Adverse childhood experiences and prescribed psychotropic medications in adults
Adverse childhood experiences and prescribed psychotropic medications in adults
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DOI：
10.1016/j.amepre.2007.01.005
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发表时间：
2007-05-01
影响因子：
5.5
通讯作者：
Giles, Wayne H.
中科院分区：
文献类型：
--
作者：
Anda, Robert F.;Brown, David W.;Giles, Wayne H.
背景：处方药是美国增长最快的医疗成本之一。然而，虐待儿童和相关的创伤应激源对成人精神药物处方的长期影响尚未被描述。这项研究评估了八种不良童年经历(ACE)与成年后精神药物处方率的关系。这些ACEs包括：虐待(情感、身体或性)、目睹家庭暴力、伴随药物滥用长大、精神病或家庭成员犯罪、父母分居/离婚。方法：收集1995-1997年间成人保健机构患者的ACES资料；1997-2004年间的处方资料。ACE的数量(ACE评分：最高8分)被用来衡量儿童时期累积的创伤应激。在15033名符合研究随访阶段(平均随访：6.1年)的成年患者中，前瞻性地评估了评分与处方精神药物使用率的关系。对2006年的数据进行了分析。多变量模型根据年龄、种族、性别和教育程度进行了调整。结果：在随访期间，处方率每年都在增加，并随着ACE分数的增加而分级(p代表趋势
Background: Prescription drugs are one of the fastest growing healthcare costs in the United States. However, the long-term influence of child abuse and related traumatic stressors on prescriptions for psychotropic medications in adults has not been described. This study assessed the relationship of eight adverse childhood experiences (ACEs) to rates of prescriptions for psychotropic medications throughout adulthood. These ACEs included: abuse (emotional, physical, or sexual), witnessing domestic violence, growing up with substance abusing, mentally ill, or criminal household members, and parental separation/divorce.Methods: Data about ACEs were collected between 1995 and 1997 from adult health maintenance organization patients; prescription data were available from 1997 to 2004. The number of ACEs (ACE Score: maximum 8) was used as a measure of cumulative traumatic stress during childhood. The relationship of the score to rates of prescribed psychotropic drugs was prospectively assessed among 15,033 adult patients eligible for the follow-up phase of the study (mean follow-up: 6.1 years). Data were analyzed in 2006. Multivariate models were adjusted for age, race, gender, and education.Results: Prescription rates increased yearly during the follow-up and in a graded fashion as the ACE Score increased (p for trend