Adverse childhood experiences and child mental health: an electronic birth cohort study.
Adverse childhood experiences and child mental health: an electronic birth cohort study.
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不良的童年经历和儿童心理健康：电子出生队列研究。
DOI：
10.1186/s12916-021-02045-x
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发表时间：
2021-08-06
期刊：
影响因子：
9.3
通讯作者：
Paranjothy S
中科院分区：
文献类型：
--
作者：
Lowthian E;Anthony R;Evans A;Daniel R;Long S;Bandyopadhyay A;John A;Bellis MA;Paranjothy S
不良童年经历 (ACE) 与一系列儿童健康结果呈负相关。在这项研究中，我们探讨了五种 ACE 与儿童心理健康诊断或症状之间的关联。 ACE 包括与患有酒精相关问题、常见精神健康障碍或严重精神疾病的人住在一起，或者经历过家庭成员的受害或死亡。我们分析了 1998 年至 2012 年间英国威尔士人口级儿童电子队列 (N = 191,035) 的数据。我们使用具有离散时变暴露变量的 Cox 回归来模拟儿童在生命的前 15 年进行心理健康诊断的时间。儿童心理健康诊断包括五类：(i) 外化症状（反社会行为），(ii) 内化症状（压力、焦虑、抑郁），(iii) 发育迟缓（例如学习障碍），(iv) 其他（例如饮食失调、人格障碍），以及 (v) 通过结合外化症状、内化症状和其他而创建的任何心理健康诊断。我们的分析针对社会剥夺和围产期危险因素进行了调整。五项个体 ACE、社会人口统计学和围产期因素（例如出生时妊娠体重）与儿童心理健康诊断风险增加之间存在很强的单变量关联。在对社会人口统计学和围产期方面进行调整后，任何儿童心理健康诊断的风险仍然存在条件性增加，这与受害有关（条件风险比（cHR）1.90，CI 95% 1.34–2.69），以及与具有常见心理健康诊断的成年人生活在一起（cHR 1.63，CI 95% 1.52–1.75）。 ACE 和剥夺之间的乘积项系数没有统计学意义。与受害或接触常见心理健康诊断以及家庭酗酒问题相关的儿童心理健康诊断风险增加，表明需要针对儿童及其家庭采取政策措施和干预策略。在线版本包含可在 10.1186/s12916-021-02045-x 获取的补充材料。
Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member. We analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors. There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34–2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52–1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant. The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families. The online version contains supplementary material available at 10.1186/s12916-021-02045-x.
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