背景:通常观察到儿童和青少年抑郁症状的纵向模式存在群体差异。然而,对成人心理健康的影响尚不清楚.本研究对儿童和青少年抑郁轨迹研究进行了系统综述,并对其对成人抑郁症状和障碍的纵向影响进行了荟萃分析。
方法:一项系统搜索确定了12项纵向研究(12项队列,N=35,058),在18岁之前进行了协调以识别常见症状轨迹。在同一组中进行随访检查,以估计与成人抑郁症状和障碍的纵向关联。使用随机效应荟萃分析。
结果:纳入的研究确定低(70.3%),中度(17.9%),高(9.5%),症状轨迹增加(9.5%)和减少(5.1%)。发现这些轨迹可以预测成年期症状和疾病的变化:低,Dx=4.5%,95%CI2.7-6.8%,Sx=8.33,SD=6.30;中度,Dx=20.9%,CI11.9-31.5%-Sx=18.13,SD=3.38;高,Dx=34.4%CI17.2-54.0%-Sx=38.80,SD=7.75;增加,Dx=38.3%,CI12.7-67.5%-Sx=24.73,SD=18.64;下降,Dx=15.4%,CI10.5-20.9%-Sx=17.00,SD=12.18。
结论:对于某些轨迹效应,置信区间很宽。高轨迹的预测效果存在显著的队列间异质性,这表明需要进一步研究以识别影响变异的特征。
结论:低症状轨迹预测较低的成人抑郁症状和障碍。计划有效地针对适度的减少,High,增加和减少轨迹可能会防止成年早期的问题。
BACKGROUND: Group differences in longitudinal patterns of child and adolescent depressive symptoms are commonly observed. However, the implications for adult mental health are unclear. This study presents a systematic
review of child and adolescent depressive symptom trajectory research and meta-analysis of their longitudinal effects on adult depressive symptoms and disorders.
METHODS: A systematic search identified 12 longitudinal studies (12 cohorts, N = 35,058) that were harmonized to identify common symptom trajectories prior to age 18 years. Examination of follow-up in the same groups was made (at average age 20.5 years) to estimate longitudinal associations with adult depressive symptoms (Sx) and disorders (Dx), using random effects meta-analyses.
RESULTS: The included studies identified Low (70.3 %), Moderate (17.9 %), High (9.5 %), Increasing (9.5 %) and Decreasing (5.1 %) symptom trajectories. These trajectories were found to predict variation in symptoms and disorders in adulthood: Low, Dx = 4.5 %, 95 % Confidence Interval [CI] 2.7-6.8 %, Sx [Mean] = 8.33, Standard Deviation [SD] = 6.30; Moderate, Dx = 20.9 %, CI 11.9-31.5 % - Sx = 18.13, SD = 3.38; High, Dx = 34.4 % CI 17.2-54.0 % - Sx = 38.80, SD = 7.75; Increasing, Dx = 38.3 %, CI 12.7-67.5 % - Sx = 24.73, SD = 18.64; Decreasing, Dx = 15.4 %, CI 10.5-20.9 % - Sx = 17.00, SD = 12.18.
CONCLUSIONS: Confidence intervals are wide for some trajectory effects. There was significant between-cohort heterogeneity in predictive effects for High trajectories, suggesting the need for further research to identify characteristics influencing variation.
CONCLUSIONS: Low symptom trajectories forecast lower adult depression symptoms and disorders. Programs effectively targeting reductions in Moderate, High, Increasing and Decreasing trajectories will likely prevent problems in early adulthood.