Department of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico D.F., Mexico.
Curr Opin Psychiatry. 2010 Jul;23(4):356-62. doi: 10.1097/YCO.0b013e32833ad79b.
Although an association between childhood adversity and psychiatric disorder has been documented, most research has centered upon those living in developed countries and the types of adversities those populations experience. Most of the world's youth, however, live in the poorest countries and face additional types of adversity for which limited data are available. The aim of this review is to synthesize recently published research and policy documents regarding the prevalence, characteristics, and mental health consequences of childhood adversity in low-income countries.
Many youth in low-income countries are exposed to war-related violence, are orphaned by AIDS, work long hours in dangerous conditions, and, among girls in Africa, undergo female genital mutilation. These children have more posttraumatic stress disorder and depression than unexposed youth. Family violence, discrimination, and poverty may exacerbate the effects of war-related trauma and AIDS orphanhood upon mental health.
Research on the psychological consequences of childhood adversity in low-income countries is increasing, but is limited by the range of mental health outcomes evaluated and by small nonrepresentative samples. Further research is warranted to inform child advocacy and to guide public policy and the actions of nongovernmental agencies involved in the protection and welfare of children.
综述目的：尽管已有文献证明儿童期逆境与精神障碍之间存在关联，但大多数研究都集中在发达国家的人群以及这些人群所经历的各种逆境类型上。然而，世界上大多数青少年都生活在最贫穷的国家，面临着其他类型的逆境，而针对这些逆境的有限数据也尚未可知。本综述的目的是综合最近发表的关于低收入国家儿童期逆境的流行率、特征和心理健康后果的研究和政策文件。
最近发现：许多低收入国家的青少年都经历过与战争相关的暴力、因艾滋病成为孤儿、在危险的条件下长时间工作，而且在非洲女孩中，还经历过女性生殖器切割。这些儿童比未暴露于逆境的青少年有更多的创伤后应激障碍和抑郁症状。家庭暴力、歧视和贫困可能会加剧与战争相关的创伤和艾滋病孤儿对心理健康的影响。
结论：关于低收入国家儿童期逆境心理后果的研究正在增加，但受到评估的心理健康结果范围以及小的非代表性样本的限制。需要进一步的研究来为儿童权益倡导提供信息，并为儿童保护和福利相关的公共政策和非政府机构的行动提供指导。
