The Association of Childhood Trauma and Personality Disorders With Chronic Depression: A Cross-Sectional Study in Depressed Outpatients
The Association of Childhood Trauma and Personality Disorders With Chronic Depression: A Cross-Sectional Study in Depressed Outpatients
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DOI：
10.4088/jcp.14m09158
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发表时间：
2015-06-01
影响因子：
5.3
通讯作者：
Brodbeck, Jeannette
中科院分区：
文献类型：
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作者：
Klein, Jan Philipp;Roniger, Antje;Brodbeck, Jeannette
目的：慢性抑郁症往往与儿童期创伤有关。然而，人格病理、童年创伤和慢性抑郁症之间可能存在相互作用。这种相互作用尚未studied.Method：本回顾性分析是基于279名患者接触的一项随机试验，在门诊心理治疗中心，从2010年至2012年的18个月期间。目前诊断的人格障碍和慢性抑郁症的存在进行了系统的评估，使用结构化临床访谈DSM-IV。使用儿童期创伤问卷（CTQ-SF）的简短形式收集儿童期创伤的回顾性报告。DSM-IV定义的慢性抑郁症是主要结局。使用相关性分析了慢性抑郁症、童年创伤和人格障碍之间的关联。至少有一个小的相关性分析的影响变量进入了一系列的logistic回归分析，以确定慢性抑郁症的预测因子和儿童创伤的调节作用。结果：回避型人格障碍的存在，但没有CTQ-SF量表，与抑郁症的慢性化（比值比[OR] = 2.20，P = 0.015）。然而，CTQ-SF的情感虐待分量表确实与回避型人格障碍相关（OR = 1.15，P =.000）。情绪虐待水平对回避型人格障碍对慢性抑郁症的影响有调节作用（OR = 1.08，P =.004）。没有患回避型人格障碍的患者有慢性抑郁症的发病率下降，如果他们回顾性报告更严重的情绪虐待水平（18.9%比39.7%，分别）。结论：回避型人格病理的存在可能与儿童创伤的影响，在慢性抑郁症的发展。这需要在前瞻性研究中得到证实。(c)版权所有2015 Physicians Postgraduate Press，Inc.
Objective: Chronic depression has often been associated with childhood trauma. There may, however, be an interaction between personality pathology, childhood trauma, and chronic depression. This interaction has not yet been studied.Method: This retrospective analysis is based on 279 patients contacted for a randomized trial in an outpatient psychotherapy center over a period of 18 months from 2010 to 2012. Current diagnoses of a personality disorder and presence of chronic depression were systematically assessed using the Structured Clinical Interview for DSM-IV. Retrospective reports of childhood trauma were collected using the short form of the Childhood Trauma Questionnaire (CTQ-SF). DSM-IV-defined chronic depression was the primary outcome. The association between chronic depression, childhood trauma, and personality disorders was analyzed using correlations. Variables that had at least a small effect on correlation analysis were entered into a series of logistic regression analyses to determine the predictors of chronic depression and the moderating effect of childhood trauma.Results: The presence of avoidant personality disorder, but no CTQ-SF scale, was associated with the chronicity of depression (odds ratio [OR] = 2.20, P =.015). The emotional abuse subscale of the CTQ-SF did, however, correlate with avoidant personality disorder (OR = 1.15, P =.000). The level of emotional abuse had a moderating effect on the effect of avoidant personality disorder on the presence of chronic depression (OR = 1.08, P =.004). Patients who did not suffer from avoidant personality disorder had a decreased rate of chronic depression if they retrospectively reported more severe levels of emotional abuse (18.9% vs 39.7%, respectively).Conclusions: The presence of avoidant personality pathology may interact with the effect of childhood trauma in the development of chronic depression. This has to be confirmed in a prospective study. (c) Copyright 2015 Physicians Postgraduate Press, Inc.