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儿童及青少年抑郁症:过去十年综述。第一部分。

Childhood and adolescent depression: a review of the past 10 years. Part I.

作者信息

Birmaher B, Ryan N D, Williamson D E, Brent D A, Kaufman J, Dahl R E, Perel J, Nelson B

机构信息

Department of Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, PA 15213, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 1996 Nov;35(11):1427-39. doi: 10.1097/00004583-199611000-00011.

Abstract

OBJECTIVE

To qualitatively review the literature of the past decade covering the epidemiology, clinical characteristics, natural course, biology, and other correlates of early-onset major depressive disorder (MDD) and dysthymic disorder (DD).

METHOD

A computerized search for articles published during the past 10 years was made and selected studies are presented.

RESULTS

Early-onset MDD and DD are frequent, recurrent, and familial disorders that tend to continue into adulthood, and they are frequently accompanied by other psychiatric disorders. These disorders are usually associated with poor psychosocial and academic outcome and increased risk for substance abuse, bipolar disorder, and suicide. In addition, DD increases the risk for MDD. There is a secular increase in the prevalence of MDD, and it appears that MDD is occurring at an earlier age in successive cohorts. Several genetic, familial, demographic, psychosocial, cognitive, and biological correlates of onset and course of early-onset depression have been identified. Few studies, however, have examined the combined effects of these correlates.

CONCLUSIONS

Considerable advances have been made in our knowledge of early-onset depression. Nevertheless, further research is needed in understanding the pathogenesis of childhood mood disorders. Toward this end, studies aimed at elucidating mechanisms and interrelationships among the different domains of risk factors are needed.

摘要

目的

对过去十年间关于早发性重度抑郁症(MDD)和心境恶劣障碍(DD)的流行病学、临床特征、自然病程、生物学及其他相关因素的文献进行定性综述。

方法

对过去10年发表的文章进行计算机检索,并呈现所选研究。

结果

早发性MDD和DD是常见、复发性且具有家族性的疾病,往往会持续至成年期,并且常伴有其他精神障碍。这些疾病通常与不良的心理社会和学业结局相关,且物质滥用、双相情感障碍和自杀风险增加。此外,DD会增加患MDD的风险。MDD的患病率呈长期上升趋势,且似乎在连续几代人群中发病年龄越来越早。已经确定了早发性抑郁症发病和病程的一些遗传、家族、人口统计学、心理社会、认知和生物学相关因素。然而,很少有研究考察这些相关因素的综合影响。

结论

我们对早发性抑郁症的认识取得了相当大的进展。尽管如此,在理解儿童情绪障碍的发病机制方面仍需要进一步研究。为此,需要开展旨在阐明不同领域危险因素之间的机制和相互关系的研究。

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