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学龄青少年的抑郁症状:不良事件的累积效应及社会支持的中介作用

Depressive symptoms of school-aged adolescents: cumulative effect of adverse events and mediation of social support.

作者信息

Andrade Célia Regina de, Oliveira Raquel de Vasconcellos Carvalhaes de, Avanci Joviana Quintes

机构信息

Fundação Oswaldo Cruz, Sergio Arouca National School of Public Health, Graduate Program in Public Health, Department of Quantitative Methods in Health - Rio de Janeiro (RJ), Brazil.

Fundação Oswaldo Cruz, Evandro Chagas National Institute of Infectious Diseases. Graduate Program in Public Health Epidemiology - Rio de Janeiro (RJ), Brazil.

出版信息

Rev Bras Epidemiol. 2025 May 9;28:e250019. doi: 10.1590/1980-549720250019. eCollection 2025.

Abstract

OBJECTIVE

To analyze the effect of cumulative adverse childhood experiences and depressive symptoms on adolescence and to identify direct and indirect relationships between the variables and the mediating role of social support.

METHODS

This is a cross-sectional study with a sample of 1,117 school-aged adolescents aged 13 to 19 years. The Children's Depression Inventory and Adverse Childhood Experiences scales were used, organized into socioeconomic, family, community, and total dimensions. Descriptive analysis was carried out and the structural equation model was used, with probit estimation, applying social support as mediator.

RESULTS

The prevalence of depressive symptoms among school-aged adolescents was 8.2%. We observed that the accumulation of socioeconomic, family, and community factors increases the occurrence of depressive symptoms, adjusted for sex, skin color, and social support. Mediation by social support explains 16.7% of the total effect of exposure to the analyzed factors. In the socioeconomic dimension, the depression probit increases by 0.033 for each category, with 21.2% mediated by social support. In the family dimension, the increase is 0.020 (25% mediated); in the community, 0.018 (16.7% mediated); and in the total dimension, 0.012 (17% mediated).

CONCLUSION

The observation of the effect of the accumulation of Adverse Childhood Experiences on depressive symptoms in adolescence requires actions in vulnerable groups, with social support helping to mitigate the risk of depression.

摘要

目的

分析童年不良经历累积及抑郁症状对青少年的影响,确定变量之间的直接和间接关系以及社会支持的中介作用。

方法

这是一项横断面研究,样本为1117名13至19岁的学龄青少年。使用了儿童抑郁量表和童年不良经历量表,分为社会经济、家庭、社区和总体维度。进行了描述性分析,并使用结构方程模型,采用概率单位估计,将社会支持作为中介变量。

结果

学龄青少年中抑郁症状的患病率为8.2%。我们观察到,在对性别、肤色和社会支持进行校正后,社会经济、家庭和社区因素的累积会增加抑郁症状的发生率。社会支持的中介作用解释了所分析因素暴露总效应的16.7%。在社会经济维度中,每增加一个类别,抑郁概率单位增加0.033,其中21.2%由社会支持介导。在家庭维度中,增加量为0.020(25%由社会支持介导);在社区维度中,增加量为0.018(16.7%由社会支持介导);在总体维度中,增加量为0.012(17%由社会支持介导)。

结论

观察童年不良经历累积对青少年抑郁症状的影响需要针对弱势群体采取行动,社会支持有助于降低抑郁风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a16f/12068810/8c5904527ab5/1980-5497-rbepid-28-e250019-gf01.jpg

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