van der Vegt Esther J M, Tieman Wendy, van der Ende Jan, Ferdinand Robert F, Verhulst Frank C, Tiemeier Henning
Dept. of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2009 Sep;44(9):724-31. doi: 10.1007/s00127-009-0494-6. Epub 2009 Feb 3.
This study investigated international adoptees who were taken out of their problematic environments as a consequence of their adoption to determine the effects of early adversities on adult psychiatric disorders, and to study whether these effects emerged de novo after childhood.
A total of 1,364 adoptees (63.5% of the baseline sample) were followed. Parents provided information about early adversities prior to adoption, and mental health problems in childhood and adolescence. In adulthood, adoptees completed a standardized interview, generating DSM-IV diagnoses.
Children who experienced multiple adversities had an increased risk of having anxiety disorders (OR = 2.22; 95% CI: 1.11-4.45), mood disorders (OR = 2.20; 95% CI: 1.00-4.86) or substance abuse/dependence (OR = 3.81; 95% CI: 1.62-8.98) in adulthood. Several effects remained significant after correction for mental health problems in childhood and adolescence.
Severe early adversities increase the risk of adult psychopathology, even when children are taken out of their problematic environments. Results suggest that psychiatric disorders may arise de novo after childhood due to early experiences.
本研究调查了因被收养而脱离问题环境的国际收养者，以确定早期逆境对成人精神障碍的影响，并研究这些影响是否在童年后才首次出现。
共随访了1364名收养者（占基线样本的63.5%）。父母提供了收养前早期逆境以及童年和青少年时期心理健康问题的信息。成年后，收养者完成了一次标准化访谈，得出了《精神疾病诊断与统计手册》第四版（DSM-IV）的诊断结果。
经历过多种逆境的儿童成年后患焦虑症（比值比[OR]=2.22；95%置信区间[CI]：1.11 - 4.45）、情绪障碍（OR = 2.20；95% CI：1.00 - 4.86）或药物滥用/依赖（OR = 3.81；95% CI：1.62 - 8.98）的风险增加。在对童年和青少年时期的心理健康问题进行校正后，几种影响仍然显著。
即使儿童脱离了问题环境，严重的早期逆境也会增加成人精神病理学的风险。结果表明，由于早期经历，精神障碍可能在童年后才首次出现。
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