מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Certain sleep patterns and elevated cortisol levels may indicate that an adolescent is at risk for depression or its recurrence, according to Dr. Uma Rao, who presented study results Sunday at the 48th annual meeting of the American Academy of Child and Adolescent Psychiatry.
Dr. Rao, an associate professor of psychiatry and biobehavioral sciences at the University of California-Los Angeles, and colleagues investigated the longitudinal clinical course of depression in adolescents, as well as predictors of depression.
"We identified a group of youngsters with no depression when they were initially assessed, but they had some sleep markers that are seen in depression, particularly reduced REM [rapid eye movement] sleep that occurs earlier during the sleep cycle, and more intense eye movements during REM," Dr. Rao told Reuters Health. "Among subjects with this sleep pattern, 20% went on to develop depression. These patterns may suggest a vulnerability."
Among adolescents who were diagnosed as depressed, 60% of those with higher levels of cortisol had recurrent episodes of depression or went on to develop a substance use disorder. In contrast, 12% of those who were depressed and had low cortisol levels developed either recurrence or a substance use disorder.
"Depression is still undertreated in adolescents," Dr. Rao told Reuters Health. "Although there is more awareness, not enough affected adolescents are being treated. Intervention is important, because individuals who have depression are less successful in their adjustment to adult life in their educational attainment, in their work life, and in relationships."
Because of the serious sequelae of adolescent depression, clinicians need to aggressively screen for and treat it, Dr. Rao added. "Adolescents who experience a depressive episode are at high risk for other disorders," she said. "For example, 20% to 30% of those who have a depressive episode will go on to have bipolar disorder. Approximately 25% to 33% of depressed adolescents are at risk for substance use disorders. Half of cases will have a recurrent depression."
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