Pine D S, Cohen P, Gurley D, Brook J, Ma Y
Division of Child Psychiatry, New York State Psychiatric Institute, NY, USA.
Arch Gen Psychiatry. 1998 Jan;55(1):56-64. doi: 10.1001/archpsyc.55.1.56.
Various studies find relationships among anxiety and depressive disorders of adolescence and adulthood. This study prospectively examines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders.
An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. The magnitude of the association between adolescent and adult anxiety or depressive disorders was quantified using odds ratios generated from logistic regression analyses and from a set of latent Markov analyses. We focus on longitudinal associations among narrowly defined DSM anxiety or depressive disorders.
In simple logistic models, adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders. There was evidence of specificity in the course of simple and social phobia but less specificity in the course of other disorders. Results from the analyses using latent variables suggested that while most adolescent disorders were no longer present in young adulthood, most adult disorders were preceded by adolescent disorders.
An anxiety or depressive disorder during adolescence confers a strong risk for recurrent anxiety or depressive disorders during early adulthood. Most anxiety and depressive disorders in young adults may be preceded by anxiety or depression in adolescence.
多项研究发现青少年期和成年期的焦虑症与抑郁症之间存在关联。本研究前瞻性地考察了青少年期与成年期焦虑症或抑郁症之间纵向关联的程度。
从纽约州北部选取了776名年轻人作为具有流行病学代表性的样本,于1983年、1985年和1992年采用结构化访谈进行基于《精神疾病诊断与统计手册》(DSM)的精神病学评估。青少年期与成年期焦虑症或抑郁症之间关联的程度通过逻辑回归分析及一组潜在马尔可夫分析得出的比值比进行量化。我们关注狭义定义的DSM焦虑症或抑郁症之间的纵向关联。
在简单逻辑模型中,青少年期焦虑症或抑郁症预示成年期焦虑症或抑郁症的风险增加约2至3倍。在单纯恐惧症和社交恐惧症病程中有特异性证据,但在其他疾病病程中特异性较低。使用潜在变量的分析结果表明,虽然大多数青少年期疾病在青年期不再存在,但大多数成年期疾病之前存在青少年期疾病。
青少年期的焦虑症或抑郁症会使成年早期复发性焦虑症或抑郁症的风险显著增加。大多数青年期的焦虑症和抑郁症可能在青少年期有焦虑或抑郁病史。