Child abuse and mental disorders in Canada
Child abuse and mental disorders in Canada
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DOI：
10.1503/cmaj.131792
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发表时间：
2014-06-10
影响因子：
14.6
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
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作者：
Afifi, Tracie O.;MacMillan, Harriet L.;Sareen, Jitender
背景：缺乏关于虐待儿童的流行率及其与精神障碍的关系的具有全国代表性的加拿大数据。我们使用当代的，全国代表性的数据，以研究3种类型的儿童虐待（身体虐待，性虐待和亲密伴侣暴力）的患病率和他们的关联与14门塔尔条件，包括自杀意念和自杀attempts.Methods：我们获得的数据从2012年加拿大社区健康调查：心理健康，收集从10个省。年龄在18岁及以上的受访者被问及虐待儿童的问题，并被选为研究样本（n = 23395）。调查采用多阶段分层整群设计（家庭应答率为79.8%）。结果：儿童虐待的发生率为32%（个别类型为8%~ 26%）。在调整社会人口学变量后，所有类型的儿童虐待与所有精神状况相关，包括自杀意念和自杀企图（调整后的比值比范围为1.4至7.9）。我们发现了一种剂量反应关系，随着经历的虐待类型数量的增加，精神状况的几率也随之增加。虐待儿童与注意力缺陷障碍、自杀意念和自杀企图之间的关联对女性的影响比男性强。解释：我们发现虐待儿童与精神状况之间存在强有力的关联。卫生保健提供者，特别是那些评估有精神健康问题的病人，需要了解特定类型的虐待儿童和某些精神状况之间的关系。成功地防止虐待儿童可以减少精神障碍、自杀意念和自杀企图的流行。
Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 men tal conditions, including suicidal ideation and suicide attempts.Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%).Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.