Martorell Almudena, Tsakanikos Elias, Pereda Amada, Gutiérrez-Recacha Pedro, Bouras Nick, Ayuso-Mateos José Luis
Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, CIBER-SAM, Madrid, Spain.
J Nerv Ment Dis. 2009 Mar;197(3):182-6. doi: 10.1097/NMD.0b013e3181923c8c.
The aim of the present study is to investigate the association between recent life events and traumatic experiences across the life span and psychiatric disorders in people with ID. One hundred seventy-seven individuals with mild and moderate intellectual disability and their principal carers were assessed. Psychiatric disorders were evaluated with a semistructured psychiatric interview, the Psychiatric Assessment for Adults with Developmental Disabilities. This interview also includes a checklist of life events experienced over the previous 12 months, which was assessed through key informants. Presence of traumas was assessed through Allen's trauma history screen, also administered to key informants. After a descriptive analysis, binary logistic regression was used to see whether traumatic events and life events predicted the presence of ICD-10 disorders. A 75% of the participants had experienced at least 1 traumatic event during their life span, and 50% of the participants had experienced at least 1 life event in the 12 months previous to the study. Binary logistic regression showed that exposure to 1 or more traumatic experiences significantly increased the odds of a mental disorder (OR = 1.8), as did exposure to life events (OR = 1.4). However, when both life events and traumatic experiences were entered together in the model, calculation of odds ratios revealed that traumatic experiences significantly increased the odds of ICD-10 disorders (OR = 1.7) although life events were no longer significant. Though they have been less studied by the literature regarding predictors of mental illness in people with intellectual disability, traumatic experiences seem to play a more important role in psychopathology than life events.
本研究的目的是调查近期生活事件与终生创伤经历之间的关联,以及智力障碍者的精神障碍情况。对177名轻度和中度智力障碍者及其主要照料者进行了评估。使用半结构化精神科访谈工具《发育障碍成人精神科评估》对精神障碍进行评估。该访谈还包括一份过去12个月内经历的生活事件清单,通过关键 informant 进行评估。通过同样向关键 informant 施测的艾伦创伤史筛查来评估创伤的存在情况。在进行描述性分析之后,使用二元逻辑回归来查看创伤事件和生活事件是否能预测国际疾病分类第十版(ICD - 10)障碍的存在。75%的参与者在其一生中至少经历过1次创伤事件,50%的参与者在研究前12个月内至少经历过1次生活事件。二元逻辑回归显示,暴露于1次或更多创伤经历会显著增加患精神障碍的几率(比值比[OR]=1.8),暴露于生活事件时也是如此(OR = 1.4)。然而,当生活事件和创伤经历同时纳入模型时,比值比的计算结果显示,尽管生活事件不再具有显著性,但创伤经历会显著增加患ICD - 10障碍的几率(OR = 1.7)。尽管关于智力障碍者精神疾病预测因素的文献对其研究较少,但创伤经历似乎在精神病理学中比生活事件发挥着更重要的作用。