Childhood adversities in relation to psychiatric disorders
Childhood adversities in relation to psychiatric disorders
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DOI：
10.1016/j.psychres.2012.11.003
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发表时间：
2013-03-30
影响因子：
11.3
通讯作者：
Rockstroh, Brigitte
中科院分区：
文献类型：
--
作者：
Pietrek, Christian;Elbert, Thomas;Rockstroh, Brigitte
大量证据证明，不良的童年经历会对心理健康产生有害影响。目前尚不清楚的是，特定发育时期的特定虐待在多大程度上可能因疾病而异，而不是增加对任何特定疾病的易感性。本研究比较了重度抑郁症（MDD）、边缘型人格障碍（BPD）、精神分裂症和精神健康受试者的童年逆境特征（逆境类型、频率、发育时期），探讨了不良童年经历对不同障碍的影响。患者报告的不良事件通常多于健康受试者。无论诊断如何，所有患者的情绪虐待都很严重。与重度抑郁症和精神分裂症相比，BPD的特点是逆境在各年龄段明显增加。56%的BPD患者、40%的MDD患者和18%的精神分裂症患者在童年早期经历过严重的逆境。压力模式（类型和时间）在不同的诊断中有所不同，但在早期有明显逆境的患者中没有。回归分析证实早期经历是BPD的预测因子，但不是重度抑郁症和精神分裂症的预测因子。青春期前的经历预测了BPD的情感和创伤症状，并缓和了与MDD症状的关联。结果表明，BPD、MDD和精神分裂症的不良童年经历存在剂量效应差异，而早期虐待超过一定程度对心理健康的影响独立于诊断。2012爱思唯尔爱尔兰有限公司版权所有。
Substantial evidence has documented that adverse childhood experiences exert deleterious effects on mental health. It is less clear to what extent specific maltreatment during specific developmental periods may vary between disorders rather than increasing vulnerability for any particular disorder. The present comparison of characteristics of childhood adversity (type and frequency of adversity, developmental period) between major depressive disorder (MDD), borderline personality disorder (BPD), schizophrenia, and psychiatrically healthy subjects examined how effects of adverse childhood experiences vary between disorders. Patients generally reported more adverse events than healthy subjects. Irrespective of diagnosis, emotional maltreatment was substantial in all patients. BPD was characterized by marked increase of adversities across age relative to MDD and schizophrenia. Fifty-six percent of BPD, 40% of MDD and 18% of schizophrenia cases experienced a significant degree of early childhood adversity. Stress pattern (type and time) varied between diagnoses, but not for patients with significant early adversities. Regression analyses confirmed early experiences as a predictor of BPD, but not of MDD and schizophrenia. Prepubescent experiences predicted affective and traumatic symptoms in BPD, and moderated the association with symptoms in MDD. Results indicate a dose-effect with differential impact of adverse childhood experiences in BPD, MDD, and schizophrenia, while early maltreatment beyond a certain degree affects mental health independent of diagnosis. (C) 2012 Elsevier Ireland Ltd. All rights reserved.