Tanskanen Antti, Hintikka Jukka, Honkalampi Kirsi, Haatainen Kaisa, Koivumaa-Honkanen Heli, Viinamäki Heimo
Department of Psychiatry, University of Kuopio and Kuopio University Hospital, Finland.
Nord J Psychiatry. 2004;58(6):459-64. doi: 10.1080/08039480410011687.
The objective of this population-based study was to determine whether traumatic experiences in general, and multiple traumatic experiences in particular, are associated with persistent self-rated depressive symptoms in adult Finnish subjects over 2 years of follow-up. The study sample included 1405 subjects aged 25-64 years. Subjects (n = 217) who were depressed both at baseline in 1999 and on follow-up 2 years later in 2001 (having persistent depressive symptoms) were compared with subjects (n = 987) having no depressive symptoms either at baseline or on follow-up. All six categories of traumatic experiences (wartime experience, natural disaster, life-threatening accident, victim of violent crime, domestic violence and childhood sexual abuse) pertained to the respondents' whole life span. Odds ratios, adjusted for significant covariates, were obtained from multiple logistic regression models that estimated the likelihood of persistent depressive symptoms in different trauma categories. Persistent depressive symptoms had a significant positive graded relationship with the number of traumatic experiences. The adjusted odds of persistent depression was 6.05 (95% CI 1.76-20.7) for men and 6.99 (95% CI 2.69-18.2) for women in those with three or more traumatic experiences compared with those with no such experiences at all. Multiple traumatic experiences substantially increase the likelihood of persistent depressive symptoms. Mental health intervention, as early as possible, may serve to prevent the chronicity of depressive reactions among victims of multiple traumas.
这项基于人群的研究旨在确定一般创伤经历，尤其是多重创伤经历，是否与成年芬兰受试者在两年随访期内持续的自评抑郁症状相关。研究样本包括1405名年龄在25至64岁之间的受试者。将1999年基线时和2001年两年后随访时均抑郁（有持续抑郁症状）的受试者（n = 217）与在基线或随访时均无抑郁症状的受试者（n = 987）进行比较。所有六类创伤经历（战时经历、自然灾害、危及生命的事故、暴力犯罪受害者、家庭暴力和童年性虐待）均涉及受访者的整个生命周期。通过多重逻辑回归模型获得经显著协变量调整后的比值比，该模型估计了不同创伤类别中持续抑郁症状的可能性。持续抑郁症状与创伤经历的数量呈显著的正分级关系。与完全没有此类经历的人相比，有三次或更多创伤经历的男性持续抑郁的调整后比值为6.05（95%可信区间1.76 - 20.7），女性为6.99（95%可信区间2.69 - 18.2）。多重创伤经历显著增加了持续抑郁症状的可能性。尽早进行心理健康干预可能有助于预防多重创伤受害者抑郁反应的慢性化。
