對於青少年及年輕人 憂鬱症是日益增加且致命的威脅


  【24drs.com】新研究指出,最近幾年,美國青少年與年輕人的重度憂鬱盛行率持續增加,且青少女更為嚴重。
  
  馬里蘭州巴爾的摩約翰霍普金斯大學彭博公衛學院Ramin Mojtabai醫師等人寫道,加上心智健康治療的改變不大,這趨勢意謂著,越來越多年輕人並未治療憂鬱症。
  
  這篇研究線上發表於11月14日小兒科期刊。
  
  研究結果是根據超過172,000名青少年以及約179,000名年輕人,回覆「全國藥物濫用及健康調查」這項美國人口年度橫斷面調查之資料。
  
  在年齡12-17歲者中,重度憂鬱發作(major depressive episodes,MDEs)的12個月盛行率躍升37%,從2005年的8.7%上升到2014年的11.3%。
  
  此數據相當於,12個月期間重度憂鬱發作(MDEs)人數在2005年(約2,200,000人)到2014年(約2,700,000人)間,增加達50萬人以上。
  
  青少女中,12個月的MDE盛行率從2004年的13.1%上升到2014年的17.3%,而青少男則是從4.5%上升到5.7%。
  
  Mojtabai醫師等人表示,這與之前的研究發現一致-最近幾年內,女孩的憂鬱症狀比男孩大幅增加,而美國最近的自殺趨勢資料顯示,青少女與年輕女性(之比率)大幅增加。
  
  18-25歲年輕人的MDE盛行率增加幅度比較溫和,從2005年的8.8%增加到2014年的9.6%。
  
  人口統計數據顯示,12-17歲者中,相較於沒有MDE的同齡者,有MDE者傾向年齡較大、未就學、單親家庭、有物質濫用問題。在18-25歲的年輕人中,有MDE者比較可能是女性、黑人、有物質濫用問題。校正物質濫用與社會人口統計因素之後,此一趨勢依舊顯著。
  
  研究者報告指出,至於治療,有MDE的青少年在過去12個月內接受任何健康照護提供者之心智健康諮詢或治療的比率,於2005-2014年間並無顯著改變。
  
  不過,青少年與年輕人在特殊心智健康照護提供者之使用情況增加、青少年的處方藥物與住院使用情況也增加。
  
  儘管如此,研究者指出,人數日增的憂鬱青少年與年輕人並未接受任何心智健康治療方法來治療他們的MDE,因此,呼籲重新進行推廣工作,特別是學院校的健康與諮詢服務,以及透過小兒科開業醫師發現那些未接受治療的青少年與年輕人並提供協助。
  
  相關評論的作者們也表示同意。
  
  密蘇里州聖路易斯華盛頓大學Anne Glowinski醫師與Giuseppe D'Amelio寫道,憂鬱症對我們美國青少年人口而言,是一個相當大且不斷增長的致命威脅,將青少年憂鬱症治療列為我們美國人口健康重點是勢在必行的。
  
  他們指出,青少年憂鬱症(盛行率)上升背後的原因,應進行科學調查。
  
  他們也指出,儘管青少年憂鬱症比率令人不安地上升,年輕人在過去一年因MDE而就診於初級照護機構之比率僅有約10%,而過去十年(在這方面)也無明顯之預算。
  
  自2007年以來,美國小兒科學院建議,醫師為11-21歲青年篩檢憂鬱症。Glowinski醫師與D'Amelio指出,遺憾的是,即使這項重要的更新指引影響了初級照護提供者去篩檢更年輕的患者,依舊沒有足夠的合格心智健康專家來照顧每年達280萬名以上—如經篩檢與確認—需要治療與監測其憂鬱症的青少年。
  
  資料來源: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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