Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2010 Jul;85(7):618-29. doi: 10.4065/mcp.2009.0583. Epub 2010 May 10.
To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders.
We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I(2) statistic was used to assess heterogeneity.
The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime diagnosis of anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94), depression (OR, 2.66; 95% CI, 2.14-3.30), eating disorders (OR, 2.72; 95% CI, 2.04-3.63), posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43), sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and suicide attempts (OR, 4.14; 95% CI, 2.98-5.76). Associations persisted regardless of the victim's sex or the age at which abuse occurred. There was no statistically significant association between sexual abuse and a diagnosis of schizophrenia or somatoform disorders. No longitudinal studies that assessed bipolar disorder or obsessive-compulsive disorder were found. Associations between sexual abuse and depression, eating disorders, and posttraumatic stress disorder were strengthened by a history of rape.
A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.
系统评估性虐待与终身精神障碍诊断之间关联的证据。
我们对 9 个数据库进行了全面检索（1980 年 1 月至 2008 年 12 月，所有年龄段，所有语言，所有人群）：MEDLINE、EMBASE、CINAHL、Current Contents、PsycINFO、ACP 期刊俱乐部、CCTR、CDSR 和 DARE。使用限定研究类型为前瞻性队列研究、病例对照研究和横断面研究的主题词和关键词，对性虐待和精神障碍的概念领域进行了描述，并将其限定为流行病学研究。6 名独立审查员从合格的纵向研究中提取描述性、质量和结果数据。使用随机效应模型对来自不同研究的比值比（ORs）和 95%置信区间（CIs）进行了汇总。使用 I(2)统计量评估异质性。
检索到 37 项符合条件的研究，包括 17 项病例对照研究和 20 项队列研究，共有 3162318 名参与者。性虐待与终身焦虑障碍（OR，3.09；95%CI，2.43-3.94）、抑郁障碍（OR，2.66；95%CI，2.14-3.30）、进食障碍（OR，2.72；95%CI，2.04-3.63）、创伤后应激障碍（OR，2.34；95%CI，1.59-3.43）、睡眠障碍（OR，16.17；95%CI，2.06-126.76）和自杀未遂（OR，4.14；95%CI，2.98-5.76）之间存在统计学显著关联。无论受害者的性别或虐待发生的年龄如何，这种关联都持续存在。性虐待与精神分裂症或躯体形式障碍的诊断之间无统计学显著关联。未发现评估双相情感障碍或强迫症的纵向研究。性虐待与抑郁障碍、进食障碍和创伤后应激障碍之间的关联因强奸史而得到加强。
性虐待史与终身多种精神障碍诊断风险增加相关。
