Childhood psychosocial stressors and adult onset arthritis: broad spectrum risk factors and allostatic load.
Childhood psychosocial stressors and adult onset arthritis: broad spectrum risk factors and allostatic load.
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儿童心理社会压力源和成人发病关节炎：广谱危险因素和稳态负荷。
DOI：
10.1016/j.pain.2009.01.034
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发表时间：
2009
期刊：
影响因子：
7.4
通讯作者：
Uda,Hidenori
中科院分区：
文献类型：
--
作者：
VonKorff,Michael;Alonso,Jordi;Ormel,Johan;Angermeyer,Matthais;Bruffaerts,Ronny;Fleiz,Clara;deGirolamo,Giovanni;Kessler,RonaldC;Kovess-Masfety,Viviane;Posada-Villa,José;Scott,KateM;Uda,Hidenori
神经，内分泌和免疫应激介质被假设为增加各种慢性疾病的风险，包括关节炎。来自世界精神卫生调查的回顾性数据（N= 18，309）被用来评估成人关节炎发作是否与儿童期逆境和早发性心理障碍有关。考克斯比例风险模型评估了儿童期逆境的数量和早发性心理障碍与关节炎发病年龄的关系。控制年龄、性别和早发性精神障碍，相对于没有儿童期逆境的人，有两种逆境的人成年后发病关节炎的风险增加（危险比= 1.27，95%CI = 1.08，1.50），而有三种或三种以上逆境的人有更高的风险（HR= 1.44，CI= 1.24，1.67）。在控制了儿童时期的不良事件后，早发性抑郁和/或焦虑障碍与成人发病关节炎的风险增加相关（HR= 1.43，CI= 1.28，1.61）。由于心理社会压力源可能是广谱的风险因素，增加了晚年各种慢性疾病（如关节炎，心脏病，糖尿病，哮喘和慢性疼痛）的风险，如果在同一项研究中评估多种疾病的结果，那么对儿童心理社会压力源的前瞻性研究可能是最有成效的。本研究的结果为未来儿童期心理社会压力源与成人期关节炎发病风险之间关系的前瞻性研究提供了方法学指导。
Neural, endocrine, and immune stress mediators are hypothesized to increase risks of diverse chronic diseases, including arthritis. Retrospective data from the World Mental Health Surveys (N= 18,309) were employed to assess whether adult onset of arthritis was associated with childhood adversities and early onset psychological disorder. Cox proportional hazard models assessed the association of number of childhood adversities and the presence of early onset psychological disorder with arthritis age of onset. Controlling for age, sex, and early onset mental disorder, relative to persons with no childhood adversities, persons with two adversities had an increased risk of adult onset arthritis (hazard ratio= 1.27, 95% CI= 1.08, 1.50), while persons with three or more adversities had a higher risk (HR= 1.44, CI= 1.24, 1.67). Early onset depressive and/or anxiety disorder was associated with an increased risk of adult onset arthritis after controlling for childhood adversities (HR= 1.43, CI= 1.28, 1.61). Since psychosocial stressors may be broad spectrum risk factors that increase risks of diverse chronic conditions in later life (eg arthritis, heart disease, diabetes, asthma, and chronic pain), prospective studies of childhood psychosocial stressors may be most productive if multiple disease outcomes are assessed in the same study. Results from this study provide methodological guidance for future prospective studies of the relationship between childhood psychosocial stressors and subsequent risk of adult onset arthritis.