Sanford M, Szatmari P, Spinner M, Munroe-Blum H, Jamieson E, Walsh C, Jones D
Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 1995 Dec;34(12):1618-28. doi: 10.1097/00004583-199512000-00012.
To identify specific clinical and social functioning variables that predict persistence of major depression over a 1-year period of follow-up.
The sample consisted of 67 adolescents with major depression, drawn from consecutive referrals to psychiatric clinics in a defined, geographic catchment area. Clinical interviews and questionnaires measuring behaviors, symptoms, and social functioning were administered to both the adolescent and a parent at inception and at follow-up. Discriminant function analyses were used to identify inception variables that predicted clinical course independent of severity of depressive symptoms and global functioning.
At 1-year follow-up, major depression remitted in 66% of subjects. Persisters were characterized at inception as older, more likely to have substance use or anxiety disorders, less involved with fathers, and less responsive to mother's discipline compared with remitters. The effect of these prognostic factors was independent of symptom severity and global functioning.
These variables appear to reflect perpetuating and ameliorating factors influencing the short-term course of major depression. The findings suggest that treatments for adolescent depression that aim to enhance parent-adolescent relationships, and that specifically target coexisting disorders, should be evaluated for effectiveness.
确定在为期1年的随访期间预测重度抑郁症持续存在的特定临床和社会功能变量。
样本包括67名患有重度抑郁症的青少年，他们来自特定地理区域内连续转诊至精神科诊所的患者。在初始阶段和随访时，对青少年及其父母进行了临床访谈以及测量行为、症状和社会功能的问卷调查。判别函数分析用于确定在不考虑抑郁症状严重程度和整体功能的情况下预测临床病程的初始变量。
在1年的随访中，66%的受试者重度抑郁症得到缓解。与缓解者相比，持续存在者在初始阶段的特征为年龄较大、更有可能患有物质使用或焦虑症、与父亲的关系较少，以及对母亲的管教反应较少。这些预后因素的影响独立于症状严重程度和整体功能。
这些变量似乎反映了影响重度抑郁症短期病程的持续和改善因素。研究结果表明，旨在加强亲子关系并专门针对共存疾病的青少年抑郁症治疗方法的有效性应予以评估。
