Objective

The prevalence of depression increases dramatically during puberty in girls. Earlier work in this sample reported that the sex steroids estradiol and testosterone were associated with increased depression in girls. Using three additional data waves (983 new observations), we retest the relative contributions of pubertal timing, pubertal status, and sex hormones on the increases in female depression.

Method

Eight waves of data from the prospective, representative Great Smoky Mountains Study were used covering female participants in the community who were 9 to 16 years of age (3,005 assessments of 630 girls; 1993−2000). Structured interviews assessed depressive disorders. Youth rated their pubertal status using Tanner stage drawings, and sex steroids were assayed from dried blood spots.

Results

Risk for depression during puberty was associated with both age and Tanner stage in univariate models. In adjusted models accounting for pubertal timing and sex steroids, the apparent effects of age and Tanner stage were attenuated both in terms of statistical significance and effect size. The only significant predictors of change in depression status during puberty were early pubertal timing (odds ratio = 5.8, 95% CI = 1.9−17.9, p = .002 after age 12 years) and higher testosterone levels (odds ratio = 2.0, 95% CI = 1.1−3.8, p = .03 for quartile-split variable).

Conclusion

The added observations have modified the original conclusions, implicating the following: testosterone only, but not estradiol; and early pubertal timing, but not age or pubertal status per se. These findings argue for multiple pubertal determinants of depression risk, including factors that are socially and biologically mediated.

中文翻译：

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青春期早期和睾丸激素与女孩青春期抑郁症的高发有关。

客观的

女孩青春期抑郁症的患病率急剧上升。该样品的早期工作报告说，性类固醇雌二醇和睾丸激素与女孩抑郁症增加有关。使用另外三个数据波（983个新观察结果），我们重新测试了青春期时机，青春期状态和性激素对女性抑郁症增加的相对贡献。

方法

前瞻性，代表性的大烟山研究使用了八波数据，覆盖了社区中9至16岁的女性参与者（对630个女孩进行了3,005次评估； 1993-2000年）。结构化的访谈评估了抑郁症。青年使用Tanner阶段绘画来评估其青春期状态，并从干血斑中测定性类固醇。

结果

在单变量模型中，青春期抑郁的风险与年龄和坦纳阶段有关。在考虑到青春期时机和性类固醇的调整模型中，年龄和坦纳期的表观影响在统计学意义和影响大小上均减弱了。青春期抑郁状态变化的唯一重要预测指标是青春期早期（几率= 5.8，95％CI = 1.9−17.9，12 岁后p = 0.002）和更高的睾丸激素水平（几率= 2.0，95 ％ CI = 1.1-3.8， 对于四分位数分割变量，p = .03）。

结论

增加的观察结果修改了原始结论，涉及以下内容：仅睾丸激素，而不是雌二醇；和青春期的提前时间，但本身不是年龄或青春期状态。这些发现证明了青春期抑郁症风险的多个决定因素，包括社会和生物学介导的因素。