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首页> 外文期刊>Journal of affective disorders >Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: Evidence of distinct subgroups at risk
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Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: Evidence of distinct subgroups at risk

机译：具有阈下抑郁症状的青少年逐步升级为严重抑郁症：不同危险人群的证据

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Background The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. Methods Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. Results Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. Limitations Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. Conclusions Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs.
机译：背景青春期亚阈值抑郁症状（SubD）的存在与发展为重性抑郁症（MDD）的高预期风险相关。对于预测从SubD升级到MDD的变量知之甚少。这项研究在青少年社区样本中使用了纵向前瞻性设计，以识别预测从SubD升级为MDD的风险因素组合。方法采用分类树分析法确定424名具有SubD终生史的青少年的危险因素组合，这些组合可提高预测MDD发病的敏感性和特异性。结果在随访期间，424例中有144例发展为MDD。发现有多个亚组的证据：在朋友支持差的青少年中，升级的最高风险是有焦虑或药物滥用障碍的一生史的参与者。在得到朋友高度支持的青少年中，那些在过去的一年中报告了多个重大生活事件或有焦虑症史的青少年，其升级风险最高。局限性研究结果可能无法为成年后首次患SubD的个体的预防工作提供信息。这项研究没有研究从SubD升级到MDD涉及的预测变量的时间顺序。结论患有SubD病史的青少年在缺乏朋友支持和焦虑或物质使用障碍的情况下，或在存在更好的朋友支持，多种主要生活事件和焦虑症的情况下，升级为MDD的风险最高。这些发现可以为青少年抑郁症预防计划的病例识别方法提供参考。

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