背景:情绪问题(EP)在青春期中期后急剧增加。早期EP与较差的长期结果相关,它们的潜在机制可能与晚期发作的EP不同。考虑到多动症之间的既定关系,自闭症,和后来的抑郁症,我们旨在研究神经发育状况和相关因素与青少年早期发作的EP之间的关联.
方法:英国两个人口队列中的青少年,雅芳父母和子女纵向研究(ALSPAC)和千年队列研究(MCS),包括在内。在11-14岁之间的优势和困难问卷(SDQ)情绪问题子量表上得分>6的个体被定义为患有早期青春期EP,而那些在16-25岁时首次得分>6的患者被定义为具有迟发EP。我们测试了青春期早期EP(总病例=887,对照组=19,582)与ICD-10/DSM-5神经发育状况之间的关联以及已知的相关性,包括:性别,出生并发症,认知能力低,特殊教育需求(SEND),和癫痫。分别在ALSPAC和MCS中进行分析,然后进行荟萃分析。
结果:在两个队列的荟萃分析中,青春期早期发作EP与女性性别相关,认知能力低下的可能性更大,发送,自闭症,多动症,和阅读困难。与晚期EP相比,青春期早期发作的EP与男性有关,认知能力低,发送,癫痫,ASD,多动症,和阅读困难。
结论:抑郁/焦虑的临床定义仅在ALSPAC中可用,相反,我们主要通过问卷定义EP,捕获更广泛的表型。
结论:患有青春期早期EP的个体可能患有共同发生的神经发育状况。临床医生应考虑评估患有EP的青少年的神经发育状况。
BACKGROUND: Emotional problems (EPs) increase sharply after mid-adolescence. Earlier EPs are associated with poorer long-term outcomes, and their underlying mechanisms may differ to later-onset EPs. Given an established relationship between ADHD, autism, and later depression, we aimed to examine associations between neurodevelopmental conditions and correlates and early adolescent-onset EPs.
METHODS: Adolescents in two UK population cohorts, Avon Longitudinal Study of Parents and Children (
ALSPAC) and Millennium Cohort Study (MCS), were included. Individuals scoring >6 on the Strengths and Difficulties Questionnaire (SDQ) emotional problems subscale between ages 11-14 were defined as having early adolescent-onset EP, whilst those scoring >6 for the first time at 16-25 were defined as having later-onset EP. We tested associations between early adolescent-onset EP (total cases = 887, controls = 19,582) and ICD-10/DSM-5 neurodevelopmental conditions and known correlates, including: sex, birth complications, low cognitive ability, special educational needs (SEND), and epilepsy. Analyses were conducted separately in
ALSPAC and MCS then meta-analysed.
RESULTS: In the meta-analysis of both cohorts, early adolescent-onset EPs were associated with female sex and greater likelihood of low cognitive ability, SEND, autism, ADHD, and reading difficulties. Compared to later-onset EP, early adolescent-onset EPs were associated with male sex, low cognitive ability, SEND, epilepsy, ASD, ADHD, and reading difficulties.
CONCLUSIONS: A clinical definition of depression/anxiety was available only in
ALSPAC, instead we primarily defined EP via questionnaires, which capture a broader phenotype.
CONCLUSIONS: Individuals with early adolescent-onset EP are likely to have a co-occurring neurodevelopmental condition. Clinicians should consider assessing for neurodevelopmental conditions in young adolescents with EPs.