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儿童期创伤与成年后的躯体和精神疾病。

Childhood Trauma and Somatic and Mental Illness in Adulthood.

机构信息

Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Neuro degenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany; Additional authors have contributed to this publication. They are listed under "cite this as" and at the end of this article together with their affiliations.

出版信息

Dtsch Arztebl Int. 2024 Jan 12;121(1):1-8. doi: 10.3238/arztebl.m2023.0225.

Abstract

BACKGROUND

Childhood trauma is associated with somatic and mental illness in adulthood. The strength of the association varies as a function of age, sex, and type of trauma. Pertinent studies to date have mainly focused on individual diseases. In this study, we investigate the association between childhood trauma and a multiplicity of somatic and mental illnesses in adulthood.

METHODS

Data from 156 807 NAKO Health Study participants were analyzed by means of logistic regressions, with adjustment for age, sex, years of education, and study site. The Childhood Trauma Screener differentiated between no/minor (n = 115 891) and moderate/severe childhood trauma (n = 40 916). The outcome variables were medical diagnoses of five somatic and two mental health conditions as stated in the clinical history.

RESULTS

Persons with childhood trauma were more likely to bear a diagnosis of all of the studied conditions: cancer (odds ratio [OR] = 1.10; 95% confidence interval: [1.05; 1.15]), myocardial infarction (OR = 1.13 [1.03; 1.24]), diabetes (OR = 1.16, [1.10; 1.23]), stroke (OR = 1.35 [1.23; 1.48]), chronic obstructive pulmonary disease (OR = 1.45 [1.38; 1.52]), depression (OR = 2.36 [2.29; 2.43]), and anxiety disorders (OR = 2.08 [2.00; 2.17]). All of these associations were stronger in younger persons, regardless of the nature of childhood trauma. Differences between the sexes were observed only for some of these associations.

CONCLUSION

Childhood trauma was associated with a higher probability of developing mental as well as somatic illness in adulthood. As childhood trauma is an element of individual history that the victim has little to no control over, and because the illnesses that can arise in adulthood in association with it are a heavy burden on the affected persons and on society, there is a need for research on these associations and for the development of preventive measures.

摘要

背景

儿童时期创伤与成年后患躯体和精神疾病有关。这种关联的强度随年龄、性别和创伤类型的不同而变化。迄今为止,相关研究主要集中在个别疾病上。在这项研究中,我们调查了儿童时期创伤与成年后患多种躯体和精神疾病之间的关联。

方法

通过逻辑回归分析,对 156807 名 NAKO 健康研究参与者的数据进行了分析,调整了年龄、性别、受教育年限和研究地点等因素。童年创伤筛查器将无/轻度(n=115891)和中度/重度童年创伤(n=40916)进行了区分。因变量为临床病史中五种躯体健康状况和两种心理健康状况的医学诊断。

结果

有儿童期创伤史的人更有可能被诊断出所有研究疾病:癌症(比值比[OR]=1.10;95%置信区间:[1.05;1.15])、心肌梗死(OR=1.13 [1.03;1.24])、糖尿病(OR=1.16,[1.10;1.23])、中风(OR=1.35 [1.23;1.48])、慢性阻塞性肺疾病(OR=1.45 [1.38;1.52])、抑郁症(OR=2.36 [2.29;2.43])和焦虑障碍(OR=2.08 [2.00;2.17])。无论儿童时期创伤的性质如何,这些关联在年轻人中更为强烈。这些关联中,仅部分关联在性别上存在差异。

结论

儿童时期创伤与成年后患精神和躯体疾病的可能性增加有关。由于儿童时期创伤是受害者几乎无法控制的个人历史的一部分,并且与之相关的成年后可能出现的疾病会给患者和社会带来沉重的负担,因此需要对这些关联进行研究,并制定预防措施。

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