Patton G C, Hibbert M E, Carlin J, Shao Q, Rosier M, Caust J, Bowes G
Centre for Adolescent Health, Royal Children's Hospital, University of Melbourne, Parkville, Australia.
J Epidemiol Community Health. 1996 Dec;50(6):661-6. doi: 10.1136/jech.50.6.661.
Psychiatric disorder often begins at adolescence. This study aimed to examine the associations between puberty and social circumstances and the adolescent rise in depression and anxiety.
A two stage cluster sampling procedure was used to identify a representative group of Australian secondary school students in years 7 (age 12-13 years), 9 (14-15 years), and 11 (16-17 years) of 45 Victorian schools. The computerised clinical interview schedule (CIS) was used to evaluate psychiatric morbidity.
A total of 2525 subjects completed the survey - an overall participation rate of 83%. Levels of depression and anxiety increased with the secondary school years and girls had significantly higher rates at each school year level. For boys, the clearest independent associations with depression and anxiety were rising school year level and high parental educational achievement. For girls menarchal status emerged as the strongest predictor. Associations with age and school year level, evident on univariate analysis, did not persist when the recency of menarche was taken into account. After addition of measures of perceived social stress to a multivariate model, a significant association between depression/anxiety and parental divorce disappeared but the association with menarche persisted.
Menarche marks a transition in the risk of depression and anxiety in girls. The pattern of findings is consistent with a biological mediation of this association.
精神疾病通常始于青春期。本研究旨在探讨青春期与社会环境之间的关联以及青少年抑郁和焦虑情绪的增加。
采用两阶段整群抽样程序，从维多利亚州45所中学中选取具有代表性的7年级（12 - 13岁）、9年级（14 - 15岁）和11年级（16 - 17岁）的澳大利亚中学生群体。使用计算机化临床访谈量表（CIS）评估精神疾病发病率。
共有2525名受试者完成了调查，总体参与率为83%。抑郁和焦虑水平随着中学年级的升高而增加，且在每个学年水平上女孩的发病率显著更高。对于男孩，与抑郁和焦虑最明显的独立关联是学年水平的上升和父母的高教育成就。对于女孩，初潮状态成为最强的预测因素。在单变量分析中明显的与年龄和学年水平的关联，在考虑初潮新近程度后不再持续。在多变量模型中加入感知社会压力的测量指标后，抑郁/焦虑与父母离异之间的显著关联消失，但与初潮的关联仍然存在。
初潮标志着女孩抑郁和焦虑风险的转变。研究结果模式与这种关联的生物学介导作用一致。
