对于青少年及年轻人 忧郁症是日益增加且致命的威胁


  【24drs.com】新研究指出,最近几年,美国青少年与年轻人的重度忧郁盛行率持续增加,且青少女更为严重。
  
  马里兰州巴尔的摩约翰霍普金斯大学彭博公卫学院Ramin Mojtabai医师等人写道,加上心智健康治疗的改变不大,这趋势意谓著,越来越多年轻人并未治疗忧郁症。
  
  这篇研究在线发表于11月14日小儿科期刊。
  
  研究结果是根据超过172,000名青少年以及约179,000名年轻人,回覆「全国药物滥用及健康调查」这项美国人口年度横断面调查之资料。
  
  在年龄12-17岁者中,重度忧郁发作(major depressive episodes,MDEs)的12个月盛行率跃升37%,从2005年的8.7%上升到2014年的11.3%。
  
  此数据相当于,12个月期间重度忧郁发作(MDEs)人数在2005年(约2,200,000人)到2014年(约2,700,000人)间,增加达50万人以上。
  
  青少女中,12个月的MDE盛行率从2004年的13.1%上升到2014年的17.3%,而青少男则是从4.5%上升到5.7%。
  
  Mojtabai医师等人表示,这与之前的研究发现一致-最近几年内,女孩的忧郁症状比男孩大幅增加,而美国最近的自杀趋势资料显示,青少女与年轻女性(之比率)大幅增加。
  
  18-25岁年轻人的MDE盛行率增加幅度比较温和,从2005年的8.8%增加到2014年的9.6%。
  
  人口统计数据显示,12-17岁者中,相较于没有MDE的同龄者,有MDE者倾向年龄较大、未就学、单亲家庭、有物质滥用问题。在18-25岁的年轻人中,有MDE者比较可能是女性、黑人、有物质滥用问题。校正物质滥用与社会人口统计因素之后,此一趋势依旧显著。
  
  研究者报告指出,至于治疗,有MDE的青少年在过去12个月内接受任何健康照护提供者之心智健康咨询或治疗的比率,于2005-2014年间并无显著改变。
  
  不过,青少年与年轻人在特殊心智健康照护提供者之使用情况增加、青少年的处方药物与住院使用情况也增加。
  
  尽管如此,研究者指出,人数日增的忧郁青少年与年轻人并未接受任何心智健康治疗方法来治疗他们的MDE,因此,呼吁重新进行推广工作,特别是学院校的健康与咨询服务,以及透过小儿科开业医师发现那些未接受治疗的青少年与年轻人并提供协助。
  
  相关评论的作者们也表示同意。
  
  密苏里州圣路易斯华盛顿大学Anne Glowinski医师与Giuseppe D'Amelio写道,忧郁症对我们美国青少年人口而言,是一个相当大且不断增长的致命威胁,将青少年忧郁症治疗列为我们美国人口健康重点是势在必行的。
  
  他们指出,青少年忧郁症(盛行率)上升背后的原因,应进行科学调查。
  
  他们也指出,尽管青少年忧郁症比率令人不安地上升,年轻人在过去一年因MDE而就诊于初级照护机构之比率仅有约10%,而过去十年(在这方面)也无明显之预算。
  
  自2007年以来,美国小儿科学院建议,医师为11-21岁青年筛检忧郁症。Glowinski医师与D'Amelio指出,遗憾的是,即使这项重要的更新指引影响了初级照护提供者去筛检更年轻的患者,依旧没有足够的合格心智健康专家来照顾每年达280万名以上—如经筛检与确认—需要治疗与监测其忧郁症的青少年。
  
  资料来源:http://www.24drs.com/
  
  Native link:Depression a Growing, Deadly Threat for Teens, Young Adults

Depression a Growing, Deadly Threat for Teens, Young Adults

By Megan Brooks
Medscape Medical News

The prevalence of major depression among US adolescents and young adults has increased substantially in recent years, and female adolescents appear most vulnerable, new research indicates.

Coupled with "little change" in mental health treatments, these trends mean that a growing number of young people have untreated depression, Ramin Mojtabai, MD, from the Bloomberg School of Public Health, Johns Hopkins University, in Baltimore, Maryland, and colleagues write.

The study was published online November 14 in Pediatrics.

Need for Action

The findings are based on data from more than 172,000 adolescents and close to 179,000 young adults who responded to the National Surveys on Drug Use and Health, annual cross-sectional surveys of the US population.

Among those aged 12 to 17 years, the 12-month prevalence of major depressive episodes (MDEs) jumped 37% from 8.7% in 2005 to 11.3% in 2014.

This translates into an increase of more than a half million adolescents with 12-month MDE between 2005 (roughly 2,200,000) and 2014 (roughly 2,700,000).

Among teenage girls, the prevalence of 12-month MDE rose from 13.1% in 2004 to 17.3% in 2014, whereas among boys, the prevalence rose from 4.5% to 5.7%.

"This aligns with past studies that also found a larger increase in depressive symptoms in girls than boys in more recent years, and recent data on trends in suicide in the United States that identified a greater increase among adolescent girls and young women," Dr Mojtabai and colleagues say.

The increase in the prevalence of MDE was more modest among young adults aged 18 to 25 years, rising from 8.8% in 2005 to 9.6% in 2014.

Demographic data show that among 12- to 17-year-olds, those with MDE are more apt to be older, not in school, and living in single-parent homes and to have substance use disorders in comparison with their peers without MDE. Among young adults aged 18 to 25 years, those with MDE are more likely to be female, black, and have a substance use disorder. The trends remained significant after adjustment for substance use disorders and sociodemographic factors.

As for treatment, the proportion of adolescents with MDE who received mental health counseling or treatment in the past 12 months for their depression from any type of healthcare provider did not change significantly between 2005 and 2014, the researchers report.

However, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents.

Nonetheless, the researchers note that the "growing number of depressed adolescents and young adults who do not receive any mental health treatment for their MDE calls for renewed outreach efforts, especially in school and college health and counseling services and pediatric practices where many of the untreated adolescents and young adults with depression may be detected and managed."

Deadly Threat

The authors of a linked commentary agree.

"Depression is a sizeable and growing deadly threat to our US adolescent population. The prioritization of youth depression treatment of our US population health is imperative," write Anne Glowinski, MD, and Giuseppe D'Amelio, of Washington University in St. Louis, Missouri.

They add that the causes behind the rise in adolescent depression should be investigated scientifically.

They also note that despite the "disturbing" rise in depression among adolescents, the percentage of young people with a history of past-year MDE seen in primary care for depression is only about 10% "and has not appreciably budged in the past decade."

Since 2007, the American Academy of Pediatrics has recommended that clinicians routinely screen youth aged 11 to 21 for depression. "Sadly, even if this important update influences primary care providers to screen more youth, there will never be enough qualified mental health specialists to take care of the 2.8 million or more adolescents per year, who, if screened and identified, will need treatment and monitoring for depression," Dr Glowinski and D'Amelio note.

The study received no funding. The authors and editorialists have disclosed no relevant financial relationships.

Pediatrics. Published online November 14, 2016.

    
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