青少年期抑郁与10年后不良结局相关

《青少年健康杂志》(Journal of Adolescent Health)5月刊发表的一项研究显示，青春期发生抑郁者在之后10年内发生各种不良结局的几率是青春期无抑郁者的2~3倍，这些不良结局包括总体健康不佳、偏头痛、心理困扰、社会支持不佳、重度饮酒和吸烟。然而，在26~27岁时，青春期发生抑郁者与青春期无抑郁者在失业状况、个人收入、婚姻状况和受教育程度方面无差异(J. Adolesc. Health 2013;52:533-8)。

在这项人群研究中，渥太华大学流行病学与社区医学部的Kiyuri Naicker及其同事采用加拿大全国人口健康调查的资料对各种健康结局进行了评估。该调查为前瞻性队列研究，包含1994年基线时年龄≥12岁的17,276名加拿大人，具有全国代表性。在本研究中，Naicker等人回顾了1,027名受试者10年内每2年收集的详细数据，这些受试者在最近1次随访时的年龄为26~27岁。

结果显示，青春期发生抑郁者在随访期间发生抑郁的几率是青春期无抑郁者的4.91倍，并且使用抗抑郁药的几率是后者的3.74倍。此外，前者在成年早期出现心理困扰(OR，3.02)、酒精滥用(OR，1.78)和每天吸烟(OR，2.89)的几率也高于后者。青春期抑郁也是成年早期发生偏头痛(OR，2.76)的强烈预测因素。与青春期无抑郁者相比，青春期发生抑郁者10年后存在社会支持水平低、压力水平高和总体健康不佳的几率明显较高。

但是，青春期抑郁与此后的失业状况、低收入或受教育程度无关，而且与婚姻状况无显著关联。研究者表示，由于目前婚姻和事业通常要到30岁时才确立，因此在30岁时再评估这些指标可能更有意义。

该研究的局限性在于纳入的非白人受试者较少，这意味着其结果可能不适用于其他人群，也无法评估种族对各种结局指标的影响。

该研究获M.S.I.基金会资助。研究者声明无经济利益冲突。

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Depression in adolescence linked to adverse outcomes 10 years later

By: MARY ANN MOON, Internal Medicine News Digital Network

People who have depression during adolescence are approximately two to three times more likely than others to experience a range of adverse outcomes during the following decade, including poor overall health, migraine headaches, psychological distress, poor social support, heavy drinking, and smoking, according to a report in the May issue of the Journal of Adolescent Health.

However, at the age of 26-27 years, they were no different from people who did not have depression during adolescence in unemployment status, personal income, marital status, or educational attainment, said Kiyuri Naicker of the department of epidemiology and community medicine, University of Ottawa, and her associates.
 
The findings of this population-based study indicate that "the onset of depression during adolescence may forecast problems in adapting during this key transitional phase leading into adulthood. At this stage, where individuals are setting themselves up for their adult lives, the consequences may be long term and have far-reaching implications; although we might not find immediate effects on employment or relationships, an increased propensity to drink heavily, smoke, feel less healthy, and live a stressful life is likely to impact the capacity of the individual to successfully navigate work and family challenges farther down the road," the investigators reported.

They assessed a variety of health outcomes using information from the National Population Health Survey, a prospective cohort study involving a nationally representative sample of 17,276 Canadians who were aged 12 and older at baseline in 1994. For this study, Ms. Naicker and her colleagues reviewed detailed data collected every 2 years over the course of a decade for 1,027 participants who were aged 26-27 years at the most recent follow-up.

People who had depression during adolescence were 4.91 times more likely than those who did not to experience depression during follow-up and 3.74 times more likely to be taking antidepressants. They also were more likely to be experiencing psychological distress (OR, 3.02); abusing alcohol (OR, 1.78); and smoking at least once a day (OR, 2.89) in early adulthood.

Depression during adolescence also was strongly predictive of migraine headaches (OR, 2.76) during young adulthood. And compared with their nondepressed peers, those who had been depressed during adolescence were much more likely to report 10 years later that they had low levels of social support, high levels of stress, and poor overall health, the investigators said (J. Adolesc. Health 2013;52:533-8).

In contrast, adolescent depression did not correlate with later unemployment, low income, or educational attainment, and was not significantly related to marital status. These outcomes "may be more meaningfully measured in individuals in their thirties," since marriage and career milestones are frequently delayed until that time in the current economic and social environment.

This study was limited in that it included few nonwhite participants. This means that the findings might not be generalizable to other, more diverse populations, and that the researchers were not able to examine the effect of race on the outcomes they assessed.

The study was funded by the M.S.I. Foundation, a health research funding organization based in Alberta, Edmonton. No financial conflicts of interest were reported.