin, Liu Xiaoming, Wang Ke

机构信息

The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, Jiangsu, China.

Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

Front Psychiatry. 2024 Oct 14;15:1460801. doi: 10.3389/fpsyt.2024.1460801. eCollection 2024.

Abstract

BACKGROUND

The prevalence of depression among adolescents has been gradually increasing with the COVID-19 pandemic, and the purpose of this study was to develop and validate logistic regression models to predict the likelihood of depression among 6-17 year olds.

METHODS

We screened participants from the National Center for Health Statistics (NCHS) in 2022. Independent risk factors were identified via univariate logistic regression analyses and least absolute shrinkage and selection operator (LASSO) for feature screening. Area under the curve (AUC) and decision curve analysis (DCA) were used to compare the predictive performance and clinical utility of these models. In addition, calibration curves were used to assess calibration.

RESULTS

Multivariate logistic regression analyses revealed that risk factors for depression included girls, higher age, treated/judged based on race/ethnicity, ever lived with anyone mentally ill, experienced as a victim of/witnessed violence, and ever had autism, ever had attention-deficit disorder (ADD), etc. Afterwards, the results are visualized using a nomogram. The AUC of the training set is 0.731 and the AUC of the test set is 0.740. Also, the DCA and calibration curves demonstrate excellent performance.

CONCLUSION

Validated nomogram can accurately predict the risk of depression in children and adolescents, providing clues for clinical practitioners to develop targeted interventions and support.

摘要

背景

随着新冠疫情的爆发,青少年抑郁症的患病率逐渐上升。本研究旨在建立并验证逻辑回归模型,以预测6至17岁青少年患抑郁症的可能性。

方法

我们于2022年从国家卫生统计中心(NCHS)筛选了参与者。通过单变量逻辑回归分析和用于特征筛选的最小绝对收缩和选择算子(LASSO)确定独立风险因素。使用曲线下面积(AUC)和决策曲线分析(DCA)比较这些模型的预测性能和临床效用。此外,使用校准曲线评估校准情况。

结果

多变量逻辑回归分析显示,抑郁症的风险因素包括女孩、年龄较大、基于种族/民族接受治疗/评判、曾与精神疾病患者一起生活、曾是暴力受害者/目睹暴力行为、曾患自闭症、曾患注意力缺陷障碍(ADD)等。之后,使用列线图将结果可视化。训练集的AUC为0.731,测试集的AUC为0.740。此外,DCA和校准曲线显示出良好的性能。

结论

经过验证的列线图可以准确预测儿童和青少年患抑郁症的风险,为临床医生制定有针对性的干预措施和支持提供线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae43/11513372/72f1803b6fdf/fpsyt-15-1460801-g001.jpg

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