Objective

Cross-sectional, longitudinal, and genetic associations exist between irritability and depression. Prior studies have examined developmental trajectories of irritability, clinical outcomes, and associations with child and familial depression. However, studies have not integrated neurobiological measures. The present study examined developmental trajectories of irritability, clinical outcomes, and cortical structure among preschoolers oversampled for depressive symptoms.

Method

Beginning at 3 to 5 years old, a sample of 271 children enriched for early depressive symptoms were assessed longitudinally by clinical interview. Latent class mixture models identified trajectories of irritability severity. Risk factors, clinical outcomes, and cortical thickness were compared across trajectory classes. Cortical thickness measures were extracted from 3 waves of magnetic resonance imaging at 7 to 12 years of age.

Results

Three trajectory classes were identified among these youth: 53.50% of children exhibited elevated irritability during preschool that decreased longitudinally, 30.26% exhibited consistently low irritability, and 16.24% exhibited consistently elevated irritability. Compared with other classes, the elevated irritability class exhibited higher rates of maternal depression, early life adversity, later psychiatric diagnoses, and functional impairment. Further, elevated baseline irritability predicted later depression beyond adversity and personal and maternal depression history. The elevated irritability class exhibited a thicker cortex in the left superior frontal and temporal gyri and the right inferior parietal lobule.

Conclusion

Irritability manifested with specific developmental trajectories in this sample enriched for early depression. Persistently elevated irritability predicted poor psychiatric outcomes, higher risk for later depression, and decreased overall function later in development. Greater frontal, temporal, and parietal cortical thickness also was found, providing neural correlates of this risk trajectory.

中文翻译：

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易患学前抑郁症的样本中的易怒性轨迹，皮层厚度和临床结果

客观的

易怒和抑郁之间存在横断面，纵向和遗传联系。先前的研究已经检查了易怒性，临床结局以及与儿童和家族性抑郁症的关系的发展轨迹。但是，研究还没有整合神经生物学措施。本研究检查了抑郁症状过度采样的学龄前儿童的易怒性，临床结局和皮质结构的发展轨迹。

方法

从3到5岁开始，通过临床访谈纵向评估了271名富含早期抑郁症状的儿童的样本。潜在类混合模型确定了易怒程度的轨迹。跨轨迹类别比较了危险因素，临床结局和皮层厚度。皮质厚度测量值是从7至12岁的3次磁共振成像波中提取的。

结果

在这些青年中确定了三个轨迹类别：53.50％的儿童在学龄前表现出较高的易怒性，并呈纵向下降趋势； 30.26％的表现出持续低的烦躁性； 16.24％的表现出持续性的烦躁性。与其他类别相比，易怒性类别表现出更高的产妇抑郁，早期生活逆境，后期精神病诊断和功能障碍的发生率。此外，基线易怒性升高预示着以后的忧郁症将超出逆境以及个人和母亲的忧郁病史。易怒性升高的类别在左上额和颞上回和右下顶小叶显示出较厚的皮层。

结论

在此样本中，易怒表现为特定的发育轨迹，可以缓解早期抑郁症。持续的易怒性预示着精神病的预后较差，以后患抑郁症的风险更高，并且在发育后期总体功能下降。还发现较大的额叶，颞叶和顶叶皮质厚度，提供了该风险轨迹的神经相关性。