The prevalence of family childhood adversities and their association with first onset of DSM-IV disorders in metropolitan China.
The prevalence of family childhood adversities and their association with first onset of DSM-IV disorders in metropolitan China.
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DOI：
10.1017/s0033291710000450
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发表时间：
2011-01
影响因子：
6.9
通讯作者：
Kessler, R. C.
中科院分区：
文献类型：
--
作者：
Lee, S.;Guo, W. J.;Tsang, A.;He, Y. L.;Huang, Y. Q.;Zhang, M. Y.;Liu, Z. R.;Shen, Y. C.;Kessler, R. C.
家庭童年逆境（fca）的普遍性及其在整个生命过程中对首次发作的后续精神障碍的共同影响很少被检查，特别是在亚洲社区。采用多阶段住户概率抽样方法，对北京和上海地区5201名18-70岁的居民进行了面对面的家庭访谈。使用世界精神卫生综合国际诊断访谈（WMH-CIDI）对四大类精神障碍和六类fca的首次发病进行了评估。通过多个竞争多元模型的最佳拟合分析了fca的联合效应。fca高度普遍且相互关联。其中一半属于家庭功能障碍群体。最佳拟合模型包括六种类型的FCA（其中家庭功能障碍FCA是最强的预测因子）、家庭功能障碍FCA的数量和其他FCA的数量。家庭功能障碍fca与随后的疾病有显著的亚加性关联。对于特定的FCAs对特定疾病的影响，没有发现特异性。与4-12岁和大于或等于25岁相比，fca的预测效果在13-24岁达到最高。对人群归因风险比例的估计表明，所有fca加起来解释了38.5%的首发疾病。正如在西方国家所发现的那样，中国儿童暴露于广泛的相互关联的fca。与家庭功能障碍相关的fca尤其与随后的精神障碍相关。介导这些长期影响的生物和/或环境因素应该在广泛的fca群体的前瞻性研究中进行研究。
The prevalence of family childhood adversities (FCAs) and their joint effects on the first onset of subsequent mental disorders throughout the life course are rarely examined, especially in Asian communities. Face-to-face household interviews of 5201 people aged 18–70 years in Beijing and Shanghai were conducted by a multi-stage household probability sampling method. The first onsets of four broad groups of mental disorders and six categories of FCAs were assessed using The World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Joint effects of FCAs were analyzed by the best fitting of several competitive multivariate models. FCAs were highly prevalent and inter-correlated. Half of them were in a family-dysfunction cluster. The best-fitting model included each of six types of FCA (with family-dysfunction FCAs being the strongest predictors), number of family-dysfunction FCAs, and number of other FCAs. Family-dysfunction FCAs had a significant subadditive association with subsequent disorders. Little specificity was found for the effects of particular FCAs with particular disorders. Predictive effects of FCAs reached the highest in ages 13–24 compared to ages 4–12 and ⩾25. Estimates of population-attributable risk proportions indicated that all FCAs together explained 38.5% of all first-onset disorders. Chinese children were exposed to a broad spectrum of inter-related FCAs, as found in Western countries. FCAs related to family dysfunction were especially associated with subsequent mental disorders. Biological and/or environmental factors that mediate these long-term effects should be studied in prospective research on broad groups of FCAs.