McCauley E, Myers K, Mitchell J, Calderon R, Schloredt K, Treder R
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
J Am Acad Child Adolesc Psychiatry. 1993 Jul;32(4):714-22. doi: 10.1097/00004583-199307000-00003.
This project was designed to provide prospective data on the clinical presentation and longitudinal course of depression in children and adolescents.
Children and their parent(s) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School Age Children) at intake, and then yearly for 3 years. Collateral data were collected on school, social, and family functioning.
Mean length of initial depressive episode was 35.6 weeks, SD of 26 weeks. Of the 65 depressed youths who completed the 3-year follow-up, 35 (54%) disclosed another episode of depression. Demographic, family-environment, and diagnostic variables were explored as predictors of characteristics of initial episode, recurrence of depression, and psychosocial competence at follow-up. Female gender and presence of a coexisting anxiety disorder were significantly related to severity of initial depression. Family environment was the only predictor significantly related to overall psychosocial competence over 3 years.
The findings confirm depression in youth as a valid clinical phenomenon, with substantial risk of recurrence. Increased levels of stress in the family environment were associated with poorer overall outcomes.
本项目旨在提供有关儿童和青少年抑郁症临床表现及病程的前瞻性数据。
儿童及其父母在初次就诊时完成一份结构化诊断访谈（学龄儿童情感障碍和精神分裂症检查表），并在随后3年每年进行一次。收集了关于学校、社交和家庭功能的旁证数据。
首次抑郁发作的平均时长为35.6周，标准差为26周。在完成3年随访的65名抑郁青少年中，35名（54%）出现了另一次抑郁发作。对人口统计学、家庭环境和诊断变量进行了探索，以作为首次发作特征、抑郁复发及随访时心理社会能力的预测因素。女性性别和并存焦虑症与首次抑郁的严重程度显著相关。家庭环境是与3年期间总体心理社会能力显著相关的唯一预测因素。
研究结果证实青少年抑郁症是一种有效的临床现象，复发风险很大。家庭环境中压力水平的增加与总体较差的结果相关。
