Stress load during childhood affects psychopathology in psychiatric patients.
Stress load during childhood affects psychopathology in psychiatric patients.
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DOI：
10.1186/1471-244x-8-63
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发表时间：
2008-07-23
期刊：
影响因子：
4.4
通讯作者：
Pröpster K
中科院分区：
文献类型：
--
作者：
Weber K;Rockstroh B;Borgelt J;Awiszus B;Popov T;Hoffmann K;Schonauer K;Watzl H;Pröpster K
儿童期的压力和创伤与不同精神疾病的成人精神病理学有关。本研究的目的是验证这种关系的压力经历在发展时期的筛选压力负荷在不同的诊断相比，健康受试者的成年精神病住院患者的生活。此外，不良经历的数量和病理学的严重程度之间的关系，这已被描述为创伤后应激障碍（PTSD）的“积木”效应，探讨了非创伤性事件的精神障碍以外的PTSD。96例诊断为重度抑郁症（MDD）、精神分裂症、药物成瘾或人格障碍（PD）的患者和31例无精神病诊断的受试者，使用早期创伤量表和创伤后应激诊断量表筛选儿童期（6岁之前）、青春期开始之前和成年期的不良经历。通过回归分析和高、低压力负荷亚组的比较，研究了压力负荷对情感症状、创伤后应激障碍和疾病严重程度的精神病理学影响。儿童期和青春期前的高压力负荷与所有参与者的负面情绪有关，而成年期则不然。在患者中，高应激负荷与抑郁和创伤后症状、疾病严重程度以及MDD和PD的诊断有关。研究结果支持这一假设的压力敏感期在发展过程中，这可能与遗传和其他脆弱性因素的影响，对精神疾病的进展。压力负荷对精神病理学严重程度的“剂量”效应并不局限于创伤和PTSD之间的关系。
Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD), was explored for non-traumatic events in psychiatric disorders other than PTSD. 96 patients with diagnoses of Major Depressive Disorder (MDD), schizophrenia, drug addiction, or personality disorders (PD) and 31 subjects without psychiatric diagnosis were screened for adverse experiences in childhood (before the age of six years), before onset of puberty, and in adulthood using the Early Trauma Inventory and the Posttraumatic Stress Diagnostic Scale. Effects of stress load on psychopathology were examined for affective symptoms, PTSD, and severity of illness by regression analyses and comparison of subgroups with high and low stress load. High stress load in childhood and before puberty, but not in adulthood, was related to negative affect in all participants. In patients, high stress load was related to depressive and posttraumatic symptoms, severity of disorder, and the diagnoses of MDD and PD. Results support the hypothesis of stress-sensitive periods during development, which may interact with genetic and other vulnerability factors in their influence on the progress of psychiatric disorders. A 'dose' effect of stress load on the severity of psychopathology is not restricted to the relationship between traumata and PTSD.