Renouf A G, Kovacs M, Mukerji P
Humboldt County Mental Health, Children, Youth, and Family Services, Eureka, CA, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):998-1004. doi: 10.1097/00004583-199707000-00023.
To examine the relationship of depressive, conduct, and comorbid disorders and social functioning in psychiatrically referred youths.
Subjects were 94 boys and 67 girls (mean age at initial assessment = 11.5 years) who were repeatedly evaluated with standardized instruments during a mean interval of 4.4 years. On the basis of their diagnoses during the follow-up, children were designated as having had depressive, conduct, or both (comorbid) disorders or other conditions. Two domains of social functioning were assessed: social competence and self-esteem.
Longitudinal analyses revealed that at any given point in time, depressive, conduct, and comorbid disorders were associated with low social competence and depressive disorder also was associated with low self-esteem. At the approximate age of 15 years, on average, children with a history of conduct or comorbid disorders had lower social competence than did children with a history of depressive disorder, but these groups endorsed similar levels of self-esteem.
Some areas of social dysfunction associated with comorbid depressive and conduct disorders appear to reflect mostly the effects of conduct disorder. The latter condition has a more severe and longer-term impact on children's social competence than does depression. In addition, whereas depression has an adverse effect on self-esteem, this effect appears to be temporary.
探讨转介至精神科的青少年中抑郁障碍、品行障碍及共病障碍与社会功能之间的关系。
研究对象为94名男孩和67名女孩（初次评估时的平均年龄 = 11.5岁），在平均4.4年的时间间隔内，使用标准化工具对他们进行多次评估。根据随访期间的诊断结果，将儿童分为患有抑郁障碍、品行障碍或两者皆有（共病）障碍或其他情况。评估了社会功能的两个领域：社会能力和自尊。
纵向分析显示，在任何给定时间点，抑郁障碍、品行障碍和共病障碍都与社会能力低下相关，抑郁障碍还与自尊低下相关。平均而言，在大约15岁时，有品行障碍或共病障碍病史的儿童的社会能力低于有抑郁障碍病史的儿童，但这些组的自尊水平相似。
与抑郁和品行共病障碍相关的一些社会功能障碍领域似乎主要反映了品行障碍的影响。与抑郁症相比，后者对儿童社会能力的影响更严重且更持久。此外，虽然抑郁症对自尊有不利影响，但这种影响似乎是暂时的。
