Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care
Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care
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DOI：
10.1016/j.chiabu.2003.06.005
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发表时间：
2004-02-01
影响因子：
4.8
通讯作者：
Yager, J
中科院分区：
文献类型：
--
作者：
Duran, B;Malcoe, LH;Yager, J
目的：研究（1）儿童虐待和忽视（CAN）的患病率、类型和严重程度;（2）CAN与使用初级保健服务的美国印第安妇女终身精神疾病之间的关系。对234名18 - 45岁的美国印第安妇女进行了一项横断面研究，她们在阿尔伯克基的一家社区印第安健康服务医院接受门诊服务，新墨西哥州。依赖性指标包括情绪、物质滥用、焦虑症以及创伤后应激障碍（PTSD），由复合国际诊断访谈测量。CAN使用童年创伤Questionnaire. Results进行评估：大约四分之三的受访者（76.5%; 95%CI = 70.4，81.7）报告某种类型的儿童虐待或忽视;超过40%的人报告暴露于严重虐待。儿童虐待的严重程度与精神障碍的终生诊断呈剂量反应关系。在调整了社会和人口统计学的相关性后，严重的儿童虐待与终生PTSD密切相关（患病率[PR]= 3.9; 95% CI = 1.9，8.0）;与终生物质使用障碍中度相关（PR = 2.3; 95% CI = 1.6，3.3）;情绪障碍（PR = 2.1; 95% CI = 1.4，3.2）;并且患有两种或多种疾病结论：CAN在我们的美国印第安妇女初级保健样本中很常见，与终身精神疾病结局呈正相关。筛查CAN和精神疾病将加强对寻求初级保健服务的患者的治疗。儿童虐待的初级预防可能会降低美国印第安妇女精神障碍的高患病率。(C)2004爱思唯尔有限公司保留所有权利。
Objective: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services.Methods: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient ambulatory services at a community-based Indian Health Service Hospital in Albuquerque, New Mexico. Dependent measures included mood, substance abuse, and anxiety disorders as well as posttraumatic stress disorder (PTSD) as measured by the Composite International Diagnostic Interview. CAN was assessed using the Childhood Trauma Questionnaire.Results: Approximately three-quarters of respondents (76.5%; 95% CI = 70.4, 81.7) reported some type of childhood abuse or neglect; over 40% reported exposure to severe maltreatment. Severity of child maltreatment was associated in a dose response manner with lifetime diagnosis of mental disorders. After adjusting for social and demographic correlates, severe child maltreatment was strongly associated with lifetime PTSD (prevalence ratio [PR] = 3.9; 95% CI = 1.9, 8.0); and was moderately associated with lifetime substance use disorders (PR = 2.3; 95% CI = 1.6, 3.3); mood disorders (PR = 2.1; 95% CI = 1.4, 3.2); and with two or more disorders (PR = 2.3; 95% CI = 1.6, 3.4).Conclusion: CAN was common in our sample of American Indian women in primary care and was positively associated with lifetime psychiatric disorders outcomes. Screening for CAN and psychiatric disorders would enhance the treatment of patients seeking primary care services. Primary prevention of child maltreatment might reduce the high prevalence of mental disorders among American Indian women. (C) 2004 Elsevier Ltd. All rights reserved.