目的:本研究的目的是确定自闭症儿童和青少年抑郁症状的纵向预测因素。
方法:参与者是诊断为自闭症的年轻人,他们是安大略省神经发育障碍网络纵向子研究的一部分。使用儿童行为检查表(CBCL)情感问题量表评估抑郁症状。使用单变量和多变量逻辑回归模型来估计基线(T1)时的临床和人口统计学特征与大约4年后(T2)的临床升高的抑郁症状(CEDS)之间的关联的比值比(ORs)和95%置信区间(CIs)。
结果:参与者的平均年龄(n=75)在T1为9.8岁(SD=2.7),在T2为14.1岁(SD=2.8)。分别有37%和35%的参与者在T1和T2时出现CEDS。此外,24%的参与者在T1和T2时都有CEDS。与T2CEDS相关的T1特征是:孤独感(OR=3.0,95%CI,1.1至8.8),自我伤害(OR=4.0,95%CI,1.1至16.9),自杀意念(OR=3.9,95%CI,1.0至16.5),更多的社交和适应技能(OR=0.3,95%CI,0.1至0.9),限制和重复行为升高(OR=3.8,95%CI,1.3至11.6),精神药物使用(OR=3.0,95%CI,1.1至8.4),注意缺陷/多动障碍(OR=2.8,95%CI,1.1至7.8),和T1CEDS(OR=8.8,95%CI,3.1至27.0)(多重比较未校正)。在调整了年龄和智商(IQ)差异后,关联仍然存在。年龄,性别,IQ,在CBCL上取笑/欺凌,家庭精神病史和家庭收入与T2CEDS无关.
结论:我们的研究结果强调了自闭症患者抑郁症状持续存在的高患病率和高潜力,并强调了早期支持对解决孤独和社会参与的重要性。
研究评估自闭症青少年抑郁的危险因素摘要目的本研究的目的是寻找自闭症青少年抑郁的危险因素。方法这项研究包括安大略省神经发育障碍网络中的自闭症青年。使用父母完成的心理健康调查和筛查工具确定抑郁症的症状。我们在两个时间点研究了75名青年,了解哪些因素可能预测更大的抑郁风险。结果我们的研究人群在第一次访问时的平均年龄是10岁,第二次访问时14岁。我们的研究发现,37%的参与者在第一次就诊时抑郁症状升高,35%在第二次访问。与未来抑郁症状相关的因素包括:孤独,自我伤害,自杀意念,高水平的限制性/重复性行为,第一次就诊时出现抑郁症状,和ADHD。防止抑郁症状的因素包括高水平的社交技能。结论我们的结果显示自闭症青年的抑郁症状水平较高,以及这种情况随着时间的推移在这个人群中持续存在的可能性。我们的发现强调了早期支持对解决孤独和社会参与的重要性。
OBJECTIVE: The objective of this study was to identify longitudinal predictors of depressive symptoms in autistic children and youth.
METHODS: Participants were youth with a diagnosis of autism who were part of the Province of Ontario Neurodevelopmental Disorders Network longitudinal substudy. Depressive symptoms were assessed using the child behaviour checklist (CBCL) affective problems subscale. Univariate and multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between clinical and demographic characteristics at baseline (T1) and clinically elevated depressive symptoms (CEDS) approximately 4 years later (T2).
RESULTS: The mean age of participants (n = 75) at T1 was 9.8 years (SD = 2.7) and at T2 was 14.1 years (SD = 2.8). A total of 37% and 35% of participants had CEDS at T1 and T2, respectively. Additionally, 24% of participants had CEDS at both T1 and T2. T1 characteristics associated with T2 CEDS were: loneliness (OR = 3.0, 95% CI, 1.1 to 8.8), self-harm (OR = 4.0, 95% CI, 1.1 to 16.9), suicidal ideation (OR = 3.9, 95% CI, 1.0 to 16.5), more social and adaptive skills (OR = 0.3, 95% CI, 0.1 to 0.9), elevated restricted and repetitive behaviours (OR = 3.8, 95% CI, 1.3 to 11.6), psychotropic medication use (OR = 3.0, 95% CI, 1.1 to 8.4), attention-deficient/hyperactivity disorder (OR = 2.8, 95% CI, 1.1 to 7.8), and T1 CEDS (OR = 8.8, 95% CI, 3.1 to 27.0) (uncorrected for multiple comparisons). Associations persisted after adjusting for age and intelligence quotient (IQ) differences. Age, sex, IQ, teasing/bullying on the CBCL, family psychiatric history and family income were not associated with T2 CEDS.
CONCLUSIONS: Our results highlight both high prevalence and high potential for the persistence of depressive symptoms in autism and emphasize the importance of early support to address loneliness and social participation.
Study assessing risk factors for depression in autistic youthPlain Language SummaryObjectiveThe goal of this study was to find risk factors for depression in autistic youth.MethodsThe study included autistic youth who were part of the Province of Ontario Neurodevelopmental Disorders Network. Symptoms of depression were identified using mental health surveys and screening tools completed by parents. We studied 75 youth over two time points, to understand what factors might predict greater depression risk.ResultsThe average age of our study population at the first visit was 10 years old, and 14 years old at the second visit. Our study found that 37% of participants had elevated symptoms of depression at the first visit, and 35% at the second visit. Factors associated with future depressive symptoms included: loneliness, self-harm, suicidal ideation, high levels of restrictive/repetitive behaviours, depressive symptoms at the first visit, and ADHD. Factors that protected against depressive symptoms included high levels of social skills.ConclusionOur results show high levels of depressive symptoms among autistic youth, and the potential for this to persist over time in this population. Our findings emphasize the importance of early supports to address loneliness and social participation.