The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi.
The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi.
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DOI：
10.1016/j.jad.2022.06.028
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发表时间：
2022-09-01
影响因子：
6.6
通讯作者：
Kim, Maria H.
中科院分区：
文献类型：
--
作者：
Masiano, Steven P.;Yu, Xiaoying;Tembo, Tapiwa;Wetzel, Elizabeth;Mphande, Mtisunge;Khama, Innocent;Mkandawire, Angella;Chitani, Mike;Liwimbi, Olive;Udedi, Michael;Mazenga, Alick;Nyasulu, Phoebe;Abrams, Elaine;Ahmed, Saeed;Kim, Maria H.
关键词：
不良童年经历 (ACE) 与焦虑和抑郁思想等常见精神障碍 (CMD) 有关。我们研究了马拉维（艾滋病毒流行资源有限的环境）感染艾滋病毒的孕妇 (PWLHIV) 中 ACE 的患病率及其与 CMD 的关系。这是一项针对参加马拉维 VITAL Start 试验（10/2018 至 06/2021）的 798 名 PWLHIV 患者的横断面研究 (NCT03654898)。使用世卫组织的不良童年经历国际问卷（ACE-IQ）工具评估 ACE 历史。使用世卫组织的自我报告问卷 20 项 (SRQ-20) 工具评估抑郁症状（躯体不适、生命力下降、焦虑和抑郁想法）。对数二项式回归用于检查累积 ACE 与每种抑郁症状之间的关联，并确定驱动这种关联的 ACE。我们样本的平均年龄为 27.5 岁。超过 95% 的人报告经历过 ≥1 次 ACE。平均而言，每位参与者报告了 4 个 ACE； 11% 的人报告了性虐待。大约 52% 和 44% 的人分别报告了焦虑和抑郁的想法。在回归中，累积 ACE 分数与抑郁症状显着相关——即使在调整多项测试后也是如此。这种关联主要是由性虐待报告推动的。母亲 ACE 的数据是自我报告的，由于回忆偏差，可能会出现测量误差。 ACE 很普遍，并且与母亲的抑郁症状有分级关系。性虐待被发现是这种关联的主要驱动因素。尽早认识 ACE 并提供创伤知情干预措施以改善 PWLHIV 患者的护理可能会减少负面的心理健康后遗症。
Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi–an HIV endemic resource-limited setting. This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO’s Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO’s Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association. The mean age of our sample was 27.5 years. Over 95% reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11% reported sexual abuse. About 52% and 44% reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms—even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse. Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias. ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.
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影响因子：
8.1
作者：
Heestermans T;Browne JL;Aitken SC;Vervoort SC;Klipstein-Grobusch K
通讯作者：
Klipstein-Grobusch K
影响因子：
5.6
作者：
Clark, Charlotte;Caldwell, Tanya;Stansfeld, Stephen A.
通讯作者：
Stansfeld, Stephen A.
DOI：
10.1080/09540121.2013.802277
发表时间：
2014-01-02
影响因子：
1.7
作者：
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通讯作者：
Aaron, Erika
DOI：
10.1016/j.socec.2014.07.001
发表时间：
2014-12-01
影响因子：
1.6
作者：
Barrett, Alan;Kamiya, Yumiko;Sullivan, Vincent O'
通讯作者：
Sullivan, Vincent O'
影响因子：
2.6
作者：
Christoforou, Rania;Ferreira, Nuno
通讯作者：
Ferreira, Nuno