Sexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis
Sexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis
复制标题
DOI：
10.4065/mcp.2009.0583
复制
发表时间：
2010-07-01
影响因子：
8.9
通讯作者：
Zirakzadeh, Ali
中科院分区：
文献类型：
--
作者：
Chen, Laura P.;Murad, M. Hassan;Zirakzadeh, Ali
目的：为了系统地评估证据之间的关联性虐待和终身诊断的精神disorders.Patients和方法：我们进行了全面的搜索（从1980年1月至2008年12月，所有年龄组，任何语言，任何人口）的9个数据库：MEDLINE，EMBASE，CINAHL，当前的内容，PsycINFO，ACP杂志俱乐部，CCTR，CDSR，和DARE。使用辅以关键词的受控词汇来界定性虐待和精神障碍的概念领域，并仅限于流行病学研究。6名独立的评价者从符合条件的纵向研究中提取了描述性、质量和结局数据。使用随机效应模型汇总研究间的比值比（OR）和95%置信区间（CI）。结果：共检索到37篇符合条件的研究，其中病例对照组17篇，队列研究20篇，共3，162，318例受试者。性虐待和焦虑症的终生诊断之间有统计学上的显著关联（OR，3.09; 95%CI，2.43-3.94），抑郁（OR，2.66; 95%CI，2.14-3.30），进食障碍（OR，2.72; 95%CI，2.04-3.63），创伤后应激障碍（OR，2.34; 95%CI，1.59-3.43）、睡眠障碍（OR，16.17; 95%CI，2.06-126.76）和自杀企图（OR，4.14; 95%CI，2.98-5.76）。无论受害者的性别或虐待发生时的年龄如何，这种联系都持续存在。性虐待与精神分裂症或躯体形式障碍的诊断之间没有统计学显著相关性。没有纵向研究，评估双相情感障碍或强迫症之间的关联性虐待和抑郁症，饮食失调，创伤后应激障碍被加强了rape.CONCLUSION：性虐待的历史是与多种精神疾病的终身诊断的风险增加。
OBJECTIVE: To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders.PATIENTS AND METHODS: We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I-2 statistic was used to assess heterogeneity.RESULTS: The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime diagnosis of anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94), depression (OR, 2.66; 95% CI, 2.14-3.30), eating disorders (OR, 2.72; 95% CI, 2.04-3.63), posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43), sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and suicide attempts (OR, 4.14; 95% CI, 2.98-5.76). Associations persisted regardless of the victim's sex or the age at which abuse occurred. There was no statistically significant association between sexual abuse and a diagnosis of schizophrenia or somatoform disorders. No longitudinal studies that assessed bipolar disorder or obsessive-compulsive disorder were found. Associations between sexual abuse and depression, eating disorders, and posttraumatic stress disorder were strengthened by a history of rape.CONCLUSION: A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.