Reinherz H Z, Giaconia R M, Pakiz B, Silverman A B, Frost A K, Lefkowitz E S
Simmons College School of Social Work, Boston, MA 02116.
J Am Acad Child Adolesc Psychiatry. 1993 Nov;32(6):1155-63. doi: 10.1097/00004583-199311000-00007.
An ongoing 14-year longitudinal study examined psychosocial antecedents of major depression in late adolescence in a community population.
Subjects were 385 adolescents followed between the ages of 5 and 18 years. Early health, familial, behavior, academic, and environmental risks for major depression were identified using data collected at ages 5, 9, 15, and 18 years. At age 18, a lifetime diagnosis of major depression was assessed using the NIMH Diagnostic Interview Schedule (DIS-III-R).
For males, neonatal health problems, dependence problems at age 5 years, perceived unpopularity and poorer perceptions of their role in the family at age 9 years, remarriage of a parent, early family discord, and anxiety at age 15 years significantly increased the risk of developing major depression. Females with major depression, compared with nondepressed females, had older parents and came from larger families, and at age 9 years had greater perceived unpopularity and anxiety, lower self-esteem, and poorer perceptions of their role in the family. Depressed females also reported more stressful life events, including death of parent and pregnancy.
Underscoring the importance of early psychosocial factors in the later development of major depression and pointing to specific risks, our findings can aid in developing strategies for prevention and early intervention.
一项正在进行的为期14年的纵向研究，考察了社区人群中青少年晚期重度抑郁症的心理社会先兆因素。
研究对象为385名年龄在5岁至18岁之间的青少年。利用在5岁、9岁、15岁和18岁时收集的数据，确定了重度抑郁症的早期健康、家庭、行为、学业和环境风险因素。在18岁时，使用美国国立精神卫生研究所诊断访谈表（DIS-III-R）评估重度抑郁症的终生诊断情况。
对于男性而言，新生儿健康问题、5岁时的依赖问题、9岁时感觉不受欢迎以及对自己在家庭中角色的认知较差、父母再婚、早期家庭不和以及15岁时的焦虑情绪，均显著增加了患重度抑郁症的风险。与未患抑郁症的女性相比，患重度抑郁症的女性父母年龄较大，来自大家庭，9岁时感觉更不受欢迎、焦虑情绪更严重、自尊心较低且对自己在家庭中角色的认知较差。患抑郁症的女性还报告了更多压力性生活事件，包括父母死亡和怀孕。
我们的研究结果强调了早期心理社会因素在重度抑郁症后期发展中的重要性，并指出了具体风险，有助于制定预防和早期干预策略。
