Abstract：
OBJECTIVE: Young caregivers experience, on average, poorer mental health outcomes than non-caregiving young people. However, it is unknown to what extent these effects differ with age, or among short-term versus long-term caregivers. Using repeated assessment of young caregiving across multiple waves of a prospective adolescent cohort study, we conducted repeated cross-sectional analyses of caregiver status and contemporaneous depressive symptoms, self-harm, and suicidality in early to middle adolescence.
METHODS: Four waves of questionnaire data from a large, longitudinal population-based cohort study (Tokyo Teen Cohort) were analyzed. Caregiver status was collected from participants aged 10, 12, 14, and 16 years. Mental health outcomes assessed were depressive symptoms, self-harm and suicidal feelings. Logistic regression analyses were conducted assessing effects of a) young caregiver status and b) new, long-term, and ex-caregiver 2-year categorizations on mental health outcomes at 12, 14, and 16 years, both unadjusted and adjusted for potential confounders (sex, low income, single-parent household, and parental distress).
RESULTS: Depressive symptoms were elevated among long-term caregivers at 14 years (unadjusted odds ratio (uOR): 3.11 [1.33-7.27], adjusted odds ratio (aOR): 2.49 [1.03-5.99]). Borderline associations between long-term caregiving and self-harm (uOR: 3.14 [1.06-9.35], aOR: 2.51 [0.82-7.63]) and suicidal feelings (uOR: 2.49 [0.98-6.34], aOR: 2.06 [0.80-5.33]) were detected at 16 years. No associations were found at age 12 years in primary analyses; sensitivity analyses indicated possible increased depressive symptoms.
CONCLUSIONS: Young caregivers with long-term caregiving roles are at the greatest risk for negative mental health outcomes, with effects concentrated in later adolescence. These findings highlight urgent need for early identification and practical and psychological support for young people shouldering caregiving burdens.
METHODS: Four waves of questionnaire data from a large, longitudinal population-based cohort study (Tokyo Teen Cohort) were analyzed. Caregiver status was collected from participants aged 10, 12, 14, and 16 years. Mental health outcomes assessed were depressive symptoms, self-harm and suicidal feelings. Logistic regression analyses were conducted assessing effects of a) young caregiver status and b) new, long-term, and ex-caregiver 2-year categorizations on mental health outcomes at 12, 14, and 16 years, both unadjusted and adjusted for potential confounders (sex, low income, single-parent household, and parental distress).
RESULTS: Depressive symptoms were elevated among long-term caregivers at 14 years (unadjusted odds ratio (uOR): 3.11 [1.33-7.27], adjusted odds ratio (aOR): 2.49 [1.03-5.99]). Borderline associations between long-term caregiving and self-harm (uOR: 3.14 [1.06-9.35], aOR: 2.51 [0.82-7.63]) and suicidal feelings (uOR: 2.49 [0.98-6.34], aOR: 2.06 [0.80-5.33]) were detected at 16 years. No associations were found at age 12 years in primary analyses; sensitivity analyses indicated possible increased depressive symptoms.
CONCLUSIONS: Young caregivers with long-term caregiving roles are at the greatest risk for negative mental health outcomes, with effects concentrated in later adolescence. These findings highlight urgent need for early identification and practical and psychological support for young people shouldering caregiving burdens.
摘要：
目标：年轻的照顾者经验，平均而言,心理健康结果比不照顾年轻人差。然而,目前还不清楚这些影响随年龄有多大的不同，或短期与长期看护者。在前瞻性青少年队列研究的多个波中使用对年轻护理的重复评估，我们对照顾者状态和同期抑郁症状进行了重复的横断面分析，自我伤害,在青春期早期到中期自杀。
方法：四波问卷数据来自一个大，对基于人群的纵向队列研究(东京青少年队列)进行了分析.从10、12、14和16岁的参与者收集看护者状态。评估的心理健康结果是抑郁症状，自我伤害和自杀的感觉。进行了Logistic回归分析，评估了a）年轻照顾者状态和b）新，长期的,和前护理人员在12、14和16岁时对心理健康结果进行2年分类，既未调整，也未调整潜在的混杂因素(性别，低收入,单亲家庭,和父母的痛苦)。
结果：长期照顾者在14岁时抑郁症状升高（未调整比值比（uOR）：3.11[1.33-7.27]，调整后赔率比（AOR）：2.49[1.03-5.99]）。长期护理和自我伤害之间的边界线关联（uOR：3.14[1.06-9.35]，OR:2.51[0.82-7.63])和自杀情绪(uOR:2.49[0.98-6.34],OR:2.06[0.80-5.33])被检测到在16年。在主要分析中没有发现12岁时的关联；敏感性分析表明抑郁症状可能增加。
结论：具有长期照顾角色的年轻照顾者面临最大的负面心理健康结果风险，影响集中在青春期后期。这些发现凸显了迫切需要为肩负着照顾负担的年轻人提供早期识别以及实际和心理支持。
方法：四波问卷数据来自一个大，对基于人群的纵向队列研究(东京青少年队列)进行了分析.从10、12、14和16岁的参与者收集看护者状态。评估的心理健康结果是抑郁症状，自我伤害和自杀的感觉。进行了Logistic回归分析，评估了a）年轻照顾者状态和b）新，长期的,和前护理人员在12、14和16岁时对心理健康结果进行2年分类，既未调整，也未调整潜在的混杂因素(性别，低收入,单亲家庭,和父母的痛苦)。
结果：长期照顾者在14岁时抑郁症状升高（未调整比值比（uOR）：3.11[1.33-7.27]，调整后赔率比（AOR）：2.49[1.03-5.99]）。长期护理和自我伤害之间的边界线关联（uOR：3.14[1.06-9.35]，OR:2.51[0.82-7.63])和自杀情绪(uOR:2.49[0.98-6.34],OR:2.06[0.80-5.33])被检测到在16年。在主要分析中没有发现12岁时的关联；敏感性分析表明抑郁症状可能增加。
结论：具有长期照顾角色的年轻照顾者面临最大的负面心理健康结果风险，影响集中在青春期后期。这些发现凸显了迫切需要为肩负着照顾负担的年轻人提供早期识别以及实际和心理支持。
