Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity
Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity
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DOI：
10.1002/da.10077
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发表时间：
2003-01-01
影响因子：
7.4
通讯作者：
Goering, P
中科院分区：
文献类型：
--
作者：
Levitan, RD;Rector, NA;Goering, P
已经确定的是，在不同人群和年龄组中，早期逆境是抑郁症和焦虑症的主要风险因素。很少有研究考虑这些协会的相对强度和共病抑郁/焦虑在理解他们的可能作用。使用来自加拿大安大略的大型社区样本的数据，我们研究了早期身体虐待、性虐待和/或父母压力与单独抑郁、单独焦虑和共病抑郁/焦虑之间的相关性。目前的样本包括6，597名年龄在15-64岁之间的人，他们使用世界卫生组织复合国际诊断访谈（CIDI）进行了访谈。使用多变量设计，我们比较了四个诊断研究组的早期逆境评分，包括正常对照组，患有重度抑郁症但无焦虑症的个体，患有一种或多种焦虑症但无重度抑郁症的个体，以及患有共病重度抑郁症和焦虑症的个体。个体将既往疾病与当前疾病分开考虑。对于过去和现在的疾病，在四个研究组中发现了早期逆境评分的高度显着差异。一个新的和强大的发现，在所有的分析一致，是一个显着的早期性虐待和共病抑郁症和焦虑症之间的关联，但不是“纯”的障碍。研究还发现，早期父母压力与重度抑郁症（与焦虑无关）之间存在密切联系。研究结果的总体模式表明，特定的逆境与日后生活中抑郁症和焦虑症的特定表现之间可能存在独特的联系。早期性虐待与抑郁/焦虑共病之间的联系特别强。（C）2003 Wiley-Liss，Inc.
It has been well established that early adversity is a major risk factor for depression and for anxiety disorders in various populations and age groups. Few studies have considered the relative strength of these associations and the possible role of co-morbid depression/anxiety in understanding them. Using data from a large community sample of Ontario, Canada, we examined the relative strength of the associations between early physical abuse, sexual abuse, and/or parental strain with depression alone, anxiety alone, and co-morbid depression/anxiety. The current sample consisted of 6,597 individuals 15-64 years of age who were interviewed using the World Health Organization Composite International Diagnostic Interview (CIDI). Using a multivariate design, we compared early adversity scores across four diagnostic study groups including normal controls, individuals with major depression but no anxiety disorders, individuals with one or more anxiety disorders without major depression, and individuals with co-morbid major depression and anxiety. Individuals. with past disorders were considered separately from those with current disorders. For both past and current disorders, highly significant differences in early adversity scores were found across the four study groups. A novel and robust finding, consistent across all analyses, was a marked association between early sexual abuse and comorbid depression and anxiety but not the "Pure" disorders. A strong association between early parental strain and major depression (independent of anxiety) was also found. The overall pattern of results suggest that there may be unique relationships linking particular adversities to particular manifestations of depression and anxiety disorders later in life. A particularly strong association between early sexual abuse and co-morbid depression/anxiety was found. (C) 2003 Wiley-Liss, Inc.