Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Germany.
Department of Health Psychology, University of Mannheim, Germany.
J Psychosom Res. 2014 Aug;77(2):104-8. doi: 10.1016/j.jpsychores.2014.06.004. Epub 2014 Jun 22.
Previous studies demonstrated that a history of childhood trauma is linked to mental disorders in adulthood, particularly to depression. Adverse childhood experiences are also considered to contribute to the risk of hypochondriasis, but the results of previous studies have not been conclusive with respect to the strength and specificity of this association. Therefore, we compared the association of adverse childhood experiences with both hypochondriasis and depression.
Fifty-eight patients with hypochondriasis, 52 patients with depression, and 52 healthy control participants completed the Childhood Trauma Questionnaire (CTQ) which assesses 5 varieties of abuse and neglect. A clinical interview (SCID-I) was used to establish DSM-IV diagnoses. Associations between childhood maltreatment, hypochondriasis and depression were estimated by means of analyses of variance and multiple linear regression analyses.
In comparison to hypochondriacal and healthy participants, patients with a current depressive disorder reported more emotional abuse as well as more emotional and physical neglect during childhood. Patients with hypochondriasis reported more emotional neglect than healthy individuals. However, when predicting the CTQ trauma types by diagnostic category adjusting for sex and comorbid DSM-IV diagnoses, emotional abuse, emotional neglect, physical abuse, physical neglect, as well as the CTQ total score were significantly associated with depression, but none of the CTQ scores was significantly related to hypochondriasis.
The findings suggest a robust association of childhood maltreatment with depression but not with hypochondriasis. This result does not support etiological models of hypochondriasis which rely on childhood maltreatment as a risk factor for the development of this disorder.
先前的研究表明,儿童时期的创伤史与成年后的精神障碍有关,尤其是与抑郁症有关。不良的童年经历也被认为会增加疑病症的风险,但先前的研究结果对于这种关联的强度和特异性并没有得出明确的结论。因此,我们比较了不良童年经历与疑病症和抑郁症的关联。
58 名疑病症患者、52 名抑郁症患者和 52 名健康对照参与者完成了儿童创伤问卷(CTQ),该问卷评估了 5 种虐待和忽视类型。使用临床访谈(SCID-I)来确定 DSM-IV 诊断。通过方差分析和多元线性回归分析来估计儿童期虐待、疑病症和抑郁症之间的关联。
与疑病症和健康参与者相比,目前患有抑郁症的患者报告在儿童时期遭受了更多的情感虐待,以及更多的情感和身体忽视。疑病症患者比健康个体报告了更多的情感忽视。然而,当根据性别和共病 DSM-IV 诊断调整诊断类别来预测 CTQ 创伤类型时,情感虐待、情感忽视、身体虐待、身体忽视以及 CTQ 总分与抑郁症显著相关,但 CTQ 评分均与疑病症无显著相关。
这些发现表明,儿童期虐待与抑郁症之间存在强烈的关联,但与疑病症无关。这一结果不支持依赖儿童期虐待作为疑病症发展的风险因素的疑病症病因学模型。